In China and other middle-income countries, neuropsychiatric conditions are the most
important cause of ill health in men and women, but efforts to scale up mental health
services have been hampered by the absence of high-quality, country-specific data
for the prevalence, treatment, and associated disability of different types of mental
disorders. We therefore estimated these variables from a series of epidemiological
studies that were done in four provinces in China.
We used multistage stratified random sampling methods to identify 96 urban and 267
rural primary sampling sites in four provinces of China; the sampling frame of 113
million individuals aged 18 years or older included 12% of the adult population in
China. 63 004 individuals, identified with simple random selection methods at the
sampling sites, were screened with an expanded version of the General Health Questionnaire
and 16,577 were administered a Chinese version of the Structured Clinical Interview
for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.
The adjusted 1-month prevalence of any mental disorder was 17.5% (95% CI 16.6-18.5).
The prevalence of mood disorders was 6.1% (5.7-6.6), anxiety disorders was 5.6% (5.0-6.3),
substance abuse disorders was 5.9% (5.3-6.5), and psychotic disorders was 1.0% (0.8-1.1).
Mood disorders and anxiety disorders were more prevalent in women than in men, and
in individuals 40 years and older than in those younger than 40 years. Alcohol use
disorders were 48 times more prevalent in men than in women. Rural residents were
more likely to have depressive disorders and alcohol dependence than were urban residents.
Among individuals with a diagnosable mental illness, 24% were moderately or severely
disabled by their illness, 8% had ever sought professional help, and 5% had ever seen
a mental health professional.
Substantial differences between our results and prevalence, disability, and treatment
rate estimates used in the analysis of global burden of disease for China draw attention
to the need for low-income and middle-income countries to do detailed, country-specific
situation analyses before they scale up mental health services.
China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health.