Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China.
BACKGROUND
This is the first study to examine variation across cohorts in lifetime risk of DSM-IV mental disorders in metropolitan China.


METHODS
Face-to-face household interviews of 2633 adults in Beijing and 2568 adults in Shanghai were conducted from November 2001 to February 2002 using a multi-stage household probability sampling method. The Chinese World Mental Health (WMH) Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI) was used for assessment.


RESULTS
Lifetime prevalence of any disorder was 13.2%. Alcohol abuse (4.7%), major depressive disorder (3.5%), and specific phobia (2.6%) were the most common disorders. The median age of onset was later for mood (43 years) than anxiety (17 years) and substance use (25 years) disorders. Compared to observed lifetime prevalence, the projected lifetime risk as of age 75 years increased by 106% for major depressive disorder (7.2%), and was uniformly higher for all disorders. Relative odds of any lifetime disorder were 4.7 in the most recent cohorts (ages 18-34) compared to the eldest cohorts (ages > or =65).


CONCLUSIONS
The findings of this cross-sectional study tally with the view that rapid socioeconomic changes may bring about increasing incidence of mental disorders in China. However, prospective longitudinal studies are needed to confirm if the increase is real. Because of the huge size of the Chinese population, any increase in projected lifetime risk of mental disorders represents an enormous increase in the number of affected individuals.
Lee
Sing
S
Department of Psychiatry, The Chinese University of Hong Kong, HKSAR, PRC. singlee@cuhk.edu.hk
Tsang
Adley
A
Zhang
Ming-Yuan
MY
Huang
Yue-Qin
YQ
He
Yan-Ling
YL
Liu
Zhao-Rui
ZR
Shen
Yu-Cun
YC
Kessler
Ronald C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003695:Delivery of Health Care; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007206:Individuality; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014505:Urban Population