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The epidemiology of depression in metropolitan China

  • S. Lee (a1), A. Tsang (a2), Y.-Q. Huang (a3), Y.-L. He (a4), Z. R. Liu (a3), M.-Y. Zhang (a4), Y.-C. Shen (a3) and R. C. Kessler (a5)
  • DOI:
  • Published online: 20 August 2008

Previous surveys on depression in China focused on prevalence estimates without providing a detailed epidemiological profile.


Face-to-face household interviews were conducted with a multi-stage household probability sample of 2633 adults (age ⩾18 years) in Beijing and 2568 in Shanghai between November 2001 and February 2002. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to assess major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria.


The lifetime prevalence and 1-year prevalence estimates of DSM-IV/CIDI MDE were 3.6% [95% confidence interval (CI) 2.8–4.4%] and 1.8% (95% CI 1.2–2.4%) respectively. No significant gender difference was found in these estimates. Respondents born in 1967 or later were at elevated lifetime risk compared with respondents born in earlier cohorts. The mean age of onset was 30.3 years. Among those reporting 1-year MDE, 15.7, 51.8, 25.3 and 6.4% reported mild, moderate, severe and very severe symptoms respectively; 4.8, 2.6 and 3.2% reported suicidal ideation, plans, and recent attempts in the same year respectively. Respondents with 1-year MDE reported a mean of 27.5 days out of role owing to their depression in the year before interview. Significant co-morbidity was found between MDE and other mental disorders [odds ratio (OR) 22.0] and chronic physical disorders (OR 3.2). Only 22.7% of respondents with 1-year MDE sought treatment.


The low prevalence and insignificant gender difference, but not patterns of onset, course, co-morbidity, and impairment, distinguish the epidemiological profile of MDE in metropolitan China from those in other countries.

Corresponding author
*Address for correspondence: Professor S. Lee, Director, Hong Kong Mood Disorders Center, 7A, Block E, Staff Quarters, Prince of Wales Hospital, Shatin, NT, Hong Kong. (Email:
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L Andrade , JJ Caraveo-Anduaga , P Berglund , RV Bijl , R De Graaf , W Vollebergh , E Dragomirecka , R Kohn , M Keller , RC Kessler , N Kawakami , C Kiliç , D Offord , TB Ustun , HU Wittchen (2003). The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. International Journal of Methods in Psychiatric Research 12, 321.

SM Chang , BJ Hahm , JY Lee , MS Shin , HJ Jeon , JP Hong , HB Lee , DW Lee , MJ Cho (2008). Cross-national difference in the prevalence of depression caused by the diagnostic threshold. Journal of Affective Disorders 106, 159167.

CN Chen , J Wong , N Lee , MW Chan-Ho , JTF Lau , M Fung (1993). The Shatin Community Mental Health Survey in Hong Kong: II. Major findings. Archives of General Psychiatry 50, 125133.

B Efron (1988). Logistic regression, survival analysis, and the Kaplan–Meier curve. Journal of the American Statistical Association 83, 414425.

M Hamilton (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5661.

HG Hwu , EK Yeh , LY Chang (1989). Prevalence of psychiatric disorders in Taiwan defined by the Chinese diagnostic interview schedule. Acta Psychiatrica Scandinavica 79, 136147.

KS Kendler , TJ Gallagher , JM Abelson , RC Kessler (1996). Lifetime prevalence, demographic risk factors, and diagnostic validity on nonaffective pyschosis as assessed in a US community sample: the National Comorbidity Survey. Archives of General Psychiatry 53, 10221031.

RC Kessler , P Bergland , WT Chiu , O Demler , S Heeringa , E Hiripi , R Jin , B-E Pennel , EE Walters , A Zaslavsky , H Zheng (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods of Psychiatric Research 13, 6992.

RC Kessler , P Berglund , O Demler , R Jin , E Walters (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.

RC Kessler , TB Üstün (2004). The World Mental Health (WMH) Survey Initiative Version of the World Mental Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods of Psychiatric Research 13, 93121.

A Kleinman (1982). Neurasthenia and depression: a study of somatization and culture in China. Culture, Medicine and Psychiatry 6, 117190.

DM Kriegsman , BW Penninx , JT Van Eijk , AJ Boeke , DJ Deeg (1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. Journal of Clinical Epidemiology 49, 14071417.

S Lee , A Tsang , K Kwok (2007 a). Twelve-month prevalence, correlates, and treatment preference of adults with DSM-IV major depressive episode in Hong Kong. Journal of Affective Disorders 98, 129136.

AC Leon , M Olfson , L Portera , L Farber , DV Sheehand (1997). Assessing psychiatric impairment in primary care with the Sheehan Disability Scale. International Journal of Methods of Psychiatric Research 27, 93105.

J Lu , Y Ruan , Y Huang , J Yao , W Dang , C Gao (2008). Major depression in Kunming: prevalence, correlates and co-morbidity in a south-western city of China. Journal of Affective Disorders. Published online: 28 March 2008. doi: 10.1016/j.jad.2008.02.018.

SM Marcus , EA Young , KB Kerbera , S Kornstein , AH Farabaugh , J Mitchell , SR Wisniewski , GK Balasubramani , MH Trivedi , AJ Rush (2005). Gender differences in depression: findings from the STAR*D study. Journal of Affective Disorders 87, 141150.

G Parker , B Chan , D Hadzi-Pavlovic (2007). Lower rates of depression in westernised Chinese in the US. Journal of Affective Disorders 104, 175178.

F Radat , J Swendsen (2005). Psychiatric comorbidity in migraine: a review. Cephalalgia 25, 165178.

AJ Rush , T Carmody , P-E Relmiz (2000). The Inventory of Depressive Symptomatology (IDS). International Journal of Methods of Psychiatric Research 9, 4559.

AJ Rush , MH Trivedl , HM Ibrahim , TJ Carmody , B Arnow , DN Klein , JC Markowiz , PT Ninan , S Kornstein , R Manber , ME Thase , JH Kocsis , MB Keller (2003). The 16 item Quick Inventory of Depressive Symptomatology (QIDS) Clinician Rating (QIDS-C) and Self-Report (QIDS-SR). Biological Psychiatry 54, 573583.

D Takeuchi , CYR Chung , MK Lin , HK Shen , K Kurasaki , CA Chun , S Sue (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry 155, 14071414.

PS Wang , E Aguilar-Gaxiola , J Alonso , MA Angermeyer , G Borges , EJ Bromet , R Bruffaerts , G de Girolamo , R de Graaf , O Gureje , JM Haro , EG Karam , RC Kessler , V Kovess , MC Lane , S Lee , D Levinson , Y Ono , M Petukhova , J Posada-Villa , S Seedat , JE Wells (2007). Worldwide use of mental health services for anxiety, mood, and substance disorders: results from 17 countries in the WHO World Mental Health (WMH) Surveys. Lancet 370, 841850.

MM Weissman , RC Bland , GJ Canino , C Faravelli , S Greenwald , HG Hwu , PR Joyce , EG Karam , CK Lee , J Lellouch , JP Lepine , SC Newman , M Rubio-Stipec , JE Wells , PJ Wickramaratne , HU Wittchen , EK Yeh (1996). Cross-national epidemiology of major depression and bipolar disorders. Journal of the American Medical Association 276, 293299.

KM Wolter (1985). Introduction to Variance Estimation. Springer-Verlag: New York.

YP Zhang , XY Li , ZQ Wang , M Man , XQ Wang , M Phillips (2006). A cross-sectional study of depressive disorders in outpatients of 50 general hospitals in Beijing [in Chinese]. Chinese Journal of Psychiatry 39, 161164.

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