Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China

Background. Psychiatric epidemiological surveys in China have repeatedly found much lower prevalence estimates than in most other parts of the world. Method. Face-to-face household interviews of 5201 subjects (2633 in Beijing and 2568 in Shanghai respectively) were conducted from November 2001 to February 2002 using a multistage household probability sampling method. A Chinese version of the World Health Organization Composite International Diagnostic Interview (CIDI) was used for assessment. Results. Twelve-month prevalence of any DSM-IV mental disorder in metropolitan China is estimated to be 7(.)0%, with major depressive disorder (2(.)0%), specific phobia (1(.)9%), and intermittent explosive disorder (1(.)7%) the most common disorders. Of these, 13(.)9% are classified as serious, 32(.)6% moderate, and 53(.)5% mild. Only 3(.)4% of respondents with any disorder sought treatment within the previous 12 months. Conclusions. Although the general pattern of disorders, risk factors, and unmet need for treatment are similar to those in other countries, a low prevalence of mental disorders is found in metropolitan China. Resolving methodological problems that cause downward bias in estimates, such as stigma-related under-reporting and diagnostic incongruity with a somatopsychic mode of symptom presentation may lead to more accurate and probably higher prevalence estimates in future epidemiological studies. As a low prevalence still translates into an enormous number of people in China, measures are urgently needed to address the huge unmet need for treatment of mental disorders.