Yueqin Huang1, Yu Wang2, Hong Wang3, Zhaorui Liu4, Xin Yu4, Jie Yan5, Yaqin Yu6, Changgui Kou6, Xiufeng Xu7, Jin Lu7, Zhizhong Wang8, Shulan He8, Yifeng Xu9, Yanling He9, Tao Li10, Wanjun Guo10, Hongjun Tian11, Guangming Xu11, Xiangdong Xu12, Yanjuan Ma12, Linhong Wang2, Limin Wang2, Yongping Yan13, Bo Wang13, Shuiyuan Xiao14, Liang Zhou14, Lingjiang Li15, Liwen Tan15, Tingting Zhang4, Chao Ma4, Qiang Li16, Hua Ding16, Hongchun Geng17, Fujun Jia18, Jianfei Shi19, Shiliang Wang20, Ning Zhang21, Xinbai Du22, Xiangdong Du23, Yue Wu24. 1. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China. Electronic address: huangyq@bjmu.edu.cn. 2. National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 3. Department of Biostatistics, School of Public Health, Peking University, Beijing, China. 4. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China. 5. School of Government, Peking University, Beijing, China. 6. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China. 7. Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China. 8. Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China. 9. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 10. Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China. 11. Tianjin Anding Hospital, Tianjin, China. 12. The Fourth People's Hospital in Urumqi, Urumqi, China. 13. Department of Epidemiology, Air Force Medical University of the Chinese People's Liberation Army, Xi'an, China. 14. Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China. 15. Mental Health Institute, the Second Xiangya Hospital, Central-south University, Changsha, China. 16. Institute of Social Science Survey, Peking University, Beijing, China. 17. Chifeng Anding Hospital, Chifeng, China. 18. Guangdong Mental Health Center, Guangzhou, China. 19. The Seventh Hospital of Hangzhou, Hangzhou, China. 20. Huzhou Third People's Hospital, Huzhou, China. 21. Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China. 22. The Third People's Hospital of Qinghai Province, Xining, China. 23. Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China. 24. Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China.
Abstract
BACKGROUND: The China Mental Health Survey was set up in 2012 to do a nationally representative survey with consistent methodology to investigate the prevalence of mental disorders and service use, and to analyse their social and psychological risk factors or correlates in China. This paper reports the prevalence findings. METHODS: We did a cross-sectional epidemiological survey of the prevalence of mental disorders (mood disorders, anxiety disorders, alcohol-use and drug-use disorders, schizophrenia and other psychotic disorders, eating disorder, impulse-control disorder, and dementia) in a multistage clustered-area probability sample of adults from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists with the Composite International Diagnostic Interview, the Structured Clinical Interview for DSM-IV Axis I disorders, the Community Screening Instrument for Dementia from the 10/66 dementia diagnostic package, and the Geriatric Mental State Examination. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted to adjust for differential probabilities of selection and differential response as well as to post-stratify the sample to match the population distribution. FINDINGS: 32 552 respondents completed the survey between July 22, 2013, and March 5, 2015. The weighted prevalence of any disorder (excluding dementia) was 9·3% (95% CI 5·4-13·3) during the 12 months before the interview and 16·6% (13·0-20·2) during the participants' entire lifetime before the interview. Anxiety disorders were the most common class of disorders both in the 12 months before the interview (weighted prevalence 5·0%, 4·2-5·8) and in lifetime (7·6%, 6·3-8·8). The weighted prevalence of dementia in people aged 65 years or older was 5·6% (3·5-7·6). INTERPRETATION: The prevalence of most mental disorders in China in 2013 is higher than in 1982 (point prevalence 1·1% and lifetime prevalence 1·3%), 1993 (point prevalence 1·1% and lifetime prevalence 1·4%), and 2002 (12-month prevalence 7·0% and lifetime prevalence 13·2%), but lower than in 2009 (1-month prevalence 17·5%). The evidence from this survey poses serious challenges related to the high burdens of disease identified, but also offers valuable opportunities for policy makers and health-care professionals to explore and address the factors that affect mental health in China. FUNDING: National Health Commission of Health (Ministry of Health) and Ministry of Science and Technology of China.
BACKGROUND: The China Mental Health Survey was set up in 2012 to do a nationally representative survey with consistent methodology to investigate the prevalence of mental disorders and service use, and to analyse their social and psychological risk factors or correlates in China. This paper reports the prevalence findings. METHODS: We did a cross-sectional epidemiological survey of the prevalence of mental disorders (mood disorders, anxiety disorders, alcohol-use and drug-use disorders, schizophrenia and other psychotic disorders, eating disorder, impulse-control disorder, and dementia) in a multistage clustered-area probability sample of adults from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists with the Composite International Diagnostic Interview, the Structured Clinical Interview for DSM-IV Axis I disorders, the Community Screening Instrument for Dementia from the 10/66 dementia diagnostic package, and the Geriatric Mental State Examination. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted to adjust for differential probabilities of selection and differential response as well as to post-stratify the sample to match the population distribution. FINDINGS: 32 552 respondents completed the survey between July 22, 2013, and March 5, 2015. The weighted prevalence of any disorder (excluding dementia) was 9·3% (95% CI 5·4-13·3) during the 12 months before the interview and 16·6% (13·0-20·2) during the participants' entire lifetime before the interview. Anxiety disorders were the most common class of disorders both in the 12 months before the interview (weighted prevalence 5·0%, 4·2-5·8) and in lifetime (7·6%, 6·3-8·8). The weighted prevalence of dementia in people aged 65 years or older was 5·6% (3·5-7·6). INTERPRETATION: The prevalence of most mental disorders in China in 2013 is higher than in 1982 (point prevalence 1·1% and lifetime prevalence 1·3%), 1993 (point prevalence 1·1% and lifetime prevalence 1·4%), and 2002 (12-month prevalence 7·0% and lifetime prevalence 13·2%), but lower than in 2009 (1-month prevalence 17·5%). The evidence from this survey poses serious challenges related to the high burdens of disease identified, but also offers valuable opportunities for policy makers and health-care professionals to explore and address the factors that affect mental health in China. FUNDING: National Health Commission of Health (Ministry of Health) and Ministry of Science and Technology of China.