Wong Stephanie M Y, Chen Eric Y H, Suen Y N, Wong Corine S M, Chang W C, Chan Sherry K W, McGorry Patrick D, Morgan Craig, van Os Jim, McDaid David, Jones Peter B, Lam T H, Lam Linda C W, Lee Edwin H M, Tang Eric Y H, Ip Charlie H, Ho Winky W K, McGhee Sarah M, Sham P C, Hui Christy L M
Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
Lancet Reg Health West Pac. 2023 Aug 19;40:100881. doi: 10.1016/j.lanwpc.2023.100881. eCollection 2023 Nov.
Hong Kong is among the many populations that has experienced the combined impacts of social unrest and the COVID-19 pandemic. Despite concerns about further deteriorations in youth mental health globally, few epidemiological studies have been conducted to examine the prevalence and correlates of major depressive episode (MDE) and other major psychiatric disorders across periods of population-level changes using diagnostic interviews.
We conducted a territory-wide household-based epidemiological study from 2019 to 2022 targeting young people aged 15-24 years. MDE, generalised anxiety disorder (GAD), panic disorder (PD), and bipolar disorder (BD) were assessed using the Composite International Diagnostic Interview-Screening Scales in 3340 young people. Psychotic disorders were assessed by experienced psychiatrists according to the DSM. Help-seeking patterns were also explored.
16.6% had any mental disorder (13.7% 12-month MDE, 2.3% BD, 2.1% GAD, 1.0% PD, 0.6% psychotic disorder). The prevalence of MDE increased from 13.2% during period 1 (May 2019-June 2020) to 18.1% during period 2 (July-December 2020), followed by 14.0% during period 3 (January-June 2021) and 13.2% during period 4 (July 2021-June 2022). Different stressors uniquely contributed to MDE across periods: social unrest-related stressors during period 1, COVID-19 stressors during period 2, and personal stressors during periods 3-4. Lower resilience, loneliness, frequent nightmares, and childhood adversity were consistently associated with MDE. Compared to other conditions, those with MDE showed the lowest service utilisation rate (16.7%). Perceiving services to "cost too much" and "talked to friends or relatives instead" were among the major reasons for not seeking help. MDE was also significantly associated with poorer functioning and health-related quality of life.
MDE can be sensitive to population-level changes, although its persistently elevated prevalence across the study period is of concern. Efforts to mitigate their impacts on youth mental health alongside personal risk factors are needed. Further work is required to increase the availability and acceptability of youth-targeted mental health services.
Food and Health Bureau (HKSAR Government).
香港是经历了社会动荡和新冠疫情综合影响的众多人群之一。尽管全球都在关注青少年心理健康的进一步恶化，但很少有流行病学研究通过诊断访谈来调查在人群层面变化期间重度抑郁发作（MDE）及其他主要精神障碍的患病率及其相关因素。
我们在2019年至2022年期间开展了一项全港范围的以家庭为基础的流行病学研究，目标人群为15至24岁的年轻人。使用复合国际诊断访谈筛查量表对3340名年轻人评估了MDE、广泛性焦虑障碍（GAD）、惊恐障碍（PD）和双相情感障碍（BD）。由经验丰富的精神科医生根据《精神疾病诊断与统计手册》对精神障碍进行评估。还探索了求助模式。
16.6%的人患有任何精神障碍（12个月MDE患病率为13.7%，BD为2.3%，GAD为2.1%，PD为1.0%，精神障碍为0.6%）。MDE的患病率从第1阶段（2019年5月至2020年6月）的13.2%增至第2阶段（2020年7月至12月）的18.1%，随后在第3阶段（2021年1月至6月）为14.0%，在第4阶段（2021年7月至2022年6月）为13.2%。不同阶段导致MDE的压力源各不相同：第1阶段是与社会动荡相关的压力源，第2阶段是新冠疫情压力源，第3至4阶段是个人压力源。较低的心理弹性、孤独感、频繁噩梦和童年逆境一直与MDE相关。与其他疾病相比，患有MDE的人服务利用率最低（16.7%）。认为服务“费用太高”以及“而是与朋友或亲戚交谈”是不寻求帮助的主要原因。MDE还与功能较差以及与健康相关的生活质量显著相关。
MDE可能对人群层面的变化敏感，尽管在整个研究期间其患病率持续升高令人担忧。需要努力减轻其对青少年心理健康的影响以及个人风险因素。还需要进一步开展工作以提高针对青少年的心理健康服务的可及性和可接受性。
香港特别行政区政府食物及卫生局
