The 12-Month Incidence and Predictors of PHQ-9–Screened Depressive Symptoms in Chinese Primary Care Patients

Weng-Yee Chin; Eric Yuk Fai Wan; Edmond Pui Hang Choi; Kit Tsui Yan Chan; Cindy Lo Kuen Lam

doi:10.1370/afm.1854

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Authors' Response to "Insights into depression in Hong Kong primary care"
Weng-Yee Chin

Published on: 26 January 2016
Insights into depression in Hong Kong primary care
Irwin Nazareth

Published on: 14 January 2016

Published on: (26 January 2016)
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Authors' Response to "Insights into depression in Hong Kong primary care"
Weng-Yee Chin, Assistant Professor
Unfortunately there is still very little data available about the onset and longitudinal outcomes of depressive disorders in many non-Western settings, and what happens to Chinese patients experiencing mood disorders is still poorly understood. We agree that much more research is needed to examine both the patient's and doctor's perspectives in recognizing and managing depressive illness, especially in our local setting.
Compet...
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Unfortunately there is still very little data available about the onset and longitudinal outcomes of depressive disorders in many non-Western settings, and what happens to Chinese patients experiencing mood disorders is still poorly understood. We agree that much more research is needed to examine both the patient's and doctor's perspectives in recognizing and managing depressive illness, especially in our local setting.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (14 January 2016)
Page navigation anchor for Insights into depression in Hong Kong primary care
Insights into depression in Hong Kong primary care
Irwin Nazareth, Professor Primary Care
This is a very important piece of research which suggests that depression amongst Hong Kong Chinese is comparable to that in the West. This to some extent counters previous suggestions that depression was generally lower in the Chinese when compared to western populations [1]. The study nevertheless, focuses on primary care attenders and hence, it is possible that rates of depression in the community may still be lower...
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This is a very important piece of research which suggests that depression amongst Hong Kong Chinese is comparable to that in the West. This to some extent counters previous suggestions that depression was generally lower in the Chinese when compared to western populations [1]. The study nevertheless, focuses on primary care attenders and hence, it is possible that rates of depression in the community may still be lower in Hong Kong than the west even though this is unlikely. The study has been very well conducted but the use of PHQ 9 for ascertaining a diagnosis of depression may have resulted in an overestimation of the extent of depression as the PHQ9 only offers information on the presence of a depressive syndrome rather than a depressive diagnosis. The use of a diagnostic tool may have yielded different results.
The risk factors for incident depression such as female gender, lower household income and family history of depression, being a smoker, having multiple comorbidities and more frequent attendance in primary care are not surprising as these factors have been previously well elucidated. It is uncertain whether the participants' past medical history, an established risk factor for the onset of depression was explored in this study. The reduced incidence in people who had seen a physician with a qualification in family medicine and training in psychological medicine suggests that there could be some "black box" preventive care being offered by these professional. Is this really the case or could this finding be confounded by some other unknown factors? This merits further investigation.
In summary, this is a highly original study in the Chinese context which is merely a step away from the creation of a risk model that could have applications for clinical use in the identification of future episodes of depression by primary care physicians in Hong Kong.
Reference
1) Xu JM. Some issues in the diagnosis of depression in China. Can J Psychiatry. 1987 Jun;32(5):368-70.
Competing interests: None declared
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Competing Interests: None declared.