Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Recognition of depression, anxiety, and alcohol abuse in a Chinese rural sample: a cross-sectional study

Authors: Yu Yu, Mi Hu, Zi-wei Liu, Hui-ming Liu, Joyce P. Yang, Liang Zhou, Shui-yuan Xiao

Published in: BMC Psychiatry | Issue 1/2016

Login to get access

Abstract

Background

Under-utilization of mental health services is a global health issue. Recognition of mental disorders, as the first step to seeking help from professional sources, has been well studied in developed countries, yet little is known about the situation in rural areas of developing countries like China. The purpose of the study is to understand the recognition of depression, anxiety, and alcohol abuse and its predictive factors in a Chinese rural sample

Methods

Face-to-face interviews were conducted on a representative rural adult sample in a cross-sectional study in China (N = 2052). Respondents were presented with three vignettes depicting depression, anxiety and alcohol abuse and asked to label the disorder and its cause to assess their recognition of the three mental disorders. They also completed the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Alcohol Use Disorders Identification Test (AUDIT) to assess their current mental health status.

Results

The alcohol abuse vignette was more frequently attributed as a mental problem than the depression vignette and anxiety vignette. The correct labeling rate was 16.1 % in the depression vignette, 15.5 % in the anxiety vignette, and 58.2 % in the alcohol vignette. Higher education is the common and also strongest factor positively predicting the recognition of all three vignettes. Beyond that, being female is an independent predictor of correct recognition of alcohol abuse, while recognition of depression and anxiety were positively predicted by younger age.

Conclusions

Lower recognition of depression and anxiety as compared to alcohol abuse confirms the importance and need to increase the public’s awareness and knowledge about common mental disorders. Recognition of common mental disorders could be improved through general public campaign and education, while paying attention to the unique predictive factors for each specific disorder and implement targeted intervention.
Appendix
Available only for authorised users
Literature
1.
Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–86.CrossRefPubMed
2.
Organization WH. Mental Health: New Understanding. New Hope. Geneva: World Health Organization; 2001. p. 2001.
3.
Qian J. Mental health care in China: providing services for under-treated patients. J Ment Health Policy Econ. 2012;15(4):179–86.PubMed
4.
Greenberg PE, Sisitsky T, Kessler RC, Finkelstein SN, Berndt ER, Davidson JR, et al. The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry. 1999;60(7):427–35.
5.
Rice DP, Miller LS. Health economics and cost implications of anxiety and other mental disorders in the United States. Br J Psychiatry Suppl. 1998;34:4–9.PubMed
6.
Goldney RD, Fisher LJ, Wilson DH, Cheok F. Mental health literacy of those with major depression and suicidal ideation: an impediment to help seeking. Suicide Life Threat Behav. 2002;32(4):394–403.CrossRefPubMed
7.
Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015;72:334.CrossRefPubMedPubMedCentral
8.
Alonso J, Codony M, Kovess V, Angermeyer MC, Katz SJ, Haro JM, De Girolamo G, De Graaf R, Demyttenaere K, Vilagut G et al. Population level of unmet need for mental healthcare in Europe. Br J Psychiatry. 2007;190:299–306.CrossRefPubMed
9.
Johnston AK, Pirkis JE, Burgess PM. Suicidal thoughts and behaviours among Australian adults: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry. 2009;43(7):635–43.CrossRefPubMed
10.
Coles ME, Schubert JR, Heimberg RG, Weiss BD. Disseminating treatment for anxiety disorders: step 1: recognizing the problem as a precursor to seeking help. J Anxiety Disord. 2014;28(8):737–40.CrossRefPubMed
11.
Roness A, Mykletun A, Dahl AA. Help-seeking behaviour in patients with anxiety disorder and depression. Acta Psychiatr Scand. 2005;111(1):51–8.CrossRefPubMed
12.
Candiago RH, Saraiva Sda S, Goncalves V, Belmonte-de-Abreu P. Shortage and underutilization of psychiatric beds in southern Brazil: independent data of Brazilian mental health reform. Soc Psychiatry Psychiatr Epidemiol. 2011;46(5):425–9.CrossRefPubMed
13.
Burgess DJ, Ding Y, Hargreaves M, van Ryn M, Phelan S. The association between perceived discrimination and underutilization of needed medical and mental health care in a multi-ethnic community sample. J Health Care Poor Underserved. 2008;19(3):894–911.CrossRefPubMed
14.
Augsberger A, Yeung A, Dougher M, Hahm HC. Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC Health Serv Res. 2015;15:542.CrossRefPubMedPubMedCentral
15.
Okazaki S. Treatment delay among Asian-American patients with severe mental illness. Am J Orthopsychiatry. 2000;70(1):58–64.CrossRefPubMed
16.
Watson NN, Hunter CD. Anxiety and depression among African American women: the costs of strength and negative attitudes toward psychological help-seeking. Cultur Divers Ethnic Minor Psychol. 2015;21(4):604–12.CrossRefPubMed
17.
Coles ME, Coleman SL. Barriers to treatment seeking for anxiety disorders: initial data on the role of mental health literacy. Depress Anxiety. 2010;27(1):63–71.CrossRefPubMed
18.
Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. 2010;10:113.CrossRefPubMedPubMedCentral
19.
U.S. Department of Health and Human Services. Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2001.
20.
Chen LY, Crum RM, Martins SS, Kaufmann CN, Strain EC, Mojtabai R. Service use and barriers to mental health care among adults with major depression and comorbid substance dependence. Psychiatr Serv. 2013;64(9):863–70.CrossRefPubMedPubMedCentral
21.
Mojtabai R, Olfson M, Sampson NA, Jin R, Druss B, Wang PS, Wells KB, Pincus HA, Kessler RC: Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychol Med. 2011;41(8):1751–61.CrossRefPubMedPubMedCentral
22.
Meltzer H, Bebbington P, Brugha T, Farrell M, Jenkins R, Lewis G. The reluctance to seek treatment for neurotic disorders. Int Rev Psychiatry. 2003;15(1–2):123–8.CrossRefPubMed
23.
Thompson A, Hunt C, Issakidis C. Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample. Soc Psychiatry Psychiatr Epidemiol. 2004;39(10):810–7.CrossRefPubMed
24.
Wang PS, Simon G, Kessler RC. The economic burden of depression and the cost-effectiveness of treatment. Int J Methods Psychiatr Res. 2003;12(1):22–33.CrossRefPubMed
25.
McGorry PDPR, Hickie IB, Jorm AF. Investing in youth mental health is a best buy. Med J Aust. 2007;187:S5–7.
26.
Haller DM, Sanci LA, Sawyer SM, Patton GC. The identification of young people’s emotional distress: a study in primary care. Br J Gen Pract. 2009;59(560):e61–70.CrossRefPubMedPubMedCentral
27.
Cowan J, Raja S, Naik A, Armstrong G. Knowledge and attitudes of doctors regarding the provision of mental health care in Doddaballapur Taluk, Bangalore Rural district, Karnataka. Int J Ment Health Syst. 2012;6(1):21.CrossRefPubMedPubMedCentral
28.
Reavley NJ, Jorm AF. Recognition of mental disorders and beliefs about treatment and outcome: findings from an Australian national survey of mental health literacy and stigma. Aust N Z J Psychiatry. 2011;45(11):947–56.CrossRefPubMed
29.
Pescosolido BA, Jensen PS, Martin JK, Perry BL, Olasfsdottir S, Fettes D. Public knowledge and assessment of child mental health problems: findings from the National Stigma Study-Children. J Am Acad Child Adolesc Psychiatry. 2008;47:339–49.CrossRefPubMed
30.
Wang J, He Y, Jiang Q, Cai J, Wang W, Zeng Q, et al. Mental health literacy among residents in Shanghai. Shanghai Arch Psychiatry. 2013;25(4):224–35.
31.
Okuyama T, Nakane Y, Endo C, Seto T, Kato M, Seki N, Akechi T, Furukawa TA, Eguchi K, Hosaka T:. Mental health literacy in Japanese cancer patients: ability to recognize depression and preferences of treatments-comparison with Japanese lay public. Psychooncology. 2007;16(9):834–42.CrossRefPubMed
32.
Amarasuriya SD, Jorm AF, Reavley NJ. Depression literacy of undergraduates in a non-western developing context: the case of Sri Lanka. BMC Res Notes. 2015;8:593.CrossRefPubMedPubMedCentral
33.
Fernandez A, Rubio-Valera M, Bellon JA, Pinto-Meza A, Luciano JV, Mendive JM, JM, Haro JM, 23Palao DJ, Serrano-Blanco A, Recognition of anxiety disorders by the general practitioner: results from the DASMAP study. Gen Hosp Psychiatry. 2012;34(3):227–33.
34.
Lauber C, Nordt C, Falcato L, Rossler W. Do people recognise mental illness? Factors influencing mental health literacy. Eur Arch Psychiatry Clin Neurosci. 2003;253(5):248–51.CrossRefPubMed
35.
Fisher LJ, Goldney RD. Differences in community mental health literacy in older and younger Australians. Int J Geriatr Psychiatry. 2003;18(1):33–40.CrossRefPubMed
36.
37.
Coles ME, Heimberg RG, Weiss BD. The public’s knowledge and beliefs about obsessive compulsive disorder. Depress Anxiety. 2013;30(8):778–85.CrossRefPubMed
38.
Robles-Garcia R, Fresan A, Berlanga C, Martinez N. Mental illness recognition and beliefs about adequate treatment of a patient with schizophrenia: association with gender and perception of aggressiveness-dangerousness in a community sample of Mexico City. Int J Soc Psychiatry. 2013;59(8):811–8.CrossRefPubMed
39.
Dahlberg KM, Waern M, Runeson B. Mental health literacy and attitudes in a Swedish community sample - investigating the role of personal experience of mental health care. BMC Public Health. 2008;8:8.CrossRefPubMedPubMedCentral
40.
Wu CY, Liu SI, Chang SS, Sun FJ. Surveys of medical seeking preference, mental health literacy, and attitudes toward mental illness in Taiwan, 1990–2000. J Formos Med Assoc. 2014;113(1):33–41.CrossRefPubMed
41.
Yu Y, Liu ZW, Hu M, Liu XG, Liu HM, Yang JP, Xiao SY: Assessment of mental health literacy using a multifaceted measure among a Chinese rural population. BMJ Open. 2015;5(10):e009054.
42.
Yu Y, Liu ZW, Hu M, Liu HM, Yang JP, Zhou L, SY X: Mental health help-seeking intentions and preferences of rural Chinese adults. PLoS One. 2015;10:e0141889.CrossRefPubMedPubMedCentral
43.
44.
Manea L, Gilbody S, McMillan D. A diagnostic meta-analysis of the Patient Health Questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. Gen Hosp Psychiatry. 2015;37(1):67–75.CrossRefPubMed
45.
Wang W, Bian Q, Zhao Y, Li X, Wang W, Du J, et al. Reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2014;36(5):539–44.
46.
Chen TM, Huang FY, Chang C, Chung H. Using the PHQ-9 for depression screening and treatment monitoring for Chinese Americans in primary care. Psychiatr Serv. 2006;57(7):976–81.CrossRefPubMed
47.
Chen S, Chiu H, Xu B, Ma Y, Jin T, Wu M, et al. Reliability and validity of the PHQ-9 for screening late-life depression in Chinese primary care. Int J Geriatr Psychiatry. 2010;25(11):1127–33.
48.
Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder:the GAD一7. Arch Intern Med. 2006;166(10):1092–7.CrossRefPubMed
49.
Schalet BD, Cook KF, Choi SW, Cella D. Establishing a common metric for self-reported anxiety: linking the MASQ, PANAS, and GAD-7 to PROMIS Anxiety. J Anxiety Disord. 2014;28(1):88–96.CrossRefPubMedPubMedCentral
50.
Vaingankar JA, Subramaniam M, Abdin E, Picco L, Phua A, Chua BY, Chong SA: Socio-demographic correlates of positive mental health and differences by depression and anxiety in an Asian community sample. Ann Acad Med Singapore. 2013;42(10):514–23.PubMed
51.
Ying DG, Jiang S, Yang H, Zhu S. Frequency of generalized anxiety disorder in Chinese primary care. Postgrad Med. 2010;122(4):32–8.CrossRefPubMed
52.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption--II. Addiction. 1993;88(6):791–804.CrossRefPubMed
53.
Reinert DF, Allen JP. The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res. 2007;31(2):185–99.CrossRefPubMed
54.
Li Q, Babor TF, Hao W, Chen X. The Chinese translations of Alcohol Use Disorders Identification Test (AUDIT) in China: a systematic review. Alcohol Alcohol. 2011;46(4):416–23.CrossRefPubMedPubMedCentral
55.
Jorm AF, Nakane Y, Christensen H, Yoshioka K, Griffiths KM, Wata Y. Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan. BMC Med. 2005;3:12.CrossRefPubMedPubMedCentral
56.
Jorm AFKA, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: A survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166:182–6.PubMed
57.
Ma YX, Zhang B, Wang HJ, Du WW, Su C, Zhai FY. Status and trend of alcohol consumption among adults in nine provinces (antonomous region) of China from 1993 to 2006. Zhonghua Yu Fang Yi Xue Za Zhi. 2011;45(4):323–9.PubMed
58.
59.
Lauber C, Nordt C, Falcato L, Rossler W. Lay recommendations on how to treat mental disorders. Soc Psychiatry Psychiatr Epidemiol. 2001;36(11):553–6.CrossRefPubMed
60.
Parker G, Gladstone G, Chee KT. Depression in the planet’s largest ethnic group: the Chinese. Am J Psychiatry. 2001;158(6):857–64.CrossRefPubMed
61.
62.
Cheng HGDF, Xiong W, Phillips MR. Prevalence of alcohol use disorders in mainland China: a systematic review. Addiction. 2015;110(5):761–74.CrossRefPubMed
Metadata
Title
Recognition of depression, anxiety, and alcohol abuse in a Chinese rural sample: a cross-sectional study
Authors
Yu Yu
Mi Hu
Zi-wei Liu
Hui-ming Liu
Joyce P. Yang
Liang Zhou
Shui-yuan Xiao
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0802-0

Other articles of this Issue 1/2016

BMC Psychiatry 1/2016 Go to the issue

Study protocol

MEDIACONNEX: a multicenter randomised trial based on short message service to reduce suicide attempt recurrence in adolescents

Research article

Association between non-compliance with psychiatric treatment and non-psychiatric service utilization and costs in patients with schizophrenia and related disorders

Research article

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study

Reviewer acknowledgement

BMC Psychiatry reviewer acknowledgement 2015

Research article

The prevalence of Nonsuicidal Self-Injury (NSSI) in a representative sample of the German population

Research article

Lipid profiles in schizophrenia associated with clinical traits: a five year follow-up study