Psychiatric epidemiological surveys in China 1960-2010: how real is the increase of mental disorders?

Community psychiatric epidemiological surveys over the last five decades have revealed a dramatic increase in the prevalence of mental disorders in China. This article summarizes the main surveys and attempts to interpret the increase of prevalence from a methodological perspective.

Regional and national surveys conducted in China during 1960-1990 focused on severe mental disorders and revealed very low and stable rates of disorders. By contrast, those performed in the last decade, whether psychiatrists or lay interviewers were used, have shown much higher and more 'reliable' rates comparable to those found in high-income countries. This is especially so for depression and anxiety disorders.

Given the sociopolitical turmoil that had previously plagued people in China, the dramatic rise in prevalence estimates of mental disorders in recent years cannot be simply interpreted as a substantive deterioration of mental health following rapid social change. Global and local factors that shape research methodology aimed at showing that mental disorders are common may play an important role in the dramatic increase. Future research in China should move beyond descriptive epidemiology. It should also address policy relevant issues in view of the limited resources available for mental health interventions.