Prevalence, persistence, and severity of 12-month and 30-day DSM-5 disorders in the World Mental Health Hong Kong Study

Abstract

<h3>Background</h3><p>The World Mental Health Hong Kong (WMHHK) Study aims to estimate 12-month and 30-day prevalence, persistence, severity, and correlates of DSM-5 anxiety, mood, and externalising disorders in Hong Kong, a densely populated city impacted by consecutive population-level stressors, including social unrest and the COVID-19 pandemic.</p><h3>Methods</h3><p>Face-to-face interviews, either in-person or video-based online, were conducted from November 2022 to March 2024 with a population-representative sample of 3053 adults aged 18 years and above. Diagnostic assessment utilised the World Mental Health Composite International Diagnostic Interview for DSM-5 (CIDI-5), evaluating ten mental disorders: anxiety (panic disorder, generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive and related disorders), mood (major depressive disorder, persistent depressive disorder, bipolar spectrum disorders), and externalising (intermittent explosive disorder, alcohol use disorder, substance use disorder) disorders. Persistence was defined as 12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases. Sociodemographic correlates were analysed using multivariable logistic regression.</p><h3>Findings</h3><p>Twelve-month and 30-day prevalence of any DSM-5 mental disorder were 10.6% (95% CI: 9.5–11.8) and 7.8% (95% CI: 6.7–8.9), respectively. Twelve-month prevalence was highest for anxiety disorders (8.0%, 95% CI: 7.1–8.9), followed by mood (4.3%, 95% CI: 3.4–5.2) and externalising (1.7%, 95% CI: 0.9–2.4) disorders. Twelve-month persistence among lifetime cases was 49.0%, overall and higher for anxiety (55.6%) than mood (39.0%) or externalising (35.3%) disorders. Younger and middle-aged adults, and who were not currently married, had elevated risks, while lower education was associated with greater disorder severity. Comorbidity was associated with increased persistence and severity across disorders.</p><h3>Interpretation</h3><p>This study shows a substantial mental health burden in Hong Kong during the post-pandemic period, highlighting the need for tailored public mental health programmes to address urban stressors in this unique context.</p>