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Abstract
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The Article published by Jin Lu, Xiufeng Xu, and colleagues in The Lancet Psychiatry on the prevalence of depressive disorders in China has attracted much interest. Due to several methodological issues, we believe that the findings should be interpreted with caution.
First, although the structured Composite International Diagnostic Interview (CIDI) 3.0 can generate point, 1-year, and lifetime prevalence of depressive disorders, only 1-year and lifetime figures were reported. The omission of point prevalence could hinder understanding of the full profile of the epidemiology of depression in China. Compared with 1-year and lifetime prevalence, the point prevalence of depressive disorder might have more important implications for the provision of timely interventions and resources across national programmes. Furthermore, because of the limitations of structured interviews administered by lay interviewers, the accuracy of psychiatric diagnoses might be unreliable. For example, in the validation study of the CIDI 3.0 in China, the specificity of the CIDI 3.0 for major depressive disorder was only 68·6% and for dysthymia was only 72·3%, suggesting that up to 31·4% of people without depression could be misdiagnosed as having depressive disorders, which could explain the low treatment rate found in this survey.
Second, the survey only included people who had resided in the selected households for at least 6 months during the past year. In China there are millions of migrant workers, with many who frequently relocate across different regions to find work and other opportunities. Considering that migrant workers are a subpopulation at high risk of depressive disorders, the exclusion of those who lived in the selected households for less than 6 months might underestimate the prevalence of depressive disorders.
Third, in this survey, the participants who had depressive disorders within the past year completed a self-report version of the Quick Inventory of Depressive Symptomatology (QIDS-SR) assessment. However...
Language: en |