Prevalence, psychosocial and physical health correlates of psychotic disorders in Hong Kong: the Hong Kong Mental Health Morbidity Survey

Abstract

BACKGROUND: Psychotic disorders are severe mental illnesses that constitute one of the highest disease burdens globally. It is known that rate and psychosocial correlates of psychosis vary across different populations. The Hong Kong Mental Morbidity Survey (HKMMS) is the first territory-wide, population-based study in Hong Kong (HK) to examine prevalence of psychotic disorders, their associated factors and impacts on psychosocial disability. METHODS: A two-phase design was adopted. In Phase I, 5719 randomly selected and demographically representative Chinese participants aged 16–75 years were assessed on functioning, quality of life (QoL), alcohol and substance use, physical health status, and a comprehensive array of socio-demographic variables between November 2010 and May 2013. Psychosis Screening Questionnaire (PSQ) was administered. Participants who were screened positive with PSQ (n=238) or had self-reported history of psychosis / antipsychotic treatment (n=74) were recruited to Phase II for diagnostic confirmation (n=232) of psychotic disorders using Structured Clinical Interview for DSM-IV and / or medical record review. RESULTS: The weighted prevalence of psychotic disorders was 2.5% (95%CI: 2.1–2.9). Participants with psychotic disorders were significantly more likely to be single and unemployed, to have lower educational attainment, lower household income, family history of psychosis, less perceived social support, history of physical or sexual trauma, and poorer psychosocial functioning and QoL than those without psychotic disorders. Participants with psychosis exhibited higher degree of physical disease burden, higher body mass index (BMI), and were more likely to be a smoker and to have substance dependence. CONCLUSION: Our findings indicate that, in HK, 1 in 40 people in the community suffer from psychotic disorders. Psychosis is associated with more adverse socio-economic situations, worse functioning, and poorer physical health. Prevalence estimate highlights substantial unmet treatment needs for people who have psychosis but have not yet received psychiatric care (approximately 1.5% of the population with psychosis). These data helps guide future development of psychiatric service for psychosis in HK. ID: 2086091