CUHK 
P R E S S   R E L E A S E
Chinese Version 
 
 
5 February 1999
 
“A"Are they physically or mentally sick?”
CUHK Finds Over One-Fifth Clinic Attendees Have Mental Disorders
 
A recent survey conducted in Hong Kong by the Departments of Psychiatry and Community & Family Medicine of The Chinese University of Hong Kong found that over one fifth of patients attending primary care clinics were actually mentally sick but they presented with more physical rather than psychological symptoms and were treated accordingly.  The study suggests a high occurrence of mental illness among patients in the community and properly handling the patients’ mental disorders is the only solution for the patients' "disease".”.

Mental illnesses have always constituted a major part of the physicians’ workload worldwide.   
The survey conducted in 13 private and public primary care clinics detected a 21.6% prevalence of mental disorders amongst 1,300 adult patients (aged 16-64 years).  Somatoform disorder (11%), depressive disorder (8.3%) and anxiety disorder (6.1%) were the predominant mental illnesses. Women were consistently more commonly affected, especially in somatoform disorder. However, age seemed not an important association factor.  No significant differences were observed among the young (aged 18-34), adult (aged 35-44), and middle-aged (aged 45-64) age-groups.

Local findings were similar to those elsewhere.  The 1992 WHO study involving nearly 27,000 adult patients (aged 18 to 64) from 15 primary care centres across the world reported the prevalence of mental disorders to be 24%.

The presence of mental illness, especially depression and anxiety, was associated with high level of disability, poor physical health, loss of productivity, and unsatisfactory household or work performance.  If the doctor treats only the physical symptoms, the patients will actually never being cured, said Professor Alfred Pang Hin-tat, Associate Professor of Department of Psychiatry.
 
It is not uncommon that primary care physicians under-recognize mental disorders. In other parts of the world, such Hidden Psychiatric Morbidity has been found to have a magnitude of error ranging from 50% to 80%.  The situation that a large proportion of the mental disorder is not recognized at the early stage may be even more severe in Hong Kong as mental illness still carries a significant degree of stigma in a predominantly Chinese society like Hong Kong. Patients bring various physical symptoms, e.g., headache, fatigue, abdominal or chest discomfort, low back pain, to their doctors. They are not ready to accept psychological causes for these physical symptoms. Likewise, their attending doctors will treat only those physical symptoms and exclude the mental causes.  Doctors are often constrained by limited time in the exploration of psychological issues. Moreover, the management of mental illness needs in-depth training which has been difficult to acquire.

With an aim of detecting the mental disorders among primary care clinic attendees and providing them with proper treatment, the Department of Psychiatry collaborates with the Department of Community & Family Medicine of The Chinese University of Hong Kong in translating into Chinese a simple, reliable, and time-saving questionnaire (the cPRIME-MD) to assist physicians to detect mental disorders at the early stage. The two Departments are currently running a pilot program for local physicians to refresh and update their skills in the diagnosis and management of mental disorders.