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Open Access Highly Accessed Study protocol

The epidemiology and natural history of depressive disorders in Hong Kong's primary care

Weng Yee Chin1*, Cindy LK Lam1, Samuel YS Wong2, Yvonne YC Lo16, Daniel YT Fong3, Tai Pong Lam1, Peter WH Lee45, Josephine WS Wong46, Billy CF Chiu15 and Kit TY Chan1

Author Affiliations

1 Department of Family Medicine and Primary Care, the University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong

2 School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong

3 School of Nursing, the University of Hong Kong, 4/F, William M.W. Mong Block 21 Sassoon Road, Pokfulam, Hong Kong

4 Department of Psychiatry, the University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong

5 Hong Kong Sanatorium and Hospital, 2 Village Road, Happy Valley, Hong Kong

6 In private practice

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BMC Family Practice 2011, 12:129  doi:10.1186/1471-2296-12-129

Published: 24 November 2011

Abstract

Background

Depressive disorders are commonly managed in primary care and family physicians are ideally placed to serve as central providers to these patients. Around the world, the prevalence of depressive disorders in patients presenting to primary care is between 10-20%, of which around 50% remain undiagnosed. In Hong Kong, many barriers exist preventing the optimal treatment and management of patients with depressive disorders. The pathways of care, the long term outcomes and the factors affecting prognosis of these patients requires closer examination.

Methods/Design

The aim of this study is to examine the prevalence, incidence and natural history of depressive disorders in primary care and the factors influencing diagnosis, management and outcomes using a cross-sectional study followed by a longitudinal cohort study.

Doctors working in primary care settings across Hong Kong have been invited to participate in this study. On one day each month over twelve months, patients in the doctor's waiting room are invited to complete a questionnaire containing items on socio-demography, co-morbidity, family history, previous doctor-diagnosed mental illness, recent mental and other health care utilization, symptoms of depression and health-related quality of life. Following the consultation, the doctors provide information regarding presenting problem, whether they think the patient has depression, and if so, whether the diagnosis is new or old, and the duration of the depressive illness if not a new diagnosis. If the doctor detects a depressive disorder, they are asked to provide information regarding patient management. Patients who consent are followed up by telephone at 2, 12, 26 and 52 weeks.

Discussion

The study will provide information regarding cross-sectional prevalence, 12 month incidence, remission rate, outcomes and factors affecting outcomes of patients with depressive disorders in primary care. The epidemiology, outcomes, pathways of care, predictors for prognosis and service needs for primary care patients with depressive disorders will be described and recommendations made for policy and service planning.