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. 2025 Nov 26:65:101757.
doi: 10.1016/j.lanwpc.2025.101757. eCollection 2025 Dec.

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

Corine S M Wong  1 , Candi M C Leung  1 , Shiyi Wu  1 , Francis P Flores  1 , Yoona Kim  1 , Xiao Xiao  1 , Solomon B K Wong  1 , Wing Chung Chang  2 , Wai Chi Chan  2 , Nancy Xiaonan Yu  3 , Calvin P W Cheng  2 , Albert K K Chung  2 , Edwin H M Lee  2 , Wai Tat Chiu  4 , William G Axinn  5 , Ronald C Kessler  4 , Michael Y Ni  1   6
Affiliations

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

Corine S M Wong et al. Lancet Reg Health West Pac. .

Abstract

Background: 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.

Methods: 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.

Findings: 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.

Interpretation: 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.

Funding: WYNG Foundation, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China; Hong Kong Jockey Club Charities Trust.

Keywords: Epidemiology; Mental disorder; Population-based study; Prevalence.

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Conflict of interest statement

In the past 3 years, Ronald C Kessler was a consultant for Cambridge Health Alliance, Child Mind Institute, Massachusetts General Hospital, RallyPoint Networks, Inc., Sage Therapeutics, University of Michigan, and University of North Carolina. He has stock options in Cerebral Inc., Mirah, PYM (Prepare Your Mind), and Verisense Health. He owns an interest in Menssano LLC.

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