Depression, anxiety, and associated health status in low-income Chinese patients

Background: Little is known about the prevalence of mental disorders and the associated impact on health status in low-income immigrant Chinese Americans. Methods: This cross-sectional study surveyed low-income Chinese patients attending a community health center in Chinatown (New York City) from July through November 2001 to determine the prevalence of depressive and anxiety disorders. Selected modules translated into Chinese from the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PHQ), a self-administered measure designed to diagnose mental health disorders in primary care, were used. To assess the relationship between mental disorders and health status and to examine convergent validity, mean scores on the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were examined according to PHQ diagnoses and calculated severity of depression. Results: A total of 856 patients were approached and data were obtained from 523 (61%) eligible participants. Thirty-two (6.1%) patients met the established criteria for major depressive disorder; 26 (5.0%) patients met the criteria for other depressive disorder; and 24 (4.6%) patients met the criteria for other anxiety disorder. Compared to patients without depression or anxiety, patients with major depressive and other anxiety disorder had significantly lower mean scores on all eight SF-36 subscales, while patients with other depressive disorder had lower mean scores on all subscales except for physical functioning. SF-36 subscale scores tended to decrease with increasing depression severity. Conclusions: Depression and anxiety were prevalent and demonstrated an adverse impact on health status, as measured by the SF-36. Strategies for screening for mental disorders may vary depending on the needs of the primary care setting and may be accomplished using a general health status measure or a disease-specific approach.