Aim
Young people in Hong Kong have been facing numerous population‐level events over the past year, including social unrest and the COVID‐19 pandemic. Representative data concerning the mental health ...of youths, however, is limited. The Hong Kong Youth Epidemiological Study of Mental Health (HK‐YES) is commissioned to provide the first representative prevalence estimates and correlates of mental disorders among young people in Hong Kong. It will also examine the help‐seeking behaviours, treatment rates, quality of life, and functional outcomes of the young people. More importantly, the direct and indirect economic costs of mental disorders in youths will be estimated.
Methods
A total of 4500 community‐dwelling participants aged 15–24 years from Hong Kong will be surveyed. Participants will be selected using a multistage stratified sampling design to provide representative estimates of the youth population in Hong Kong. All interviews will be conducted using computer‐assisted personal interviewing methods for assessments covering areas of psychiatric diagnoses, symptomatology, functioning, quality of life, disability, service utilization, health economic costs of mental disorders, and sociodemographic and lifestyle characteristics. A population‐weighted prevalence will be estimated using survey weights. Methods such as multivariate logistic and linear regression analyses will be used to calculate the risks and odds of factors that might be associated with different mental disorders.
Conclusion
As the first population‐based youth study in Hong Kong, HK‐YES collects extensive and representative data on different mental conditions and their associated factors among young people. The information gathered will be important for future planning on youth mental health services in Hong Kong and will offer the opportunity for a more meaningful comparison of data with other youth populations.
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BFBNIB, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Negative symptoms are an important symptom dimension in schizophrenia that are often least responsive to antipsychotic medications. We revisit the current practice of identifying ‘primary’ negative ...symptoms and suggest that its concept would benefit from a further elaboration of their timing of emergence in relation to the dynamic neurobiological changes to enhance their utility in clinical decision-making and research.
Objectives
Regular engagement in physical activity (PA) has numerous health benefits in young children. Young children’s parents can influence their children’s PA behavior through different ...PA-related parenting practices. This cross-sectional study examined the independent contributions of socio-demographic, family/home and parent-perceived neighborhood environmental characteristics explaining PA-related parenting practices encouraging or discouraging PA among Hong Kong preschool-aged children (3–5 years-old).
Methods
Hong Kong Chinese preschoolers’ parents were recruited from pre-selected kindergartens and Maternal and Child Health Centers located in areas stratified by residential density and socio-economic status. They self-completed socio-demographic, family/home and perceived neighborhood characteristics and PA-related parenting practices questionnaires. Generalized linear models were used to examine associations of socio-demographic, family/home and neighborhood variables with PA-related parenting practices.
Results
Socio-demographic and family/home characteristics were significantly correlated with parenting practices encouraging and discouraging PA. Parent-perceived neighborhood characteristics were significantly correlated with parenting practices discouraging PA only.
Conclusions for Practice
This study identified correlates of PA-related parenting practices among parents of Hong Kong Chinese preschoolers. The findings suggest future PA-promoting interventions among Chinese preschoolers via the promotion of parenting practices encouraging children’s PA should consider multiple factors, including family relationships and childcare sharing, promotion of PA and its benefits among parents, and neighborhood social cohesion, traffic safety and safety from crime.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Aim
Hong Kong's existing mental health services are inadequate in addressing young people's needs. The LevelMind@JC project established an early intervention platform of community‐based ...youth‐specific mental health centres involving youth workers, cross‐disciplinary professionals, and young people. The project intends to (1) pilot a community platform that incorporates a youth‐friendly early screening tool with preventative intervention capabilities, (2) set up a state‐of‐the‐art training system for youth mental health workers, (3) establish a community clinical support team and (4) develop a timely evaluation system to monitor the service and evaluate its outcome and cost‐effectiveness against generic youth services.
Methods
Six hundred LevelMind@JC service users will be assessed alongside 600 young people visiting generic youth centres and 100 young people in the community. Participants will be matched according to age, gender, years of education, socioeconomic status, and level of distress. Assessments, administered at baseline and at 3, 6 and 12 months, will cover demographic characteristics, psychological distress, quality of life, depressive and anxiety symptoms, functioning, physical health and lifestyle, personality and social measures, cognitive measures and health economics. Mixed‐model ANOVAs will be used to indicate interactions between services and between time points.
Conclusion
Built upon a community‐based support model, LevelMind@JC aims to promote positive mental health in young people through the collaboration of cross‐disciplinary mental health professionals. If efficacy and cost‐effectiveness are established, the project could be scaled up, implicating a wider reach of care. We anticipate its success to be critical in combatting mental health issues stemming from both personal and population‐level stressors.
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BFBNIB, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Background:
Ethnic minorities (EMs) typically underutilise mental health services (EMs) with issues that are not shared by the local population. Understanding the underlying perceived factors could ...help reduce their mental health disparities.
Aims:
This is a qualitative study aiming to examine the barriers that prevent EMs from seeking mental health services in Hong Kong.
Methods:
Six semistructured focus groups with 31 EMs who resided in Hong Kong were conducted from May 31 to June 26, 2021. The outcome measures were the themes and subthemes of perspectives on mental health service use.
Results:
Among 31 adults (20 64.5% women, 11 35.5% men; 17 54.8% aged 25–39 years) who participated, most participants self-identified as Indian (13 41.95) or Pakistani (10 32.3). There were 16 individuals (51.6%) who reported severe or higher levels of anxiety or depressive symptoms, while 12 individuals (38.7%) reported moderate levels. Three emerging themes identified for the barriers to help-seeking for psychiatric intervention were (1) preexisting problems, (2) psychaitric service lacks cultural sensitivity and (3) personal or family limitation, while that for the recommendations to improve help-seeking had six themes: (1) improve cultural sensitivity, (2) make EM mental health practitioners available, (3) improve professional conduct, (4) improve on-site support, (5) improve financial support and (6) improve mental health promotion in schools.
Conclusion:
This study found that EMs in Hong Kong experience double stigma, which keeps them away from seeking professional mental health care. There were also disparities in the use of mental health services by ethnicity. The study also made recommendations for promoting EM help-seeking at the individual, governmental and community levels.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Objective
This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, ...particularly the COVID‐19 pandemic.
Methods
Complete data of interest from two telephone surveys conducted in 2020 (n = 1182) and 2021 (n = 1108) were analysed. Participants self‐reported depressive and anxiety symptoms using the Patient Health Questionnaire 4‐item version (PHQ), psychotic‐like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor‐Davidson Resilience Scale 2‐item version (CD‐RISC‐2).
Results
We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between‐year differences. Resilience and age interaction effects were significant when comparing the high PHQ‐high PQB group to the low PHQ‐low PQB group only in 2021 but not in 2020.
Conclusions
This study provides valuable insights into the impact of the COVID‐19 pandemic on mental health in Hong Kong, emphasising the age‐dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well‐being and identify ways to enhance resilience among older individuals during public health crises.
Key points
COVID‐19 had a significant impact on mental health with depressive and anxiety symptoms and psychotic‐like experiences being a concern.
Resilience is a protective factor, weaker in older participants, against depressive and anxiety symptoms and psychotic‐like experiences.
Targeted support strategies should consider age‐related differences in resilience to promote mental well‐being during public health crises.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract
Background
The development of a valid and simple-to-use self-administered tool in Asian adolescents for clinical screening and intervention remains limited. The present study assessed the ...psychometric characteristics and validity of the Generalised Anxiety Disorder Scale-7 (GAD-7) among adolescents in Hong Kong.
Methods
Epidemiological data from 3,261 Hong Kong adolescents aged 15 - 24 years were analysed for the construct validity, criterion validity, concurrent validity, and Rasch Model. All analyses were age- and gender-weighted according to the distributions of Hong Kong’s general population.
Results
The GAD-7 showed high internal consistency and strong fit to the one-factor structure. The best cut-off value was set at 7 or more. Regression models found that the total scores of the scale were positively associated with symptoms of depression and hypomania, schizotypal personality and alcohol dependence. Rasch model analysis found that the separation index was 2.18 and 16.51 for the respondents and items, respectively and all residual pairs had small correlation coefficients (i.e., < 0.3).
Conclusions
All psychometric findings presented in this study support the use of the GAD-7 as a legitimate measure of anxiety severity. A cut-off score of 7 should indicate a potential diagnosable condition in Asian adolescents, which requires our attention but should not be used as a formal diagnostic screening tool. The findings revealed the local dependence of the items of the GAD-7 and that the scale can separate respondents into at least two groups and items into numerous groups according to the separation index.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background and aims
Proactive brief cessation advice by a lay counsellor combined with a referral to a smoking cessation service (active referral) is effective in increasing service use and quitting ...in community smokers. We compared the effect of two modified approaches to referrals on the cessation outcomes in community smokers.
Design
Three‐arm cluster‐randomized trial.
Setting
General community in Hong Kong.
Participants
Daily cigarette smokers (n = 1163; 77.7% male).
Interventions
Participants were randomized to receive on‐site active referral (OSR, n = 395), where lay counsellors helped participants make appointments with a smoking cessation service of their choice plus tailored reminders; mobile text messaging referral (TMR, n = 385), where participants were encouraged to use a smoking cessation service via text messages; or brief cessation advice only (control, n = 383).
Measurements
The primary outcome was a self‐reported 7‐day point‐prevalence abstinence at 6 months post‐treatment initiation. Secondary outcomes included 7‐day point‐prevalence abstinence at 3 and 18 months, biochemically validated abstinence, smoking reduction and the use of cessation services at 3, 6 and 18 months.
Findings
Using intention‐to‐treat analysis, the OSR (17.7%) and TMR (17.1%) groups had significantly higher self‐reported abstinence than the control (12.0%) group at 6 months odds ratio (OR) for OSR versus control = 1.58, 95% confidence interval (CI) = 1.06–2.36; OR for TMR versus control = 1.52, 95% CI = 1.01–2.28; both P < 0.05. The corresponding validated abstinence rates at 6 months were 7.6, 7.8 and 3.9% (OR for TMR versus control = 2.02, 95% CI = 1.07–3.81; OR for TMR versus control = 2.07, 95% CI = 1.10–3.92; both P < 0.05). Self‐reported and validated abstinence were similar at 18 months. OSR groups had higher rates of smoking cessation service use than the control group at all follow‐ups (all P < 0.001). The smoking reduction rates were similar in continuing smokers.
Conclusions
Simple active referrals (in person or via text messaging) to smoking cessation services increased abstinence rates among smokers in Hong Kong compared with general brief cessation advice. On‐site active referral increased the use of smoking cessation services compared with general brief cessation advice.
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BFBNIB, DOBA, FSPLJ, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Little is known about long-term employment outcomes for patients with first-episode schizophrenia-spectrum (FES) disorders who received early intervention services.
We compared the 10-year employment ...trajectory of patients with FES who received early intervention services with those who received standard care. Factors differentiating the employment trajectories were explored.
Patients with FES (N = 145) who received early intervention services in Hong Kong between 1 July 2001 and 30 June 2002 were matched with those who entered standard care 1 year previously. We used hierarchical clustering analysis to explore the 10-year employment clusters for both groups. We used the mixed model test to compare cluster memberships and piecewise regression analysis to compare the employment trajectories of the two groups.
There were significantly more patients who received the early intervention service in the good employment cluster (early intervention: N = 98 67.6%; standard care: N = 76 52.4%; P = 0.009). In the poor employment cluster, there was a significant difference in the longitudinal pattern between early intervention and standard care for years 1-5 (P < 0.0001). The number of relapses during the first 3 years, months of full-time employment during the first year and years of education were significant in differentiating the clusters of the early intervention group.
Results suggest there was an overall long-term benefit of early intervention services on employment. However, the benefit was not sustained for all patients. Personalisation of the duration of the early intervention service with a focus on relapse prevention and early vocational reintegration should be considered for service enhancement.
BackgroundWe investigated the association between paternal smoking, avoidance behaviors and maternal protective actions and smoke-free home rules with infant's saliva cotinine in Hong Kong.MethodsSix ...hundred and seventy-five non-smoking mothers (mean age 32.6 years) who attended the maternal-child health clinics with their newborns aged ≤18 months completed a questionnaire about paternal smoking and avoidance behaviors, maternal protective actions, smoke-free rules at home, and infant's second-hand smoke (SHS) exposure. Three hundred and eighty-nine infants provided saliva sample and its cotinine was tested.ResultsThe geometric mean of infant's saliva cotinine was 1.07 ng/ml (95% confidence interval (CI): 0.98, 1.16). Infants living in smoking families with SHS exposure had significantly higher cotinine level than in non-smoking families (adjusted β=0.25, 95% CI: 0.16, 0.33). Paternal smoking near infants (within 1.5 m) was associated with higher cotinine level (adjusted β=0.60, 95% CI: 0.22, 0.98), which was not reduced by avoidance behaviors (e.g., smoking in kitchen or balcony). Even fathers smoking ≥3 m away from infants was associated with higher cotinine level than non-smoking families (adjusted β=0. 09, 95% CI: 0.01, 0.16). Maternal protective actions and smoke-free home rules were not significantly associated with reduced cotinine level.ConclusionPaternal smoking avoidance, maternal protective actions, and smoke-free policy at home did not reduce infant's saliva cotinine.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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