Evidence for the 2008 Economic Crisis Exacerbating Depression in Hong Kong

Background: There is a lack of population-level research on the relationship between economic contraction and specific mental disorders and how individual-level variables may mediate such a relationship.

Methods: Two cross-sectional surveys using identical random sampling and diagnostic methods were conducted among Hong Kong adults in 2007 (January-February) and 2009 (April-May). 3016 and 2011 Chinese speaking adults completed structured interviews based on the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV).

Results: The twelve-month prevalence of DSM-IV major depressive episode (MDE) was significantly higher in 2009 (12.5%) than 2007 (8.5%). A significant increase of prevalence was found in both male and female respondents, those in the highest (55-65 years) age group, having secondary education level, were married/cohabited, divorced/widowed, employed, home-making, and in the lowest and high-middle income groups. Those with large investment loss had a significantly higher prevalence of MDE (20.3%) than those with less or no-investment loss (9.2-13.7%). The symptom pattern and severity of depression in 2007 and 2009 were similar.

Conclusion: Economic contraction triggered by a global financial crisis was associated with a significant increase in the risk of depression in the Hong Kong population. This increase was not explained primarily by unemployment and had a significant contribution from employed, home-making, high-middle income, and having married people. A holistic perspective that encompasses both ecological and individual levels of analysis is essential for studying the net impact of economic contraction on depression across communities and sociodemographic groups and for health policy planning.