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Journal of Cross-Cultural Psychology
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Symptom Patterns in Depression and "Subthreshold" Depression among Adolescents in Hong Kong and the United States

Sunita Mahtani Stewart

University of Texas Southwestern Medical Center at Dallas, sunita.stewart{at}utsouthwestern.edu

Peter M. Lewinsohn

Oregon Research Institute

Peter W. H. Lee

The University of Hong Kong

L. M. Ho

The University of Hong Kong

Betsy Kennard

University of Texas Southwestern Medical Center at Dallas

Carroll W. Hughes

University of Texas Southwestern Medical Center at Dallas

Graham J. Emslie

University of Texas Southwestern Medical Center at Dallas

This study compared the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) Major Depressive Disorder (MDD) diagnostic interview information from a representative, stratified sample of 85 (selected from 2,212) Hong Kong and 1,706 age- and sex-matched U.S. adolescents. Current prevalence rates (Hong Kong: 2.2%, 95% Confidence Interval [CI] = 1.3% to 3.1%; United States: 2.2%, 95% CI = 1.6% to 3.0%) were similar in the two cultures. More Hong Kong compared to U.S. adolescents reported fatigue/loss of energy and fewer reported irritability. All Hong Kong participants with MDD reported fatigue, sleep, and concentration difficulties. Hong Kong adolescents who did not meet criteria for MDD but reported high levels of depressive symptoms showed social function and cognitions similar to youth with MDD and dissimilar to nondepressed youth. The results suggest that adolescent MDD is as prevalent in Hong Kong as in the West and that "subthreshold" depression is not a benign condition. Comparisons of symptom patterns in the two cultures showed culture’s influences on expressions of distress.

Journal of Cross-Cultural Psychology, Vol. 33, No. 6, 559-576 (2002)
DOI: 10.1177/022022102238269
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