Symptom patterns in depression and "subthreshold" depression among adolescents in Hong Kong and the United States

Sunita Mahtani Stewart, Peter M. Lewinsohn, Peter W H Lee, Lai Ming Ho, Betsy Kennard, Carroll W. Hughes, Graham J. Emslie

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)559-576
Number of pages18
JournalJournal of Cross-Cultural Psychology
Issue number6
StatePublished - Nov 2002

ASJC Scopus subject areas

  • Social Psychology
  • Cultural Studies
  • Anthropology


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