S. M. NG ET AL.
Copyright © 2011 SciRes . CM
key d iffere nce, howe ver, is that stagna tion synd ro me ha s
a prominent somatic component characterized by ob-
struction-like discomforts at throat, chest, stomach or
abdomen. An emphasis on somatic symptoms makes it
socially legitimate to seek medical care. Stagnation syn-
drome and other ‘mind/body disorders’ are often exam-
ined by general Chinese medicine practitioners in the
community. It is thus reasonable to expect that many
Chinese people with mental disorders turn up at TCM
clinics. Ho wever, systematic studies on this area are still
awaited.
The objective of the current study is to investigate the
incoming pathways and overall prevalence of common
mental disorders of new pati ents of a TCM clinic of a
major healthcare provider in Hong Kong. The scope of
the study did not include returning patients mainly be-
cause of methodological considerations. Returning pa-
tient s had big heterogeneity in terms of stage of recovery
and duration of treatment at the clinic. Besides, there
might be significant systemic differences between re-
turning and defaulting patients. Access to defaulting pa-
tients for making such assessment would be difficult.
From a methodological research perspective, the mental
healt h pro file o f retur ning p atie nts had to be i nves tigated
by a substantially more sophisticated design in future
studies.
Ethical approval for this study was sought from the
Joint Institutional Review Board of the University of
Hong K ong a nd the Hosp ita l Aut hori ty Hon g Ko ng Wes t
Cluster, with compliance to the Declaration of Helsinki.
2. Methods
1) Participants: current study adopted a cross-sectional
questionnaire survey design. Participants were recruited
through 100% consecutive sampling of new patients o f a
TCM c linic during a pre-designated 5-week period. In-
clusion criteria were: 1) b e ing a ‘new case’ in accordance
to the clinic’s ad ministra tive definition, i.e. a patient who
is seeking treatment for a certain medical condition for
the first time, or presenting at a particular sub-specialty
of the clinic for the first time; 2) if the patient is aged
under 13 or mentally unfit to be interviewed, he/she is
accompanied by a carer who can be the informant; and 3)
the patient or, if applicable, his/her carer can communi-
cate effectively in Cantonese or Putonghua. During the
designated study period, 436 subjects meeting inclusion
criteria were approached. A response rate of 84.2% was
achieved, resulting in 367 completed questionnair e s.
There were 111 (30.2%) male and 256 (69.8%) female.
Mean age was 44.0 years (SD = 17.1).
2) Interviewers: six part-time interviewers were spe-
cifically employed for the study by the investigating in-
stitution. All o f them were retired nurses with around 20
to 30 years of clinical and management experience in
public hospitals in Hong Kong. They were trained on
administering the questio nnaires b y the fir st a utho r, pri n-
cipal investiga t or of the study.
3) measures:
• Demographic data: These included gender, age,
marital status, educational lev el, personal and fam-
ily income, type of housing, religious beliefs and
household composition.
• Incoming pathway: This section captured p a tie nt s’
help-seeking behaviors in the month prior to first
consultation at the TCM clinic, i.e. (1) methods
used to deal with the presenting health problem,
and (2) frequency of using the me t h o d(s).
• Mental Health: The 12-Item General Health Ques-
tionnaire (GHQ-12) [8] is a self-administered
screening instrument for identifying non-psychotic
psychiatric disorders in community settings. It has
been widely used in primary care settings and its
measurement properties have been studied in di-
verse cultur al set tings [ 3]. T he Chinese vers ion ha s
been validated and found to have satisfactory psy-
chometric properties, with sensitivity and specific-
ity at 78% and 77% respectively [9,10]. For esti-
mation of overall prevalence of common mental
disorders, current study adopted the 0-0-1 -1 coding
and a cut-off point of ≥5 [11].
4) procedures: At any one time during the 5 -week data
collection period, two to three interviewers stationed at
the clinic for conducting interviews following a struc-
tured question naire. All ne w patients were invite d to par-
ticipate in the study. Consented patients were inter-
viewed individually in a room with privacy inside the
clinic. All completed questionnaires were sent to the
principal investigator directly. The clinic had no access
to the collected data.
3. Results
1) Dur ation o f Presenting Problems: Rega rdin g the d ura-
tion of the presenting problems, the key findings are
sum marized in Table 1 b elow.
2) Results sho wed a wide range in the dur atio n of pre-
senting problems. While 31.7% presenting problems had
lasted for less than a month at first consultation, 37.8%
had lasted for over 1 year. Overall, 68.3% presenting
problems had lasted for over 1 month.
3) Treatments Used Prior to First Consultations: Par-
ticipants were asked whether they had employed any
methods to deal with their presenting health problems in
the mo nth pri or to t he first consultation. The major find-
ings are summarized in Table 2 below.
