SynopsisThe problems which arise in the use of a psychiatric screening instrument in a language and culture other than that in which it was designed and developed are considered. An account is given of the development of a psychiatric screening questionnaire suitable for use in Chinese community samples. The questionnaire was derived from a Chinese translation of the General Health Questionnaire, with the addition of specially designed, culturally-relevant items. Discriminant function analysis was then used to select a subset of 12 items which discriminated well between ‘cases’ and ‘normals’ in the community.

The internal consistency and factor structure of the Chinese Health Questionnaire (CHQ) were investigated in 2 samples in Taiwan, one from 3 communities (n = 1023) and the other from consecutive attenders for health screening in a general hospital (n = 386). Cronbach's alpha coefficients were calculated to be 0.84 and 0.83 for the 12-item and 0.90 and 0.92 for the 30-item CHQ version. Four factors similarly extracted for the CHQ-30 in both samples include somatic symptoms, anxiety and worrying, social dysfunction, and depression and poor family relationship. The implications of these findings were discussed from a cross-cultural perspective.

SynopsisA community study of minor psychiatric morbidity (MPM) was carried out on three population samples aged 15 and above randomly selected from rural (Yenpu), suburban (Chishan), and urban (Kaohsiung) communities (N = 350 for each) in Taiwan. A two-stage case finding strategy was applied with a newly developed and validated screening questionnaire (CHQ), and a modified Chinese version of the Clinical Interview Schedule (CIS-CV). The total response rate was 99·4% and there was no time lag between the CHQ screening and the second stage clinical interview conducted by a psychiatrist. The weighted validity of the CHQ was found to be acceptable (sensitivity 69·6%, specificity 94·8%, misclassification rate 11·4%). The overall weighted prevalence rate was 18·0% for men and 33·3% for women. Both the CIS and the CHQ data are used as the morbidity indices to investigate the sociodemographic risk factors of MPM. A higher risk of MPM, which occupied 92% of the total morbidity, was found to be associated with women aged 35 and above, the unemployed men, and the lower socioeconomic status after linear modelling.

SynopsisThe basic symptoms of minor psychiatric morbidity (MPM) reported elsewhere were also found in a community survey in Taiwan. However, differences in the patterns of and manifestations of the symptoms were evident. Contrary to most Western surveys, the prevalence of anxiety (24·7 %) was found to be higher than that of depression (8·3 %) in Taiwan. Possible explanations based on sociocultural characteristics of the Chinese family were proposed. The notion of somatization as a predominant symptom in Chinese neurotic patients advocated by some research workers was not supported in this study. As a result of findings in community cases, it is argued that the importance of somatization has been considerably overemphasized as a factor in the illness behaviour of neurotic cases in Chinese and other cultures, and it is therefore not a culturespecific disease phenomenon. It is also suggested that certain culture-specific neurotic syndromes reported in Chinese, such asshen-ching-shuai-jo(neurasthenia) andshen-k'uei(semen loss syndrome), are clinically equivalent to MPM. Implications of the present findings on crosscultural research and management of MPM were discussed.

SynopsisA two-stage case-identification method, using a modified General Health Questionnaire (GHQ) and the Clinical Interview Schedule (CIS), was applied in a pilot study of mental disorders in an urban city in Taiwan. The validity of the modified GHQ was proved to be greater than that of the original, with a very high sensitivity and specificity. The Chinese version of the CIS was found to be feasible for community study in Taiwan. The total prevalence rate of all mental disorders was 26·0%, with a higher morbidity among females.