Depression and post-traumatic stress during major social unrest in Hong Kong: a 10-year prospective cohort study

Ni, Michael Y.; Yao, Xiaoxin I; Leung, Kathy; Yau, Cynthia; Leung, Candi M C; Lun, Phyllis; Flores, Francis P; Chang, Wing Chung; Cowling, Benjamin J.; Leung, Gabriel M.

doi:10.1016/s0140-6736(19)33160-5

Cited by 218 publications

(195 citation statements)

References 24 publications

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“…Finally, the social movement has created well-being problems in people of Hong Kong. Based on a large community sample, Ni et al (2020) reported that the prevalence of probable depression was 11.2% in 2019 which was much higher than that during 2009-14 (1.9%) and 6.5% after the Occupy Central Movement in 2017. Besides, the estimated PTSD prevalence rate was 12.8%.…”

Section: Impairment Of Quality Of Life and Well-beingmentioning

confidence: 93%

Protests in Hong Kong (2019–2020): a Perspective Based on Quality of Life and Well-Being

Shek

2020

Applied Research Quality Life

110

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Triggered by the Fugitive Offenders and Mutual Legal Assistance in Criminal Matters Legislation (Amendment) Bill 2019 in Hong Kong (Extradition Bill), many protests have taken place in Hong Kong in 2019-2020. Using a perspective based on quality of life and well-being in different ecological systems, it is argued that the process of introducing the Bill is the "heat" which has ignited the "fuels" represented by 12 preexisting and new issues in quality of life and well-being. These issues included distrust in the Central Government, lack of national identity, political dissatisfaction, economic strains, mental health threats, drop in family quality of life, lack of life skills education, lack of evidence-based national education in the formal curriculum, slow response of the Government, and alleged excessive use of force by the police. The fire has been intensified by "four strong winds", including disinformation and misinformation, anonymity of the protesters, public support for the students, and support given by parties outside Hong Kong. Possible solutions in terms of promotion of quality of life and well-being with reference to the fire triangle are discussed.

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Section: Impairment Of Quality Of Life and Well-beingmentioning

confidence: 93%

Protests in Hong Kong (2019–2020): a Perspective Based on Quality of Life and Well-Being

Shek

2020

Applied Research Quality Life

110

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“…The economy of Hong Kong had deteriorated sharply and many businesses closed. The prevalence of depression and post-traumatic stress increased substantially during the period of major social unrest in Hong Kong compared with previously (Ni et al, 2020). Many health and community services for older people have been suspended or much scaled down since the start of the COVID-19 outbreak including mental health services, day hospitals, and daycare services.…”

Section: International Perspectives On the Pandemic And Suicidementioning

confidence: 99%

COVID-19: the implications for suicide in older adults

Wand

Zhong

Chiu

et al. 2020

Int. Psychogeriatr.

163

134

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“…Although the sample recruitment may be biased towards those who are reluctant to seek help from healthcare professionals, this study will provide valuable evidence regarding the utility of proACT-S as a preventive tool for individuals considering face-to-face therapy or who are receptive to lifestyle medicine for depression and insomnia in Hong Kong. Given that all participants in this study are suffering from MDD and insomnia, it is believed distress arising from the prolonged Hong Kong Extradition Bill protests would make them more vulnerable to stress-related disorders, such as mood and sleep disorders [26]. Therefore, the current social turmoil brought about by the Hong Kong Extradition Bill protests may undermine the magnitude of reduction in poor sleep quality, depression severity and insomnia severity after completing this study's treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The Hong Kong extradition protests began in June 2019 (i.e., three months after the recruitment) and have continued since then. The social turmoil arising from the protests is likely to trigger a mental health crisis, as revealed by a longitudinal survey finding that nearly one in ten people in Hong Kong are suffering from probable depression [26]. It is believed that many participants in this study will be affected by the social turmoil, which may have a bearing on the CBT-I efficacy.…”

Section: Study Settingmentioning

confidence: 91%

Treating depression with a smartphone-delivered self-help cognitive behavioural therapy for insomnia: Study protocol for a parallel group randomized controlled trial

Hui

Wong

Ka-Yiu

et al. 2020

Preprint

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Background Depression is a major public health concern. Emerging research has shown that cognitive behavioural therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibility, accessibility, and help-seeking stigma. CBT-I delivered via smartphone application could be a potential solution. This paper aims to report a protocol designed to evaluate the efficacy of a self-help smartphone-based CBT-I, compared to a waitlist control, for people with major depression and insomnia. Methods A two-arm parallel randomized controlled trial is conducted in a target sample of 285 non-suicidal Hong Kong Chinese older than 17 years of age with major depression and insomnia. Participants complete an online rapid screening, followed by a telephone diagnostic interview. Those who meet the eligibility criteria are randomized in a ratio of 1:1 to receive either CBT-I immediately or to a waitlist control condition. The CBT-I consists of six weekly modules and is delivered through a smartphone application proACT-S. This smartphone app has been pilot tested and revamped to improve user experience. An online randomized algorithm is used to perform randomization to ensure allocation concealment. The primary outcomes are changes over the measurement points in sleep quality, insomnia severity, and depression severity. The secondary outcomes include changes over the measurement points in anxiety, subjective health, treatment expectancy, and acceptability of treatment. Assessments are administered at baseline, post-intervention, and 6-week follow up. The recruitment is underway. Important adverse events, if any, are documented. Multilevel linear mixed model based on intention-to-treat principle will be conducted to examine the efficacy of the CBT-I interventions. Discussion It is expected that proACT-S is an efficacious brief sleep-focused self-help treatment for people with major depression and insomnia. If proven efficacious, due to its self-help nature, proACT-S may be applicable as a community-based early intervention, reducing the burden of the public healthcare system in Hong Kong.

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Depression and post-traumatic stress during major social unrest in Hong Kong: a 10-year prospective cohort study

Cited by 218 publications

References 24 publications

Protests in Hong Kong (2019–2020): a Perspective Based on Quality of Life and Well-Being

Protests in Hong Kong (2019–2020): a Perspective Based on Quality of Life and Well-Being

COVID-19: the implications for suicide in older adults

Treating depression with a smartphone-delivered self-help cognitive behavioural therapy for insomnia: Study protocol for a parallel group randomized controlled trial

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