Childhood maltreatment of various types has been associated with onset of depression in adults. Previous epidemiological studies in Asian countries have confirmed a high level of childhood maltreatment, especially physical maltreatment. Yet, depression appears to be less prevalent in Asian countries than in western cultures. This study aimed to investigate the protective effect of a Chinese cultural factor, namely filial piety, against clinical depression. The study also aimed to examine the relation between filial piety, childhood maltreatment-specific inferences and adult inferential styles, so as to understand the mechanism of how filial piety protects against depression in Chinese population. Depressed outpatients (n = 80) and community controls (n = 80) were recruited from a psychiatric out-patient clinic and from community centres respectively. The two groups were compared on levels of filial piety, adult inferential styles and levels of childhood maltreatment. Depressed participants, compared to community controls, had higher levels of reported experiences of childhood maltreatment and lower levels of filial piety. Filial piety moderates adult negative inferential style and global belief of maltreatment through interacting with reported experiences of childhood maltreatment. Such moderation effect was found only in physical and emotional child maltreatment experiences, but not in sexual child maltreatment. Filial piety might be a protective factor against depression through its moderating effect on explanations and global belief of childhood maltreatment experiences.
[Copyright of Informa Healthcare. Full article may be available at the publisher's website:
http://dx.doi.org/10.3109/09540261.2010.544645]

The Hospital Authority employs over 60,000 staff and manages 41 public hospitals and institutions, 47 specialist outpatient clinics and 74 general outpatient clinics throughout Hong Kong. It received HK$41.14 billion (L3.475 billion) of funding from the government in the year 2012 to 2013, which represented 92% of its funding income (Census & Statistics Department, 2013). This public healthcare system uses 3% of the Hong Kong gross domestic product (GDP) to provide 88% of inpatient services and 28% outpatient services locally, while the private sector provides only 12% of inpatient services and 72% of outpatient services with 2.3% of GDP. There is a heavy reliance on the public sector to provide healthcare to most of the patients requiring more intensive hospitalization. Hong Kong currently only has about 280 specialists in psychiatry serving a population of over 7 million people, of whom 90 work in the private sector. According to the World Health Organization (WHO) Mental Health Atlas 2011 country profiles (WHO, 2011), the number of psychiatrists per 100,000 population is 4.39, compared to 12.76 in Australia, 10.1 in Japan, 5.12 in Korea, and 2.81 in Singapore. There is a shortage of psychiatrists, especially in the public mental health sector, which urgently needs to be tackled. This article looks at the current trend in psychiatry teaching and recruitment from medical school and the training scheme provided by the Hong Kong College of Psychiatrists.
[Copyright of International Review of Psychiatry is the property of Informa Healthcare. Full article may be available at the publisher's website:
http://dx.doi.org/10.3109/09540261.2013.816656]