Professor LEE Sing
Hong Kong based bilingual Chinese clinician-psychiatrist, teacher, researcher, advocate and public education leader with some local, regional and international impacts.
One of nine professors of The Chinese University of Hong Kong (CUHK) who have been named by Clarivate Analytics in the list of “Highly Cited Researchers 2018 and 2019”, which identifies the most influential researchers as determined by their peers around the world. The honour is given to researchers who published a high number of papers that rank in the top 1% most-cited in their respective fields of study and year of publication.
Positions and Experience
- Fellow, The Hong Kong Academy of Medicine, 1994.
- Freeman Foundation Fellowship, Department of Social Medicine, Harvard Medical, School, Boston, USA, 1996-7.
- Fellow, Royal College of Psychiatrists (FRCPsych, UK), 1999.
- Lecturer, Department of Global Health and Social Medicine, Harvard Medical School, USA, 1997-2003.
- Advisor to the Eating Disorders Work Group of the DSM-IV (1994), American Psychiatric Association, USA.
- Advisor to Section on Eating Disorders, DSM-Text Revision (2000) Work Group, American Psychiatric Association, USA
- Chairman, Section on classification and diagnostic assessment, World Psychiatric Association (WPA), 1999-2003.
- Director, Hong Kong Eating Disorders Center, The Chinese University of Hong Kong, since 1999.
- Director, Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, since 2001.
- Member of the “Somatic Symptom and Related Disorders” workgroup of the DSM-5, American Psychiatric Association, USA, 2006-2013.
- Asia-Pacific regional coordinator, World Mental Health Initiative; previously Chief Scientific Advisor, World Mental Health Survey in China (Beijing, Shanghai), organized by Harvard School of Public Health and World Health Organization, since 2000.
- Member of the College surveys and interventions workgroup of the World Mental Health Initiative, working with Dr Arthur Mak in the same department to address the mounting problem of college student suicide in Hong Kong, since 2016.
- A member of the Scientific Advisory Board of the Precision Treatment of Mental Disorders (PTMD) Initiative led by Professor Ron Kessler at Harvard Medical School. This is a web based worldwide attempt to predict response to specific types of treatments in an effort to help provide clinical decision support for future treatment selection, since 2017.
I have been teaching clinical year medical students and supervising psychiatric residents for three decades at the Department of Psychiatry, Faculty of Medicine, CUHK. Apart from seminars, workshops, and tutorials, this took the form of a weekly teaching round that dedicates 2-3 hours to discussing a single patient or scenario presented by medical students and/or psychiatric trainees. The discussion emphasized the emergent nature of psychopathology, complexity of treatment and outcomes, as well as the empathic understanding of patients’ reaction (illness) to their symptoms (disease) and coping in their local worlds.
General research profile
Social, cultural and epidemiological psychiatry, with over 300 academic publications as well as a series of books written in Chinese for the local community.
Research highlights and impacts
- Eating disorders and culture: The emergence of eating disorders in Chinese society, especially non-fat phobic anorexia nervosa and its implication on diagnosis and cross-cultural psychopathology. The finding that fat phobia is not always present in anorexic patients has subsequently been replicated in countries around the world, including in the USA. Because of my research, I became Advisors to the Eating Disorders Work Group of the DSM-IV (1994) and the DSM-Text Revision (2000) Work Group, American Psychiatric Association. The concept of non-fat phobia has been incorporated into the DSM 5 diagnosis of anorexia nervosa. In a landmark study of the medium term outcome of Chinese patients with anorexia nervosa published in the American Journal of Psychiatry, I further showed that cultural factors not only shaped the form of the anorexic illness, but also impacted on its course, specifically, its transformation into bulimia nervosa. This indicates a dialectical relationship between culture and psychopathology (selective publication #1, #2, #3 and #4). Because of the lack of specialist service, public education, and support groups for eating disorder sufferers and their family members, I have set up the Hong Kong Eating Disorders Centre at the university, and the Hong Kong Eating Disorders Association which is an NGO that provides counseling service, monthly parent support groups and public education.
- The transformative relationship between neurasthenia and depression in China: showing that economic reform and social change construct the experience, manifestation and biomedical configuration of somatic and psychological distress. Likewise, the experience of distress, disorders and their classification reflect social and structural changes in society including the psychiatric profession itself. Because of my interest in psychiatric diagnosis, I became Chairman, Section on classification and diagnostic assessment, World Psychiatric Association (WPA), 1999-2003. Moreover, because of my research on somatization and the relationship between somatic and psychological distress, I became a member of the “Somatic Symptom and Related Disorders” workgroup of the DSM-5, American Psychiatric Association, 2006-2013 (selective publication #5, #6, #7, #8 and #9).
- Community psychiatric epidemiological surveys in Hong Kong, Beijing, Shanghai and Shenzhen, China: indicating that contrary to the findings of decades of previous surveys, mental disorders have become common and exhibit a globally recognizable pattern of correlates in China. Being the Asia-Pacific regional Coordinator of The World Mental Health Initiative, I have helped utilize China surveys data in a large series of both country-specific and cross-national studies – a needed step given the enormous population of China in the world (see WHM publications for an extended series of publications in world leading journals such as Lancet, World Psychiatry and JAMA Psychiatry). In regard to the high prevalence and severe under-treatment of mental disorders demonstrated in my research, I set up and directed the Hong Kong Mood Disorders Centre at the university in 2001. This Centre has conducted and published a series of community psychiatric surveys showing nearly all specific forms of emotional illnesses (such as panic disorder, social anxiety disorder, generalized anxiety disorder, bipolar and non-bipolar depression) are as common in Hong Kong as they are in developed countries (e.g., selective publication #10 and #11). It has conducted skills focussed training of over 600 general and non-psychiatric specialist practitioners in primary care (including 17 clinical psychologists who worked at the Centre), and extensive mental health public education and advocacy in Hong Kong. The training of doctors has emphasized practical psychoeducational skills and the empathic consideration of patients’ subjective experience of illness and treatment. Primary care doctors are playing a greater role in the management of common mental disorders in Hong Kong today. It has been generally felt that the extensive public health education and training of doctors the Centre has conducted could have enhanced the landscape of primary mental health care in Hong Kong.
- Application of combined qualitative and quantitative methods in studying how Chinese psychiatric patients experience hurtful social stigma and disempowering side effects of psychotropic medications because of structural discrimination specific to our community (selective publication #12, #13 and #14). In connection with such research, I set up the Hong Kong Family Link Mental Health Advocacy Association in 2000 with the help of an academic social worker (Dr Marcus Chiu of Baptist University then). This is an NGO that advocates for the betterment of the mentally ill. Using a “train-the-trainer” model and an eight modular locally devised psychoeducational course, the Association has by 2018 empowered and trained about 1,500 family members of psychiatric patients. The benefits of the course, which extended to other Asian communities, were empirically demonstrable (selective publication #15).
Mak ADP, Wu JCY, Chan Y, Tse YK, Lee S. Associations between Gastro-oesophageal Reflux Disease, Generalised Anxiety Disorder, Major Depressive Episodes, and Healthcare Utilisation: a Community-based Study. East Asian Arch Psychiatry. 2019 Jun;29(2):41-47.
Mak AD, Chung VCH, Yuen SY, Tse YK, Wong SYS, Ju Y, Hung SS, Leung KC, You JHS, Lui R, Wong SH, Leung ONW, Lam LCW, Lee S, Wu JCY. Noneffectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome. J Gastroenterol Hepatol. 2019 Mar 19.
- Lee S, Ho TP, and LKG Hsu (1993) Fat phobic and non-fat phobic anorexia nervosa - a comparative study of 70 Chinese patients in Hong Kong. Psychological Medicine, 23, 999-1017.
- Lee S, Chan YYL, and Hsu LKG (2003) The intermediate term outcome of Chinese patients with anorexia nervosa in Hong Kong. American Journal of Psychiatry, 160, 967-972.
- Lee S (1996) Reconsidering the status of anorexia nervosa as a Western culture-bound syndrome. Social Science & Medicine, 42, 21-34.
- Lee S (1999) Fat, fatigue and the feminine: The changing cultural experience of women in Hong Kong. Culture, Medicine & Psychiatry, 23, 51-73.
- Lee S (2011) Depression: Coming of age in China. In: Kleinman A, Yan YX, Jing J, Lee S, Zhang E, Pan TS, Wu F, and Guo JH. Deep China - The Moral Life of the Person: What Anthropology and Psychiatry Tell Us About China Today. Berkeley: University of California Press.
- Lee S, Yu H, Wing YK et al (2000) Psychiatric morbidity and illness experience of primary care patients with chronic fatigue in Hong Kong. American Journal of Psychiatry, 157, 380-384.
- Lee S (1996) Cultures in psychiatric nosology: the CCMD-2-R and international classification of mental disorders. Culture, Medicine & Psychiatry, 20, 421-472.
- Lee S (1998) Higher earnings, bursting trains, and exhausted bodies: The creation of travelling psychosis in post-reform China. Social Science & Medicine, 47, 1247-1261.
- Lee S, Creed FH, Ma YL, Leung CM (2015). Somatic symptom burden and health anxiety in the population and their correlates. Journal of Psychosomatic Research, 78, 71-76.
- Lee S, Lee MTY, and Kwok K (2005) A community-based telephone survey of social anxiety disorder in Hong Kong. Journal of Affective Disorders, 88, 183-186.
- Lee S, Tsang A, and Kwok K (2005) A community-based telephone survey of panic disorder in Hong Kong. Depression and Anxiety, 22, 77-83.
- Lee S, Chiu MYL, Tsang A, Chui H, and Kleinman A (2006) Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science and Medicine, 62, 1685-1696.Lee S, Chiu MYL, Tsang A, Chui H, and Kleinman A (2006) Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science and Medicine, 62, 1685-1696.
- Lee S, Chan LYY, Chan AMY, Kwok KPS, and Kleinman A (2005) The experience of SARS-related stigma at Amoy Gardens. Social Science and Medicine, 61, 2038-2046.
- Lee S, Lee MTY, Chiu MYL, and Kleinman A (2005) Experience of social stigma by people with schizophrenia in Hong Kong. British Journal of Psychiatry, 186, 153-157.
- Chiu M, Wei G, and Lee S (2006) Personal tragedy or system failure – a qualitative analysis of narratives of caregivers of people with severe mental illness in Hong Kong and Taiwan. International Journal of Psychiatry, 52, 413-423.