CONTEXT: Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. OBJECTIVE: To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. DESIGN, SETTING, AND PARTICIPANTS: Face-to-face household surveys of 60 463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. MAIN OUTCOME MEASURES: The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview. RESULTS: The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5% to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country. CONCLUSIONS: Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases, especially those at risk for progressing to more serious disorders.
CONTEXT: Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. OBJECTIVE: To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. DESIGN, SETTING, AND PARTICIPANTS: Face-to-face household surveys of 60 463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. MAIN OUTCOME MEASURES: The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview. RESULTS: The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5% to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country. CONCLUSIONS: Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases, especially those at risk for progressing to more serious disorders.
Authors: Ronny Bruffaerts; Jose Posada-Villa; Ali Obaid Al-Hamzawi; Oye Gureje; Yueqin Huang; Chiyi Hu; Evelyn J Bromet; Maria Carmen Viana; Hristo Ruskov Hinkov; Elie G Karam; Guilherme Borges; Silvia E Florescu; David R Williams; Koen Demyttenaere; Viviane Kovess-Masfety; Herbert Matschinger; Daphna Levinson; Giovanni de Girolamo; Yutaka Ono; Ron de Graaf; Mark Oakley Browne; Brendan Bunting; Miguel Xavier; Josep Maria Haro; Ronald C Kessler Journal: Br J Psychiatry Date: 2014-11-13 Impact factor: 9.319
Authors: Katharine A Phillips; Dan J Stein; Scott L Rauch; Eric Hollander; Brian A Fallon; Arthur Barsky; Naomi Fineberg; David Mataix-Cols; Ygor Arzeno Ferrão; Sanjaya Saxena; Sabine Wilhelm; Megan M Kelly; Lee Anna Clark; Anthony Pinto; O Joseph Bienvenu; Joanne Farrow; James Leckman Journal: Depress Anxiety Date: 2010-06 Impact factor: 6.505
Authors: Karen D Lincoln; Robert Joseph Taylor; Linda M Chatters; Sean Joe Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2012-04-26 Impact factor: 4.328
Authors: K M Scott; R Bruffaerts; G E Simon; J Alonso; M Angermeyer; G de Girolamo; K Demyttenaere; I Gasquet; J M Haro; E Karam; R C Kessler; D Levinson; M E Medina Mora; M A Oakley Browne; J Ormel; J P Villa; H Uda; M Von Korff Journal: Int J Obes (Lond) Date: 2007-08-21 Impact factor: 5.095