Andrew A Nierenberg1,2, Meredith G Harris3,4, Alan E Kazdin5, Victor Puac-Polanco6, Nancy Sampson6, Daniel V Vigo7,8, Wai Tat Chiu6, Hannah N Ziobrowski6, Jordi Alonso9,10,11, Yasmin Altwaijri12, Guilherme Borges13, Brendan Bunting14, José Miguel Caldas-de-Almeida15, Josep Maria Haro16,17, Chi-Yi Hu18, Andrzej Kiejna19, Sing Lee20, John J McGrath21,22,23, Fernando Navarro-Mateu24,25,26, José Posada-Villa27, Kate M Scott28, Juan C Stagnaro29, Maria C Viana30, Ronald C Kessler6. 1. Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 3. School of Public Health, The University of Queensland, Herston, QLD, Australia. 4. Queensland Centre for Mental Health Research, The Park Centre for Mental Health, QLD, Australia. 5. Department of Psychology, Yale University, New Haven, CT, USA. 6. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 7. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. 8. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. 9. Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. 10. CIBER en Epidemiología y Salud Pública (CIBERESP), Spain. 11. Pompeu Fabra University (UPF), Barcelona, Spain. 12. Epidemiology Section, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 13. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 14. School of Psychology, Ulster University, Londonderry, United Kingdom. 15. Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal. 16. Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain. 17. Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia. 18. Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China. 19. Psychology Research Unit for Public Health, WSB University, Torun, Poland. 20. Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong. 21. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark. 22. Queensland Brain Institute, University of Queensland, St. Lucia, QLD, Australia. 23. Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia. 24. UDIF-SM, Servicio Murciano de Salud, Murcia, Spain. 25. IMIB-Arrixaca, Murcia, Spain. 26. CIBERESP, Murcia, Spain. 27. Faculty of Social Sciences, Colegio Mayor de Cundinamarca University, Bogota, Colombia. 28. Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand. 29. Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina. 30. Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil.
Abstract
OBJECTIVES: To examine patterns and predictors of perceived treatment helpfulness for mania/hypomania and associated depression in the WHO World Mental Health Surveys. METHODS: Face-to-face interviews with community samples across 15 countries found n = 2,178 who received lifetime mania/hypomania treatment and n = 624 with lifetime mania/hypomania who received lifetime major depression treatment. These respondents were asked whether treatment was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Patterns and predictors of treatment helpfulness were examined separately for mania/hypomania and depression. RESULTS: 63.1% (mania/hypomania) and 65.1% (depression) of patients reported ever receiving helpful treatment. However, only 24.5-22.5% were helped by the first professional seen, which means that the others needed to persist in help seeking after initial unhelpful treatments in order to find helpful treatment. Projections find only 22.9% (mania/hypomania) and 43.3% (depression) would persist through a series of unhelpful treatments but that the proportion helped would increase substantially if persistence increased. Few patient-level significant predictors of helpful treatment emerged and none consistently either across the two components (i.e., provider-level helpfulness and persistence after earlier unhelpful treatment) or for both mania/hypomania and depression. Although prevalence of treatment was higher in high-income than low/middle-income countries, proportional helpfulness among treated cases was nearly identical in the two groups of countries. CONCLUSIONS: Probability of patients with mania/hypomania and associated depression obtaining helpful treatment might increase substantially if persistence in help-seeking increased after initially unhelpful treatments, although this could require seeing numerous additional treatment providers. In addition to investigating reasons for initial treatments not being helpful, messages reinforcing the importance of persistence should be emphasized to patients.
OBJECTIVES: To examine patterns and predictors of perceived treatment helpfulness for mania/hypomania and associated depression in the WHO World Mental Health Surveys. METHODS: Face-to-face interviews with community samples across 15 countries found n = 2,178 who received lifetime mania/hypomania treatment and n = 624 with lifetime mania/hypomania who received lifetime major depression treatment. These respondents were asked whether treatment was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Patterns and predictors of treatment helpfulness were examined separately for mania/hypomania and depression. RESULTS: 63.1% (mania/hypomania) and 65.1% (depression) of patients reported ever receiving helpful treatment. However, only 24.5-22.5% were helped by the first professional seen, which means that the others needed to persist in help seeking after initial unhelpful treatments in order to find helpful treatment. Projections find only 22.9% (mania/hypomania) and 43.3% (depression) would persist through a series of unhelpful treatments but that the proportion helped would increase substantially if persistence increased. Few patient-level significant predictors of helpful treatment emerged and none consistently either across the two components (i.e., provider-level helpfulness and persistence after earlier unhelpful treatment) or for both mania/hypomania and depression. Although prevalence of treatment was higher in high-income than low/middle-income countries, proportional helpfulness among treated cases was nearly identical in the two groups of countries. CONCLUSIONS: Probability of patients with mania/hypomania and associated depression obtaining helpful treatment might increase substantially if persistence in help-seeking increased after initially unhelpful treatments, although this could require seeing numerous additional treatment providers. In addition to investigating reasons for initial treatments not being helpful, messages reinforcing the importance of persistence should be emphasized to patients.
Authors: Ronald C Kessler; Katie A McLaughlin; Jennifer Greif Green; Michael J Gruber; Nancy A Sampson; Alan M Zaslavsky; Sergio Aguilar-Gaxiola; Ali Obaid Alhamzawi; Jordi Alonso; Matthias Angermeyer; Corina Benjet; Evelyn Bromet; Somnath Chatterji; Giovanni de Girolamo; Koen Demyttenaere; John Fayyad; Silvia Florescu; Gilad Gal; Oye Gureje; Josep Maria Haro; Chi-Yi Hu; Elie G Karam; Norito Kawakami; Sing Lee; Jean-Pierre Lépine; Johan Ormel; José Posada-Villa; Rajesh Sagar; Adley Tsang; T Bedirhan Ustün; Svetlozar Vassilev; Maria Carmen Viana; David R Williams Journal: Br J Psychiatry Date: 2010-11 Impact factor: 9.319
Authors: Lakshmi N Yatham; Sidney H Kennedy; Sagar V Parikh; Ayal Schaffer; David J Bond; Benicio N Frey; Verinder Sharma; Benjamin I Goldstein; Soham Rej; Serge Beaulieu; Martin Alda; Glenda MacQueen; Roumen V Milev; Arun Ravindran; Claire O'Donovan; Diane McIntosh; Raymond W Lam; Gustavo Vazquez; Flavio Kapczinski; Roger S McIntyre; Jan Kozicky; Shigenobu Kanba; Beny Lafer; Trisha Suppes; Joseph R Calabrese; Eduard Vieta; Gin Malhi; Robert M Post; Michael Berk Journal: Bipolar Disord Date: 2018-03-14 Impact factor: 6.744
Authors: Sarah Sportiche; Pierre Alexis Geoffroy; Clara Brichant-Petitjean; Sebastien Gard; Jean-Pierre Khan; Jean-Michel Azorin; Chantal Henry; Marion Leboyer; Bruno Etain; Jan Scott; Frank Bellivier Journal: Aust N Z J Psychiatry Date: 2016-08-23 Impact factor: 5.744
Authors: Ronald C Kessler; Alan E Kazdin; Sergio Aguilar-Gaxiola; Ali Al-Hamzawi; Jordi Alonso; Yasmin A Altwaijri; Laura H Andrade; Corina Benjet; Chrianna Bharat; Guilherme Borges; Ronny Bruffaerts; Brendan Bunting; José Miguel Caldas de Almeida; Graça Cardoso; Wai Tat Chiu; Alfredo Cía; Marius Ciutan; Louisa Degenhardt; Giovanni de Girolamo; Peter de Jonge; Ymkje Anna de Vries; Silvia Florescu; Oye Gureje; Josep Maria Haro; Meredith G Harris; Chiyi Hu; Aimee N Karam; Elie G Karam; Georges Karam; Norito Kawakami; Andrzej Kiejna; Viviane Kovess-Masfety; Sing Lee; Victor Makanjuola; John J McGrath; Maria Elena Medina-Mora; Jacek Moskalewicz; Fernando Navarro-Mateu; Andrew A Nierenberg; Daisuke Nishi; Akin Ojagbemi; Bibilola D Oladeji; Siobhan O'Neill; José Posada-Villa; Victor Puac-Polanco; Charlene Rapsey; Ayelet Meron Ruscio; Nancy A Sampson; Kate M Scott; Tim Slade; Juan Carlos Stagnaro; Dan J Stein; Hisateru Tachimori; Margreet Ten Have; Yolanda Torres; Maria Carmen Viana; Daniel V Vigo; David R Williams; Bogdan Wojtyniak; Miguel Xavier; Zahari Zarkov; Hannah N Ziobrowski Journal: World Psychiatry Date: 2022-06 Impact factor: 79.683
Authors: Meredith G Harris; Alan E Kazdin; Richard J Munthali; Daniel V Vigo; Irving Hwang; Nancy A Sampson; Ali Al-Hamzawi; Jordi Alonso; Laura Helena Andrade; Guilherme Borges; Brendan Bunting; Silvia Florescu; Oye Gureje; Elie G Karam; Sing Lee; Fernando Navarro-Mateu; Daisuke Nishi; Charlene Rapsey; Kate M Scott; Juan Carlos Stagnaro; Maria Carmen Viana; Bogdan Wojtyniak; Miguel Xavier; Ronald C Kessler Journal: Int J Ment Health Syst Date: 2022-01-29