Ymkje Anna de Vries1, Meredith G Harris2, Daniel Vigo3, Wai Tat Chiu4, Nancy A Sampson4, Ali Al-Hamzawi5, Jordi Alonso6, Laura H Andrade7, Corina Benjet8, Ronny Bruffaerts9, Brendan Bunting10, José Miguel Caldas de Almeida11, Giovanni de Girolamo12, Silvia Florescu13, Oye Gureje14, Josep Maria Haro15, Chiyi Hu16, Elie G Karam17, Norito Kawakami18, Viviane Kovess-Masfety19, Sing Lee20, Jacek Moskalewicz21, Fernando Navarro-Mateu22, Akin Ojagbemi23, José Posada-Villa24, Kate Scott25, Yolanda Torres26, Zahari Zarkov27, Andrew Nierenberg28, Ronald C Kessler29, Peter de Jonge30. 1. Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, the Netherlands. 2. School of Public Health, The University of Queensland, Herston, QLD 4006, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, QLD 4072, Australia. 3. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. 4. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 5. College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq. 6. Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain. 7. Núcleo de Epidemiologia Psiquiátrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil; Section of Psychiatric Epidemiology - LIM 23, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 8. Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 9. Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium. 10. School of Psychology, Ulster University, Londonderry, United Kingdom. 11. Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal. 12. IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. 13. National School of Public Health, Management and Development, Bucharest, Romania. 14. Department of Psychiatry, University College Hospital, Ibadan, Nigeria. 15. Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain; Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia. 16. Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China. 17. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon; Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon. 18. Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan. 19. Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France. 20. Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong. 21. Institute of Psychiatry and Neurology, Warsaw, Poland. 22. UDIF-SM, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Región de Murcia, Spain. 23. Department of Psychiatry, University of Ibadan, Nigeria. 24. Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia (Cundinamarca University, calle 28 # 5B 02, Bogotá, 11001000 (zip), Colombia. 25. Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand. 26. Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia. 27. Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria. 28. Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA. 29. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. Electronic address: kessler@hcp.med.harvard.edu. 30. Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands.
Abstract
BACKGROUND: Although randomized trials show that specific phobia treatments can be effective, it is unclear whether patients experience treatment as helpful in clinical practice. We investigated this issue by assessing perceived treatment helpfulness for specific phobia in a cross-national epidemiological survey. METHODS: Cross-sectional population-based WHO World Mental Health (WMH) surveys in 24 countries (n=112,507) assessed lifetime specific phobia. Respondents who met lifetime criteria were asked whether they ever received treatment they considered helpful and the number of professionals seen up to the time of receiving helpful treatment. Discrete-event survival analysis was used to calculate conditional-cumulative probabilities of obtaining helpful treatment across number of professionals seen and of persisting in help-seeking after prior unhelpful treatment. RESULTS: 23.0% of respondents reported receiving helpful treatment from the first professional seen, whereas cumulative probability of receiving helpful treatment was 85.7% after seeing up to 9 professionals. However, only 14.7% of patients persisted in seeing up to 9 professionals, resulting in the proportion of patients ever receiving helpful treatment (47.5%) being much lower than it could have been with persistence in help-seeking. Few predictors were found either of perceived helpfulness or of persistence in help-seeking after earlier unhelpful treatments. LIMITATIONS: Retrospective recall and lack of information about either types of treatments received or objective symptomatic improvements limit results. CONCLUSIONS: Despite these limitations, results suggest that helpfulness of specific phobia treatment could be increased, perhaps substantially, by increasing patient persistence in help-seeking after earlier unhelpful treatments. Improved understanding is needed of barriers to help-seeking persistence.
BACKGROUND: Although randomized trials show that specific phobia treatments can be effective, it is unclear whether patients experience treatment as helpful in clinical practice. We investigated this issue by assessing perceived treatment helpfulness for specific phobia in a cross-national epidemiological survey. METHODS: Cross-sectional population-based WHO World Mental Health (WMH) surveys in 24 countries (n=112,507) assessed lifetime specific phobia. Respondents who met lifetime criteria were asked whether they ever received treatment they considered helpful and the number of professionals seen up to the time of receiving helpful treatment. Discrete-event survival analysis was used to calculate conditional-cumulative probabilities of obtaining helpful treatment across number of professionals seen and of persisting in help-seeking after prior unhelpful treatment. RESULTS: 23.0% of respondents reported receiving helpful treatment from the first professional seen, whereas cumulative probability of receiving helpful treatment was 85.7% after seeing up to 9 professionals. However, only 14.7% of patients persisted in seeing up to 9 professionals, resulting in the proportion of patients ever receiving helpful treatment (47.5%) being much lower than it could have been with persistence in help-seeking. Few predictors were found either of perceived helpfulness or of persistence in help-seeking after earlier unhelpful treatments. LIMITATIONS: Retrospective recall and lack of information about either types of treatments received or objective symptomatic improvements limit results. CONCLUSIONS: Despite these limitations, results suggest that helpfulness of specific phobia treatment could be increased, perhaps substantially, by increasing patient persistence in help-seeking after earlier unhelpful treatments. Improved understanding is needed of barriers to help-seeking persistence.
Authors: Meredith G Harris; Alan E Kazdin; Wai Tat Chiu; Nancy A Sampson; Sergio Aguilar-Gaxiola; Ali Al-Hamzawi; Jordi Alonso; Yasmin Altwaijri; Laura Helena Andrade; Graça Cardoso; Alfredo Cía; Silvia Florescu; Oye Gureje; Chiyi Hu; Elie G Karam; Georges Karam; Zeina Mneimneh; Fernando Navarro-Mateu; Bibilola D Oladeji; Siobhan O'Neill; Kate Scott; Tim Slade; Yolanda Torres; Daniel Vigo; Bogdan Wojtyniak; Zahari Zarkov; Yuval Ziv; Ronald C Kessler Journal: JAMA Psychiatry Date: 2020-08-01 Impact factor: 21.596
Authors: K J Wardenaar; C C W Lim; A O Al-Hamzawi; J Alonso; L H Andrade; C Benjet; B Bunting; G de Girolamo; K Demyttenaere; S E Florescu; O Gureje; T Hisateru; C Hu; Y Huang; E Karam; A Kiejna; J P Lepine; F Navarro-Mateu; M Oakley Browne; M Piazza; J Posada-Villa; M L Ten Have; Y Torres; M Xavier; Z Zarkov; R C Kessler; K M Scott; P de Jonge Journal: Psychol Med Date: 2017-02-22 Impact factor: 7.723
Authors: Josep Maria Haro; Saena Arbabzadeh-Bouchez; Traolach S Brugha; Giovanni de Girolamo; Margaret E Guyer; Robert Jin; Jean Pierre Lepine; Fausto Mazzi; Blanca Reneses; Gemma Vilagut; Nancy A Sampson; Ronald C Kessler Journal: Int J Methods Psychiatr Res Date: 2006 Impact factor: 4.035
Authors: Ymkje Anna de Vries; Annelieke M Roest; Elisabeth H Bos; Johannes G M Burgerhof; Hanna M van Loo; Peter de Jonge Journal: Br J Psychiatry Date: 2018-06-28 Impact factor: 9.319
Authors: Ronny Bruffaerts; Meredith G Harris; Alan E Kazdin; Daniel V Vigo; Nancy A Sampson; Wai Tat Chiu; Ali Al-Hamzawi; Jordi Alonso; Yasmin A Altwaijri; Laura Andrade; Corina Benjet; Giovanni de Girolamo; Silvia Florescu; Josep Maria Haro; Chi-Yi Hu; Aimee Karam; Elie G Karam; Viviane Kovess-Masfety; Sing Lee; John J McGrath; Fernando Navarro-Mateu; Daisuke Nishi; Siobhan O'Neill; José Posada-Villa; Kate M Scott; Margreet Ten Have; Yolanda Torres; Bogdan Wojtyniak; Miguel Xavier; Zahari Zarkov; Ronald C Kessler Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2022-03-09 Impact factor: 4.519
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
Authors: Dan J Stein; Alan E Kazdin; Ayelet Meron Ruscio; Wai Tat Chiu; Nancy A Sampson; Hannah N Ziobrowski; Sergio Aguilar-Gaxiola; Ali Al-Hamzawi; Jordi Alonso; Yasmin Altwaijri; Ronny Bruffaerts; Brendan Bunting; Giovanni de Girolamo; Peter de Jonge; Louisa Degenhardt; Oye Gureje; Josep Maria Haro; Meredith G Harris; Aimee Karam; Elie G Karam; Viviane Kovess-Masfety; Sing Lee; Maria Elena Medina-Mora; Jacek Moskalewicz; Fernando Navarro-Mateu; Daisuke Nishi; José Posada-Villa; Kate M Scott; Maria Carmen Viana; Daniel V Vigo; Miguel Xavier; Zahari Zarkov; Ronald C Kessler Journal: BMC Psychiatry Date: 2021-08-09 Impact factor: 3.630