Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries
Abstract BACKGROUND: Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12-month DSM-IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proporti...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2018 |
| País: | España |
| Recursos: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/132365 |
| Acesso em linha: | https://hdl.handle.net/2445/132365 |
| Access Level: | acceso abierto |
| Palavra-chave: | Ansietat Enquestes Serveis sanitaris Anxiety Surveys Health services |
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Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countriesAlonso Caballero, JordiLiu, ZhaoruiEvans Lacko, SaraSadikova, EkaterinaSampson, Nancy A.Chatterji, SomnathAbdulmalik, JibrilAguilar Gaxiola, SergioAl-Hamzawi, Ali ObaidAndrade, Laura HelenaBruffaerts, RonnyCardoso, GraçaCia, Alfredo H.Florescu, Silvia E.Girolamo, Giovanni deGureje, OyeHaro Abad, Josep MariaHe, YanlingJonge, Peter deKaram, Elie GeorgesKawakami, NoritoKovess-Masfety, VivianeLee, SingLevinson, DaphnaMedina Mora, Maria ElenaNavarro Mateu, FernandoPennell, Beth-EllenPiazza, MarinaPosada Villa, JoséHave, Margreet tenZarkov, ZahariKessler, Ronald C.Thornicroft, GrahamWHO World Mental Health Survey CollaboratorsAnsietatEnquestesServeis sanitarisAnxietySurveysHealth servicesAbstract BACKGROUND: Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12-month DSM-IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proportion who (i) perceived a need for treatment; (ii) received any treatment; and (iii) received possibly adequate treatment. METHODS: Data from 23 community surveys in 21 countries of the World Mental Health (WMH) surveys. DSM-IV mental disorders were assessed (WHO Composite International Diagnostic Interview, CIDI 3.0). DSM-IV included posttraumatic stress disorder among anxiety disorders, while it is not considered so in the DSM-5. We asked if, in the previous 12 months, respondents felt they needed professional treatment and if they obtained professional treatment (specialized/general medical, complementary alternative medical, or nonmedical professional) for 'problems with emotions, nerves, mental health, or use of alcohol or drugs.' Possibly adequate treatment was defined as receiving pharmacotherapy (1+ months of medication and 4+ visits to a medical doctor) or psychotherapy, complementary alternative medicine or nonmedical care (8+ visits). RESULTS: Of 51,547 respondents (response = 71.3%), 9.8% had a 12-month DSM-IV anxiety disorder, 27.6% of whom received any treatment, and only 9.8% received possibly adequate treatment. Of those with 12-month anxiety only 41.3% perceived a need for care. Lower treatment levels were found for lower income countries. CONCLUSIONS: Low levels of service use and a high proportion of those receiving services not meeting adequacy standards for anxiety disorders exist worldwide. Results suggest the need for improving recognition of anxiety disorders and the quality of treatment.Wiley2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/132365Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1002/da.22711Depression and Anxiety, 2018, vol. 35, num. 3, p. 195-208https://doi.org/10.1002/da.22711info:eu-repo/grantAgreement/EC/FP7/337673(c) Wiley, 2018info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1323652026-05-27T06:46:51Z |
| dc.title.none.fl_str_mv |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| title |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| spellingShingle |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries Alonso Caballero, Jordi Ansietat Enquestes Serveis sanitaris Anxiety Surveys Health services |
| title_short |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| title_full |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| title_fullStr |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| title_full_unstemmed |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| title_sort |
Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries |
| dc.creator.none.fl_str_mv |
Alonso Caballero, Jordi Liu, Zhaorui Evans Lacko, Sara Sadikova, Ekaterina Sampson, Nancy A. Chatterji, Somnath Abdulmalik, Jibril Aguilar Gaxiola, Sergio Al-Hamzawi, Ali Obaid Andrade, Laura Helena Bruffaerts, Ronny Cardoso, Graça Cia, Alfredo H. Florescu, Silvia E. Girolamo, Giovanni de Gureje, Oye Haro Abad, Josep Maria He, Yanling Jonge, Peter de Karam, Elie Georges Kawakami, Norito Kovess-Masfety, Viviane Lee, Sing Levinson, Daphna Medina Mora, Maria Elena Navarro Mateu, Fernando Pennell, Beth-Ellen Piazza, Marina Posada Villa, José Have, Margreet ten Zarkov, Zahari Kessler, Ronald C. Thornicroft, Graham WHO World Mental Health Survey Collaborators |
| author |
Alonso Caballero, Jordi |
| author_facet |
Alonso Caballero, Jordi Liu, Zhaorui Evans Lacko, Sara Sadikova, Ekaterina Sampson, Nancy A. Chatterji, Somnath Abdulmalik, Jibril Aguilar Gaxiola, Sergio Al-Hamzawi, Ali Obaid Andrade, Laura Helena Bruffaerts, Ronny Cardoso, Graça Cia, Alfredo H. Florescu, Silvia E. Girolamo, Giovanni de Gureje, Oye Haro Abad, Josep Maria He, Yanling Jonge, Peter de Karam, Elie Georges Kawakami, Norito Kovess-Masfety, Viviane Lee, Sing Levinson, Daphna Medina Mora, Maria Elena Navarro Mateu, Fernando Pennell, Beth-Ellen Piazza, Marina Posada Villa, José Have, Margreet ten Zarkov, Zahari Kessler, Ronald C. Thornicroft, Graham WHO World Mental Health Survey Collaborators |
| author_role |
author |
| author2 |
Liu, Zhaorui Evans Lacko, Sara Sadikova, Ekaterina Sampson, Nancy A. Chatterji, Somnath Abdulmalik, Jibril Aguilar Gaxiola, Sergio Al-Hamzawi, Ali Obaid Andrade, Laura Helena Bruffaerts, Ronny Cardoso, Graça Cia, Alfredo H. Florescu, Silvia E. Girolamo, Giovanni de Gureje, Oye Haro Abad, Josep Maria He, Yanling Jonge, Peter de Karam, Elie Georges Kawakami, Norito Kovess-Masfety, Viviane Lee, Sing Levinson, Daphna Medina Mora, Maria Elena Navarro Mateu, Fernando Pennell, Beth-Ellen Piazza, Marina Posada Villa, José Have, Margreet ten Zarkov, Zahari Kessler, Ronald C. Thornicroft, Graham WHO World Mental Health Survey Collaborators |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Ansietat Enquestes Serveis sanitaris Anxiety Surveys Health services |
| topic |
Ansietat Enquestes Serveis sanitaris Anxiety Surveys Health services |
| description |
Abstract BACKGROUND: Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12-month DSM-IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proportion who (i) perceived a need for treatment; (ii) received any treatment; and (iii) received possibly adequate treatment. METHODS: Data from 23 community surveys in 21 countries of the World Mental Health (WMH) surveys. DSM-IV mental disorders were assessed (WHO Composite International Diagnostic Interview, CIDI 3.0). DSM-IV included posttraumatic stress disorder among anxiety disorders, while it is not considered so in the DSM-5. We asked if, in the previous 12 months, respondents felt they needed professional treatment and if they obtained professional treatment (specialized/general medical, complementary alternative medical, or nonmedical professional) for 'problems with emotions, nerves, mental health, or use of alcohol or drugs.' Possibly adequate treatment was defined as receiving pharmacotherapy (1+ months of medication and 4+ visits to a medical doctor) or psychotherapy, complementary alternative medicine or nonmedical care (8+ visits). RESULTS: Of 51,547 respondents (response = 71.3%), 9.8% had a 12-month DSM-IV anxiety disorder, 27.6% of whom received any treatment, and only 9.8% received possibly adequate treatment. Of those with 12-month anxiety only 41.3% perceived a need for care. Lower treatment levels were found for lower income countries. CONCLUSIONS: Low levels of service use and a high proportion of those receiving services not meeting adequacy standards for anxiety disorders exist worldwide. Results suggest the need for improving recognition of anxiety disorders and the quality of treatment. |
| publishDate |
2018 |
| dc.date.none.fl_str_mv |
2018 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion |
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article |
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acceptedVersion |
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https://hdl.handle.net/2445/132365 |
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https://hdl.handle.net/2445/132365 |
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Inglés |
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Inglés |
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Versió postprint del document publicat a: https://doi.org/10.1002/da.22711 Depression and Anxiety, 2018, vol. 35, num. 3, p. 195-208 https://doi.org/10.1002/da.22711 info:eu-repo/grantAgreement/EC/FP7/337673 |
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(c) Wiley, 2018 info:eu-repo/semantics/openAccess |
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(c) Wiley, 2018 |
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openAccess |
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application/pdf |
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Wiley |
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Wiley |
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Articles publicats en revistes (Medicina) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona |
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Universidad de Barcelona |
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Dipòsit Digital de la UB |
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Dipòsit Digital de la UB |
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