Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries

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...

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Detalhes bibliográficos
Autores: Alonso Caballero, Jordi, WHO World Mental Health Survey Collaborators
Tipo de documento: artigo
Estado:Versión aceptada para publicación
Data de publicação:2018
País:España
Recursos:Universitat Pompeu Fabra
Repositório:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/36426
Acesso em linha:http://hdl.handle.net/10230/36426
http://dx.doi.org/10.1002/da.22711
Access Level:Acceso aberto
Palavra-chave:Adequate treatment
Anxiety disorders
Health services
Perceived need for care
Surveys
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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
Adequate treatment
Anxiety disorders
Health services
Perceived need for care
Surveys
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
WHO World Mental Health Survey Collaborators
author Alonso Caballero, Jordi
author_facet Alonso Caballero, Jordi
WHO World Mental Health Survey Collaborators
author_role author
author2 WHO World Mental Health Survey Collaborators
author2_role author
dc.subject.none.fl_str_mv Adequate treatment
Anxiety disorders
Health services
Perceived need for care
Surveys
topic Adequate treatment
Anxiety disorders
Health services
Perceived need for care
Surveys
description 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
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/36426
http://dx.doi.org/10.1002/da.22711
url http://hdl.handle.net/10230/36426
http://dx.doi.org/10.1002/da.22711
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Depress Anxiety. 2018; 35(3):195-208
info:eu-repo/grantAgreement/EC/FP7/337673
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countriesAlonso Caballero, JordiWHO World Mental Health Survey CollaboratorsAdequate treatmentAnxiety disordersHealth servicesPerceived need for careSurveysBackground: 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.The U.S. National Comorbidity Survey Replication (NCS‐R) is supported by the National Institute of Mental Health (NIMH; U01‐MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA). SEL (Sara Evans‐Lacko) currently holds a Starting Grant from the European Research Council (337673). The Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trust. Dr. Thornicroft is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust. Dr. Thornicroft acknowledges support from the following: the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust; the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit awarded to South London and Maudsley NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust; the European Union Seventh Framework Programme (FP7/2007‐2013) Emerald project.Wiley201920192018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/36426http://dx.doi.org/10.1002/da.22711reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésDepress Anxiety. 2018; 35(3):195-208info:eu-repo/grantAgreement/EC/FP7/337673This is the peer reviewed version of the following article: Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S et al. Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries. Depress Anxiety. 2018; 35(3):195-208. DOI 10.1002/da.22711, which has been published in final form at http://dx.doi.org/10.1002/da.22711. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/364262026-06-12T07:21:37Z
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