Autor/a:
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Alonso Caballero, Jordi; Liu, Zhaorui; Evans Lacko, Sara; Sadikova, Ekaterina; Sampson, Nancy; Chatterji, Somnath; Abdulmalik, Jibril; Aguilar Gaxiola, Sergio; Al-Hamzawi, Ali Obaid; Andrade, Laura Helena; Bruffaerts, Ronny; Cardoso, Graça; Cia, Alfredo; Florescu, Silvia; Girolamo, Giovanni de; Gureje, Oye; Haro Abad, Josep Maria; He, Yanling; Jonge, Peter de; Karam, Elie G.; 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
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Abstract:
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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. |