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Title: Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries
Author: 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
Keywords: Ansietat
Serveis sanitaris
Health services
Issue Date: May-2018
Publisher: Wiley
Abstract: 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.
Note: Versió postprint del document publicat a:
It is part of: Depression and Anxiety, 2018, vol. 35, num. 3, p. 195-208
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ISSN: 1091-4269
Appears in Collections:Articles publicats en revistes (Medicina)

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