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PHILIP S WANG MATTHIAS ANGERMEYER GUILHERME BORGES RONNY BRUFFAERTS WAI TAT CHIU GIOVANNI DE GIROLAMO JOHN FAYYAD OYE GUREJE JOSEP MARIA HARO YUEQIN HUANG RONALD C KESSLER VIVIANE KOVESS DAPHNA LEVINSON YOSHIBUMI NAKANE MARK A OAKLEY BROWN JOHAN H ORMEL JOSé POSADA-VILLA SERGIO AGUILAR-GAXIOLA JORDI ALONSO SING LEE STEVEN HEERINGA BETH-ELLEN PENNELL SOMNATH CHATTERJI T. BEDIRHAN üSTüN 《World psychiatry》2007,6(3):177-185
Data are presented on patterns of failure and delay in making initial treatment
contact after first onset of a mental disorder in 15 countries in the World
Health Organization (WHO)''s World Mental Health (WMH) Surveys. Representative
face-to-face household surveys were conducted among 76,012 respondents aged
18 and older in Belgium, Colombia, France, Germany, Israel, Italy, Japan,
Lebanon, Mexico, the Netherlands, New Zealand, Nigeria, People''s Republic
of China (Beijing and Shanghai), Spain, and the United States. The WHO Composite
International Diagnostic Interview (CIDI) was used to assess lifetime DSM-IV
anxiety, mood, and substance use disorders. Ages of onset for individual disorders
and ages of first treatment contact for each disorder were used to calculate
the extent of failure and delay in initial help seeking. The proportion of
lifetime cases making treatment contact in the year of disorder onset ranged
from 0.8 to 36.4% for anxiety disorders, from 6.0 to 52.1% for mood disorders,
and from 0.9 to 18.6% for substance use disorders. By 50 years, the proportion
of lifetime cases making treatment contact ranged from 15.2 to 95.0% for anxiety
disorders, from 7.9 to 98.6% for mood disorders, and from 19.8 to 86.1% for
substance use disorders. Median delays among cases eventually making contact
ranged from 3.0 to 30.0 years for anxiety disorders, from 1.0 to 14.0 years
for mood disorders, and from 6.0 to 18.0 years for substance use disorders.
Failure and delays in treatment seeking were generally greater in developing
countries, older cohorts, men, and cases with earlier ages of onset. These
results show that failure and delays in initial help seeking are pervasive
problems worldwide. Interventions to ensure prompt initial treatment contacts
are needed to reduce the global burdens and hazards of untreated mental disorders. 相似文献
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RONALD C KESSLER MATTHIAS ANGERMEYER JAMES C ANTHONY RON DE GRAAF KOEN DEMYTTENAERE ISABELLE GASQUET GIOVANNI DE GIROLAMO SEMYON GLUZMAN OYE GUREJE JOSEP MARIA HARO NORITO KAWAKAMI AIMEE KARAM DAPHNA LEVINSON MARIA ELENA MEDINA MORA MARK A OAKLEY BROWNE JOSé POSADA-VILLA DAN J STEIN CHEUK HIM ADLEY TSANG SERGIO AGUILAR-GAXIOLA JORDI ALONSO SING LEE STEVEN HEERINGA BETH-ELLEN PENNELL PATRICIA BERGLUND MICHAEL J GRUBER MARIA PETUKHOVA SOMNATH CHATTERJI T. BEDIRHAN üSTüN 《World psychiatry》2007,6(3):168-176
Data are presented on the lifetime prevalence, projected lifetime risk,
and age-of-onset distributions of mental disorders in the World Health Organization
(WHO)''s World Mental Health (WMH) Surveys. Face-to-face community surveys
were conducted in seventeen countries in Africa, Asia, the Americas, Europe,
and the Middle East. The combined numbers of respondents were 85,052. Lifetime
prevalence, projected lifetime risk, and age of onset of DSM-IV disorders
were assessed with the WHO Composite International Diagnostic Interview (CIDI),
a fully-structured lay administered diagnostic interview. Survival analysis
was used to estimate lifetime risk. Median and inter-quartile range (IQR)
of age of onset is very early for some anxiety disorders (7-14, IQR: 8-11)
and impulse control disorders (7-15, IQR: 11-12). The age-of-onset distribution
is later for mood disorders (29-43, IQR: 35-40), other anxiety disorders (24-50,
IQR: 31-41), and substance use disorders (18-29, IQR: 21-26). Median and IQR
lifetime prevalence estimates are: anxiety disorders 4.8-31.0% (IQR: 9.9-16.7%),
mood disorders 3.3-21.4% (IQR: 9.8-15.8%), impulse control disorders 0.3-25.0%
(IQR: 3.1-5.7%), substance use disorders 1.3-15.0% (IQR: 4.8-9.6%), and any
disorder 12.0-47.4% (IQR: 18.1-36.1%). Projected lifetime risk is proportionally
between 17% and 69% higher than estimated lifetime prevalence (IQR: 28-44%),
with the highest ratios in countries exposed to sectarian violence (Israel,
Nigeria, and South Africa), and a general tendency for projected risk to be
highest in recent cohorts in all countries. These results document clearly
that mental disorders are commonly occurring. As many mental disorders begin
in childhood or adolescents, interventions aimed at early detection and treatment
might help reduce the persistence or severity of primary disorders and prevent
the subsequent onset of secondary disorders. 相似文献
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SALIH ALHASNAWI SABAH SADIK MOHAMMAD RASHEED ALI BABAN MAHDI M. AL-ALAK ABDULRAHMAN YONIS OTHMAN YONIS OTHMAN NEZAR ISMET OSMAN SHAWANI SRINIVASA MURTHY MONAF ALJADIRY SOMNATH CHATTERJI NAEEMA AL-GASSEER EMMANUEL STREEL NIRMALA NAIDOO MOHAMED MAHOMOUD ALI MICHAEL J GRUBER MARIA PETUKHOVA NANCY A. SAMPSON RONALD C. KESSLER ON BEHALF OF THE IRAQ MENTAL HEALTH SURVEY STUDY GROUP 《World psychiatry》2009,8(2):97-109
Data on the prevalence and correlates of anxiety, mood, behavioral, and substance disorders are presented from a 2007-8 national survey of the Iraq population, the Iraq Mental Health Survey (IMHS). The IMHS was carried out by the Iraq Ministry of Health in collaboration with the Iraq Ministry of Planning and the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. Interviews were administered to a probability sample of Iraqi household residents by trained lay interviewers. The WHO Composite International Diagnostic interview (CIDI) was used to assess DSM-IV disorders. The response rate was 95.2%. The estimated lifetime prevalence of any disorder was 18.8%. Cohort analysis documented significantly increasing lifetime prevalence of most disorders across generations. This was most pronounced for panic disorder and post-traumatic stress disorder, with lifetime-to-date prevalence 5.4-5.3 times as high at comparable ages in the youngest (ages 18-34) as oldest (ages 65+) cohorts. Anxiety disorders were the most common class of disorders (13.8%) and major depressive disorder (MDD) the most common disorder (7.2%). Twelve-month prevalence of any disorder was 13.6%, with 42.1% of cases classified mild, 36.0% moderate, and 21.9% serious. The disorders most often classified serious were bipolar disorder (76.9%) and substance-related disorders (54.9%). Socio-demographic correlates were generally consistent with international epidemiological surveys, with the two exceptions of no significant gender differences in mood disorders and positive correlations of anxiety and mood disorders with education. Only 2.2% of IMHS respondents reported receiving treatment for emotional problems in the 12 months before interview, including 23.7% of those with serious, 9.2% with moderate, and 5.3% with mild disorders and 0.9% of other respondents. Most healthcare treatment, which was roughly equally distributed between the general medical and specialty sectors, was of low intensity. Further analyses of barriers to seeking treatment are needed to inform government efforts to expand the detection and treatment of mental disorders 相似文献
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