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.
| Original language | English |
|---|---|
| Pages (from-to) | 195-208 |
| Number of pages | 14 |
| Journal | Depression and Anxiety |
| Volume | 35 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2018 |
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Keywords
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anxiety Disorders/therapy
- Female
- Global Health/statistics & numerical data
- Health Care Surveys/statistics & numerical data
- Humans
- Male
- Mental Health/statistics & numerical data
- Middle Aged
- Patient Acceptance of Health Care/statistics & numerical data
- Quality of Health Care/statistics & numerical data
- Young Adult
Cite this
Treatment gap for anxiety disorders is global : Results of the World Mental Health Surveys in 21 countries. / WHO World Mental Health Survey Collaborators.
In: Depression and Anxiety, Vol. 35, No. 3, 03.2018, p. 195-208.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment gap for anxiety disorders is global
T2 - Results of the World Mental Health Surveys in 21 countries
AU - WHO World Mental Health Survey Collaborators
AU - Alonso, Jordi
AU - Liu, Zhaorui
AU - Evans-Lacko, Sara
AU - Sadikova, Ekaterina
AU - Sampson, Nancy
AU - Chatterji, Somnath
AU - Abdulmalik, Jibril
AU - Aguilar-Gaxiola, Sergio
AU - Al-Hamzawi, Ali
AU - Andrade, Laura H
AU - Bruffaerts, Ronny
AU - Cardoso, Graça
AU - Cia, Alfredo
AU - Florescu, Silvia
AU - de Girolamo, Giovanni
AU - Gureje, Oye
AU - Haro, Josep M
AU - He, Yanling
AU - de Jonge, Peter
AU - Karam, Elie G
AU - Kawakami, Norito
AU - Kovess-Masfety, Viviane
AU - Lee, Sing
AU - Levinson, Daphna
AU - Medina-Mora, Maria Elena
AU - Navarro-Mateu, Fernando
AU - Pennell, Beth-Ellen
AU - Piazza, Marina
AU - Posada-Villa, José
AU - Ten Have, Margreet
AU - Zarkov, Zahari
AU - Kessler, Ronald C
AU - Thornicroft, Graham
N1 - © 2018 Wiley Periodicals, Inc.
PY - 2018/3
Y1 - 2018/3
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anxiety Disorders/therapy
KW - Female
KW - Global Health/statistics & numerical data
KW - Health Care Surveys/statistics & numerical data
KW - Humans
KW - Male
KW - Mental Health/statistics & numerical data
KW - Middle Aged
KW - Patient Acceptance of Health Care/statistics & numerical data
KW - Quality of Health Care/statistics & numerical data
KW - Young Adult
U2 - 10.1002/da.22711
DO - 10.1002/da.22711
M3 - Article
C2 - 29356216
VL - 35
SP - 195
EP - 208
JO - Depression and Anxiety
JF - Depression and Anxiety
SN - 1091-4269
IS - 3
ER -