Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 288, Issue -, Pages 199-209Publisher
ELSEVIER
DOI: 10.1016/j.jad.2021.04.001
Keywords
Helpfulness of treatment; Simple phobia; Specific phobia; World Mental Health Surveys
Categories
Funding
- United States National Institute of Mental Health (NIMH) [R01 MH070884]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- United States Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center [FIRCA R03-TW006481]
- Pan American Health Organization
- Eli Lilly and Company
- Ortho-McNeil Pharmaceutical Inc.
- Bristol-Myers Squibb
- Argentinian Ministry of Health (Ministerio de Salud de la Nacion) [2002-17270/13 5]
- State of Sao Paulo Research Foundation (FAPESP) [03/00204-3]
- Ministry of Health
- National Center for Public Health Protection
- Ministry of Health and European Economic Area Grants
- Ministry of Social Protection
- European Commission [QLG5-1999-01042, SANCO 2004123, EAHC 20081308]
- Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain [FIS 00/0028]
- Ministerio de Ciencia y Tecnologia, Spain [SAF 2000-158-CE]
- Generalitat de Catalunya [2017 SGR 452, 2014 SGR 748]
- Instituto de Salud Carlos III [CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP]
- GlaxoSmithKline
- Iraqi IMHS team
- Japanese Fund through United Nations Development Group Iraq Trust Fund (UNDG ITF)
- European Fund through United Nations Development Group Iraq Trust Fund (UNDG ITF)
- Japan Ministry of Health, Labour and Welfare [H13-SHOGAI-023, H14-TOKUBETSU-026, H16KOKORO-013, H25-SEISHIN-IPPAN-006]
- Lebanese Ministry of Public Health
- WHO (Lebanon)
- National Institute of Health/Fogarty International Center [R03 TW006481-01]
- Algorithm
- AstraZeneca
- National Institute of Psychiatry Ramon de la Fuente [INPRFMDIES 4280]
- National Council on Science and Technology [CONACyT-G30544-H]
- Pan American Health Organization (PAHO)
- New Zealand Ministry of Health
- Health Research Council
- WHO (Geneva)
- WHO (Nigeria)
- Federal Ministry of Health, Abuja, Nigeria
- Health & Social Care Research & Development Division of the Public Health Agency
- Polish project Epidemiology of Mental Health and Access to Care -EZOP Project [PL 0256]
- National Institute of Health of the Ministry of Health of Peru
- European Economic Area Financial Mechanism
- Polish Ministry of Health
- Champalimaud Foundation
- Foundation for Science and Technology (FCT)
- Ministry of Public Health
- Eli Lilly Romania SRL
- Saudi Basic Industries Corporation (SABIC), King Abdulaziz City for Science and Technology (KACST), Ministry of Health (Saudi Arabia)
- King Saud University
- Ministry of Economy and Planning, General Authority for Statistics
- Shenzhen Bureau of Health
- Shenzhen Bureau of Science, Technology, and Information
- Regional Health Authorities of Murcia (Servicio Murciano de Salud and Consejeria de Sanidad y Politica Social)
- Fundaci 'on para la Formaci 'on e Investigaci 'on Sanitarias (FFIS) of Murcia
- National Institute of Mental Health (NIMH) [U01-MH60220]
- National Institute of Drug Abuse (NIDA)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Robert Wood Johnson Foundation (RWJF) [044708]
- John W. Alden Trust
- King Faisal Specialist Hospital and Research Center
- Center for Excellence on Research in Mental Health (CES University)
- Benta
- Bella Pharma
- Eli Lilly
- Glaxo Smith Kline
- Lundbeck
- Novartis
- OmniPharma
- Pfizer
- Phenicia
- Servier
- UPO
- Alcohol Advisory Council
- Norwegian Financial Mechanism
- Gulbenkian Foundation
Ask authors/readers for more resources
The study found that while a significant number of respondents reported receiving helpful treatment for specific phobias, only a small proportion persisted in seeking help from multiple professionals. Patient persistence in help-seeking after unsuccessful treatments could potentially increase the effectiveness of specific phobia treatment, but further research on barriers to help-seeking persistence is needed.
Background: Although randomized trials show that specific phobia treatments can be effective, it is unclear whether patients experience treatment as helpful in clinical practice. We investigated this issue by assessing perceived treatment helpfulness for specific phobia in a cross-national epidemiological survey. Methods: Cross-sectional population-based WHO World Mental Health (WMH) surveys in 24 countries (n=112,507) assessed lifetime specific phobia. Respondents who met lifetime criteria were asked whether they ever received treatment they considered helpful and the number of professionals seen up to the time of receiving helpful treatment. Discrete-event survival analysis was used to calculate conditional-cumulative probabilities of obtaining helpful treatment across number of professionals seen and of persisting in help-seeking after prior unhelpful treatment. Results: 23.0% of respondents reported receiving helpful treatment from the first professional seen, whereas cumulative probability of receiving helpful treatment was 85.7% after seeing up to 9 professionals. However, only 14.7% of patients persisted in seeing up to 9 professionals, resulting in the proportion of patients ever receiving helpful treatment (47.5%) being much lower than it could have been with persistence in help-seeking. Few predictors were found either of perceived helpfulness or of persistence in help-seeking after earlier unhelpful treatments. Limitations: Retrospective recall and lack of information about either types of treatments received or objective symptomatic improvements limit results. Conclusions: Despite these limitations, results suggest that helpfulness of specific phobia treatment could be increased, perhaps substantially, by increasing patient persistence in help-seeking after earlier unhelpful treatments. Improved understanding is needed of barriers to help-seeking persistence.
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