期刊
DEPRESSION AND ANXIETY
卷 35, 期 3, 页码 195-208出版社
WILEY
DOI: 10.1002/da.22711
关键词
adequate treatment; anxiety disorders; health services; perceived need for care; surveys
资金
- Sanofi Aventis
- Lundbeck
- Infosoft Technologies
- Ministry of Health, Labour, and Welfare
- Japan Society for Promotion of Science
- MRC [MR/S001255/1] Funding Source: UKRI
- FOGARTY INTERNATIONAL CENTER [R03TW006481] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH070884, U01MH060220, R01MH069864, R13MH066849] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [R01DA016558, K05DA015799] Funding Source: NIH RePORTER
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.
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