Determinants of effective treatment coverage for posttraumatic stress disorder: findings from the World Mental Health Surveys

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  • dc.contributor.author Stein, Dan J.
  • dc.contributor.author Alonso Caballero, Jordi
  • dc.contributor.author WHO World Mental Health Survey Collaborators
  • dc.date.accessioned 2023-06-02T06:03:33Z
  • dc.date.available 2023-06-02T06:03:33Z
  • dc.date.issued 2023
  • dc.description.abstract Background: Posttraumatic stress disorder (PTSD) is associated with significant morbidity, but efficacious pharmacotherapy and psychotherapy are available. Data from the World Mental Health Surveys were used to investigate extent and predictors of treatment coverage for PTSD in high-income countries (HICs) as well as in low- and middle-income countries (LMICs). Methods: Seventeen surveys were conducted across 15 countries (9 HICs, 6 LMICs) by the World Health Organization (WHO) World Mental Health Surveys. Of 35,012 respondents, 914 met DSM-IV criteria for 12-month PTSD. Components of treatment coverage analyzed were: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) effective treatment coverage. Regression models investigated predictors of treatment coverage. Results: 12-month PTSD prevalence in trauma exposed individuals was 1.49 (S.E., 0.08). A total of 43.0% (S.E., 2.2) received any mental health services, with fewer receiving adequate pharmacotherapy (13.5%), adequate psychotherapy (17.2%), or effective treatment coverage (14.4%), and with all components of treatment coverage lower in LMICs than HICs. In a multivariable model having insurance (OR = 2.31, 95 CI 1.17, 4.57) and severity of symptoms (OR = .35, 95% CI 0.18, 0.70) were predictive of effective treatment coverage. Conclusion: There is a clear need to improve pharmacotherapy and psychotherapy coverage for PTSD, particularly in those with mild symptoms, and especially in LMICs. Universal health care insurance can be expected to increase effective treatment coverage and therefore improve outcomes.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Stein DJ, Kazdin AE, Munthali RJ, Hwang I, Harris MG, Alonso J, et al. Determinants of effective treatment coverage for posttraumatic stress disorder: findings from the World Mental Health Surveys. BMC Psychiatry. 2023 Apr 4;23(1):226. DOI: 10.1186/s12888-023-04605-2
  • dc.identifier.doi http://dx.doi.org/10.1186/s12888-023-04605-2
  • dc.identifier.issn 1471-244X
  • dc.identifier.uri http://hdl.handle.net/10230/57025
  • dc.language.iso eng
  • dc.publisher BioMed Central
  • dc.relation.ispartof BMC Psychiatry. 2023 Apr 4;23(1):226
  • dc.rights © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Contact coverage
  • dc.subject.keyword Effective treatment coverage
  • dc.subject.keyword Insurance
  • dc.subject.keyword Posttraumatic stress disorder
  • dc.title Determinants of effective treatment coverage for posttraumatic stress disorder: findings from the World Mental Health Surveys
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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