Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries

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  • dc.contributor.author Alonso Caballero, Jordi
  • dc.contributor.author WHO World Mental Health Survey Collaborators
  • dc.date.accessioned 2019-01-24T13:22:37Z
  • dc.date.available 2019-01-24T13:22:37Z
  • dc.date.issued 2018
  • dc.description.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.
  • dc.description.sponsorship The U.S. National Comorbidity Survey Replication (NCS‐R) is supported by the National Institute of Mental Health (NIMH; U01‐MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA). SEL (Sara Evans‐Lacko) currently holds a Starting Grant from the European Research Council (337673). The Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trust. Dr. Thornicroft is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust. Dr. Thornicroft acknowledges support from the following: the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust; the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit awarded to South London and Maudsley NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust; the European Union Seventh Framework Programme (FP7/2007‐2013) Emerald project.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S et al. Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries. Depress Anxiety. 2018; 35(3):195-208. DOI 10.1002/da.22711
  • dc.identifier.doi http://dx.doi.org/10.1002/da.22711
  • dc.identifier.issn 1091-4269
  • dc.identifier.uri http://hdl.handle.net/10230/36426
  • dc.language.iso eng
  • dc.publisher Wiley
  • dc.relation.ispartof Depress Anxiety. 2018; 35(3):195-208
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/337673
  • dc.rights This is the peer reviewed version of the following article: Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S et al. Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries. Depress Anxiety. 2018; 35(3):195-208. DOI 10.1002/da.22711, which has been published in final form at http://dx.doi.org/10.1002/da.22711. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.subject.keyword Adequate treatment
  • dc.subject.keyword Anxiety disorders
  • dc.subject.keyword Health services
  • dc.subject.keyword Perceived need for care
  • dc.subject.keyword Surveys
  • dc.title Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/acceptedVersion

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