Perceived helpfulness of bipolar disorder treatment: Findings from the World Health Organization World Mental Health Surveys.
Por:
Nierenberg AA, Harris MG, Kazdin AE, Puac-Polanco V, Sampson N, Vigo DV, Chiu WT, Ziobrowski HN, Alonso J, Altwaijri Y, Borges G, Bunting B, Caldas-de-Almeida JM, Haro JM, Hu CY, Kiejna A, Lee S, McGrath JJ, Navarro-Mateu F, Posada-Villa J, Scott KM, Stagnaro JC, Carmen Viana M, Kessler RC and WHO World Mental Health Survey Collaborators
Publicada:
1 sep 2021
Ahead of Print:
28 mar 2021
Categoría:
Biological psychiatry
Resumen:
OBJECTIVES: To examine patterns and predictors of perceived treatment helpfulness for mania/hypomania and associated depression in the WHO World Mental Health Surveys. METHODS: Face-to-face interviews with community samples across 15 countries found n = 2,178 who received lifetime mania/hypomania treatment and n = 624 with lifetime mania/hypomania who received lifetime major depression treatment. These respondents were asked whether treatment was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Patterns and predictors of treatment helpfulness were examined separately for mania/hypomania and depression. RESULTS: 63.1% (mania/hypomania) and 65.1% (depression) of patients reported ever receiving helpful treatment. However, only 24.5-22.5% were helped by the first professional seen, which means that the others needed to persist in help seeking after initial unhelpful treatments in order to find helpful treatment. Projections find only 22.9% (mania/hypomania) and 43.3% (depression) would persist through a series of unhelpful treatments but that the proportion helped would increase substantially if persistence increased. Few patient-level significant predictors of helpful treatment emerged and none consistently either across the two components (i.e., provider-level helpfulness and persistence after earlier unhelpful treatment) or for both mania/hypomania and depression. Although prevalence of treatment was higher in high-income than low/middle-income countries, proportional helpfulness among treated cases was nearly identical in the two groups of countries. CONCLUSIONS: Probability of patients with mania/hypomania and associated depression obtaining helpful treatment might increase substantially if persistence in help-seeking increased after initially unhelpful treatments, although this could require seeing numerous additional treatment providers. In addition to investigating reasons for initial treatments not being helpful, messages reinforcing the importance of persistence should be emphasized to patients.
Filiaciones:
Nierenberg AA:
Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
Harris MG:
School of Public Health, The University of Queensland, Herston, Queensland, Australia
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
Kazdin AE:
Department of Psychology, Yale University, New Haven, CT, USA
Puac-Polanco V:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Sampson N:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Vigo DV:
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
Chiu WT:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Ziobrowski HN:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Alonso J:
Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
Pompeu Fabra University (UPF), Barcelona, Spain
Altwaijri Y:
Epidemiology Section, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
Borges G:
National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
Bunting B:
School of Psychology, Ulster University, Londonderry, United Kingdom
Caldas-de-Almeida JM:
Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
Haro JM:
Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
Hu CY:
Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
Kiejna A:
Psychology Research Unit for Public Health, WSB University, Torun, Poland
Lee S:
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
McGrath JJ:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
Navarro-Mateu F:
UDIF-SM, Servicio Murciano de Salud, Murcia, Región de Murcia, Spain
IMIB-Arrixaca, Murcia, Región de Murcia, Spain
CIBERESP, Murcia, Región de Murcia, Spain
Posada-Villa J:
Faculty of Social Sciences, Colegio Mayor de Cundinamarca University, Bogota, Colombia
Scott KM:
Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
Stagnaro JC:
Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
Carmen Viana M:
Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
Kessler RC:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Green Accepted, Green Submitted
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