Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys.


Por: Kessler RC, Kazdin AE, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Altwaijri YA, Andrade LH, Benjet C, Bharat C, Borges G, Bruffaerts R, Bunting B, de Almeida JMC, Cardoso G, Chiu WT, Cía A, Ciutan M, Degenhardt L, de Girolamo G, de Jonge P, de Vries YA, Florescu S, Gureje O, Haro JM, Harris MG, Hu C, Karam AN, Karam EG, Karam G, Kawakami N, Kiejna A, Kovess-Masfety V, Lee S, Makanjuola V, McGrath JJ, Medina-Mora ME, Moskalewicz J, Navarro-Mateu F, Nierenberg AA, Nishi D, Ojagbemi A, Oladeji BD, O'Neill S, Posada-Villa J, Puac-Polanco V, Rapsey C, Ruscio AM, Sampson NA, Scott KM, Slade T, Stagnaro JC, Stein DJ, Tachimori H, Ten Have M, Torres Y, Viana MC, Vigo DV, Williams DR, Wojtyniak B, Xavier M, Zarkov Z and Ziobrowski HN

Publicada: 1 jun 2022
Categoría: Psychiatry and mental health

Resumen:
Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful.

Filiaciones:
Kessler RC:
 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

Kazdin AE:
 Department of Psychology, Yale University, New Haven, CT, USA

Aguilar-Gaxiola S:
 Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA

Al-Hamzawi A:
 College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq

Alonso J:
 Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain

Altwaijri YA:
 Epidemiology Section, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Andrade LH:
 Núcleo de Epidemiologia Psiquiátrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

Benjet C:
 Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico

Bharat C:
 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia

Borges G:
 Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico

Bruffaerts R:
 Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven, Leuven, Belgium

Bunting B:
 School of Psychology, Ulster University, Londonderry, UK

de Almeida JMC:
 Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, NOVA University of Lisbon, Lisbon, Portugal

Cardoso G:
 Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, NOVA University of Lisbon, Lisbon, Portugal

Chiu WT:
 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

Cía A:
 Anxiety Disorders Research Center, Buenos Aires, Argentina

Ciutan M:
 National School of Public Health, Management and Professional Development, Bucharest, Romania

Degenhardt L:
 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia

de Girolamo G:
 IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy

de Jonge P:
 Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands

de Vries YA:
 Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands

Florescu S:
 National School of Public Health, Management and Professional Development, Bucharest, Romania

Gureje O:
 Department of Psychiatry, University College Hospital, Ibadan, Nigeria

Haro JM:
 Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain

Harris MG:
 School of Public Health, University of Queensland, Herston, and Queensland Centre for Mental Health Research, Wacol, QLD, Australia

Hu C:
 Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, China

Karam AN:
 Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon

Karam EG:
 Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon

 Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon

Karam G:
 Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon

 Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon

Kawakami N:
 Department of Mental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

Kiejna A:
 Psychology Research Unit for Public Health, WSB University, Torun, Poland

Kovess-Masfety V:
 Laboratoire de Psychopathologie et Processus de Santé EA 4057, Université de Paris, Paris, France

Lee S:
 Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong

Makanjuola V:
 Department of Psychiatry, University College Hospital, Ibadan, Nigeria

McGrath JJ:
 School of Public Health, University of Queensland, Herston, and Queensland Centre for Mental Health Research, Wacol, QLD, Australia

 National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark

Medina-Mora ME:
 Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico

Moskalewicz J:
 Institute of Psychiatry and Neurology, Warsaw, Poland

Navarro-Mateu F:
 Unidad de Docencia, Investigación y Formación en Salud Mental, Universidad de Murcia, Murcia, Spain

Nierenberg AA:
 Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Nishi D:
 Department of Mental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

Ojagbemi A:
 Department of Psychiatry, University College Hospital, Ibadan, Nigeria

Oladeji BD:
 Department of Psychiatry, University College Hospital, Ibadan, Nigeria

O'Neill S:
 School of Psychology, Ulster University, Londonderry, UK

Posada-Villa J:
 Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia

Puac-Polanco V:
 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

Rapsey C:
 Department of Psychological Medicine, University of Otago, Dunedin, New Zealand

Ruscio AM:
 Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA

Sampson NA:
 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

Scott KM:
 Department of Psychological Medicine, University of Otago, Dunedin, New Zealand

Slade T:
 Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia

Stagnaro JC:
 Departamento de Psiquiatría y Salud Mental, Universidad de Buenos Aires, Buenos Aires, Argentina

Stein DJ:
 Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

Tachimori H:
 National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan

Ten Have M:
 Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

Torres Y:
 Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia

Viana MC:
 Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil

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

Williams DR:
 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

Wojtyniak B:
 Centre of Monitoring and Analyses of Population Health, National Institute of Public Health - National Research Institute, Warsaw, Poland

Xavier M:
 Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, NOVA University of Lisbon, Lisbon, Portugal

Zarkov Z:
 Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria

Ziobrowski HN:
 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
ISSN: 17238617





World Psychiatry
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ, Italia
Tipo de documento: Article
Volumen: 21 Número: 2
Páginas: 272-286
WOS Id: 000791742800019
ID de PubMed: 35524618
imagen Bronze, Green Published, Green Submitted

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