Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys.
Por:
Vigo DV, Kazdin AE, Sampson NA, Hwang I, Alonso J, Andrade LH, Ayinde O, Borges G, Bruffaerts R, Bunting B, de Girolamo G, Florescu S, Gureje O, Haro JM, Harris MG, Karam EG, Karam G, Kovess-Masfety V, Lee S, Navarro-Mateu F, Posada-Villa J, Scott K, Stagnaro JC, Have MT, Wu CS, Xavier M and Kessler RC
Publicada:
23 jun 2022
Ahead of Print:
23 jun 2022
Resumen:
BACKGROUND: Most individuals with major depressive disorder (MDD) receive either no care or inadequate care. The aims of this study is to investigate potential determinants of effective treatment coverage. METHODS: In order to examine obstacles to providing or receiving care, the type of care received, and the quality and use of that care in a representative sample of individuals with MDD, we analyzed data from 17 WHO World Mental Health Surveys conducted in 15 countries (9 high-income and 6 low/middle-income). Of 35,012 respondents, 3341 had 12-month MDD. We explored the association of socio-economic and demographic characteristics, insurance, and severity with effective treatment coverage and its components, including type of treatment, adequacy of treatment, dose, and adherence. RESULTS: High level of education (OR = 1.63; 1.19, 2.24), private insurance (OR = 1.62; 1.06, 2.48), and age (30-59yrs; OR = 1.58; 1.21, 2.07) predicted effective treatment coverage for depression in a multivariable logistic regression model. Exploratory bivariate models further indicate that education may follow a dose-response relation; that people with severe depression are more likely to receive any services, but less likely to receive adequate services; and that in low and middle-income countries, private insurance (the only significant predictor) increased the likelihood of receiving effective treatment coverage four times. CONCLUSIONS: In the regression models, specific social determinants predicted effective coverage for major depression. Knowing the factors that determine who does and does not receive treatment contributes to improve our understanding of unmet needs and our ability to develop targeted interventions.
Filiaciones:
Vigo DV:
Department of Psychiatry, University of British Columbia, UBC Hospital - Detwiller Pavilion, Room 2813, 2255 Wesbrook Mall, UBC Vancouver Campus, Vancouver, BC, V6T 2A1, Canada.
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Kazdin AE:
Department of Psychology, Yale University, 2 Hillhouse Avenue- 208205, New Haven, CT, 06520, USA
Sampson NA:
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
Hwang I:
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
Alonso J:
IMIM-Hospital del Mar Medical Research Institute, PRBB Building, Doctor Aiguader, 88, 08003, Barcelona, Spain
CIBER en Epidemiología Y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
Pompeu Fabra University (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain
Andrade LH:
University of São Paulo Medical School, Núcleo de Epidemiologia Psiquiátrica - LIM 23, Rua Dr. Ovidio Pires de Campos, 785, São Paulo, CEP, 05403-010, Brazil
Ayinde O:
Department of Psychiatry, University College Hospital, University of Ibadan, Ibadan, 5116, PMB, Nigeria
Borges G:
National Institute of Psychiatry Ramón de La Fuente Muñiz, Calzada México-Xochimilco, 101, Colonia San Lorenzo Huipulco, 14370, Mexico City, DF, Mexico
Bruffaerts R:
University Psychiatric Center, University of Louvain - KU Leuven, Herestraat 49, B-3000, Leuven, Belgium
Bunting B:
School of Psychology, Ulster University, College Avenue, Londonderry, BT48 7JL, UK
de Girolamo G:
Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni 4, Brescia, Italy
Florescu S:
National School of Public Health, Management and Development, 31 Vaselor Str., 21253, Bucharest, Romania
Gureje O:
Department of Psychiatry, University College Hospital, University of Ibadan, Ibadan, 5116, PMB, Nigeria
Haro JM:
National School of Public Health, Management and Development, 31 Vaselor Str., 21253, Bucharest, Romania
Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain
Harris MG:
School of Public Health, The University of Queensland, c/o QCMHR, Locked Bag 500, Archerfield, QLD, 4108, Australia
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wolston Park Rd,, Wacol, QLD, 4076, Australia
Karam EG:
Department of Psychiatry & Clinical Psychology, St. George Hospital University Medical Center, Beirut, 166378, Ashrafieh, Lebanon
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Rond Point Saloumeh, Sin el Fil, Beirut, Lebanon
Institute for Development Research Advocacy and Applied Care (IDRAAC), Achrafieh, St. George Hospital Street, Beirut, Lebanon
Karam G:
Department of Psychiatry & Clinical Psychology, St. George Hospital University Medical Center, Beirut, 166378, Ashrafieh, Lebanon
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Rond Point Saloumeh, Sin el Fil, Beirut, Lebanon
Institute for Development Research Advocacy and Applied Care (IDRAAC), Achrafieh, St. George Hospital Street, Beirut, Lebanon
Kovess-Masfety V:
EHESP-School of Public Health, Paris Descartes University, 20 Avenue George Sand La Plaine, 93210, Saint Denis, France
Lee S:
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong, China
G/F Multicentre, Tai Po Hospital, Tai Po, Hong Kong, China
Navarro-Mateu F:
Murcia Health Service, C/ Lorca, nº 58. -El Palmar, 30120, Murcia, Spain
Posada-Villa J:
Colegio Mayor de Cundinamarca University, Calle 28 No. 6-02, 11001000, Bogotá, Colombia
Scott K:
Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
Stagnaro JC:
Faculty of Medicine, University of Buenos Aires, Paraguay 2155, C1121ABG CABA, Buenos Aires, Argentina
Have MT:
Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Da Costakade 45Postbus 725, 3500, 3521 VS, Utrecht, The Netherlands
Wu CS:
Department of Psychiatry, National Taiwan University Hospital & College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
Xavier M:
Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), Nova Medical School, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
Kessler RC:
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
Green Published, gold
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