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Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries
Author(s) -
Alonso Jordi,
Liu Zhaorui,
EvansLacko Sara,
Sadikova Ekaterina,
Sampson Nancy,
Chatterji Somnath,
Abdulmalik Jibril,
AguilarGaxiola Sergio,
AlHamzawi Ali,
Andrade Laura H.,
Bruffaerts Ronny,
Cardoso Graça,
Cia Alfredo,
Florescu Silvia,
Girolamo Giovanni,
Gureje Oye,
Haro Josep M.,
He Yanling,
Jonge Peter,
Karam Elie G.,
Kawakami Norito,
KovessMasfety Viviane,
Lee Sing,
Levinson Daphna,
MedinaMora Maria Elena,
NavarroMateu Fernando,
Pennell BethEllen,
Piazza Marina,
PosadaVilla José,
ten Have Margreet,
Zarkov Zahari,
Kessler Ronald C.,
Thornicroft Graham
Publication year - 2018
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22711
Subject(s) - anxiety , cidi , psychiatry , mental health , medicine , specific phobia , anxiety disorder , generalized anxiety disorder , clinical psychology
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.