Undertreatment of people with major depressive disorder in 21 countries

被引：646

作者：

Thornicroft, Graham ^{[1
]}

Chatterji, Somnath ^{[2
]}

Evans-Lacko, Sara ^{[3
]}

Gruber, Michael ^{[4
]}

Sampson, Nancy ^{[4
]}

Aguilar-Gaxiola, Sergio ^{[5
]}

Al-Hamzawi, Ali ^{[6
]}

Alonso, Jordi ^{[7
,8
,9
]}

Andrade, Laura ^{[10
]}

Borges, Guilherme ^{[11
]}

Bruffaerts, Ronny ^{[12
]}

Bunting, Brendan ^{[13
,25
]}

Caldas de Almeida, Jose Miguel ^{[14
,15
]}

Florescu, Silvia ^{[16
]}

de Girolamo, Giovanni ^{[17
]}

Gureje, Oye ^{[18
,19
]}

Haro, Josep Maria ^{[20
]}

He, Yanling ^{[21
]}

Hinkov, Hristo ^{[22
]}

Karam, Elie ^{[23
,24
,25
]}

Kawakami, Norito ^{[26
]}

Lee, Sing ^{[27
]}

Navarro-Mateu, Fernando ^{[28
]}

Piazza, Marina ^{[29
]}

Posada-Villa, Jose ^{[30
]}

de Galvis, Yolanda Torres ^{[31
]}

Kessler, Ronald C. ^{[32
]}

机构：

[1] Kings Coll London, Inst Psychiat, Ctr Global Mental Hlth, Psychol & Neurosci, London, England

[2] WHO, Dept Informat, Evidence & Res, Geneva, Switzerland

[3] Kings Coll London, Inst Psychiat, Ctr Global Mental Hlth, Psychol & Neuroscience, London, England

[4] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA

[5] Univ Calif Davis, Ctr Reduct Hlth Dispar, Sacramento, CA 95817 USA

[6] Al Qadisia Univ, Coll Med, Diwania Governorate, Iraq

[7] IMIM Hosp Mar Med Res Inst, Hlth Serv Res Unit, Barcelona, Spain

[8] Pompeu Fabra Univ UPF, Barcelona, Spain

[9] CIBERESP, Barcelona, Spain

[10] Univ Sao Paulo, Inst Psychiat, Sect Psychiat Epidemiol, Sch Med, LIM-23 Sao Paulo, Brazil

[11] Inst Nacl Psiquiatria, Calzada Mexico Xochimilco 101, Mexico City, DF, Mexico

[12] Katholieke Univ Leuven, UPC KUL, Univ Psychiat Ctr, Campus Gasthuisberg, Leuven, Belgium

[13] Univ Ulster, Londonderry, North Ireland

[14] Univ Nova Lisboa, CEDOC, Lisbon, Portugal

[15] Univ Nova Lisboa, Nova Med Sch, Fac Ciencias Med, Lisbon, Portugal

[16] Natl Sch Publ Hlth, Management & Profess Dev, Bucharest, Romania

[17] IRCCS Ctr Giovanni Dio Fatebenefratelli, IRCCS St John God Clin Res Ctr, Brescia, Italy

[18] Univ Coll Hosp, Dept Psychiat, Ibadan, Nigeria

[19] Univ Coll Hosp, Dept Psychiat, Ibadan, Nigeria

[20] Univ Barcelona, CIBERSAM, Parc Sanitari St Joan de Deu, Sant Boi De Llobregat, Barcelona, Spain

[21] Shanghai Jiao Tong Univ, Shanghai Mental Hlth Ctr, Sch Med, Shanghai, Peoples R China

[22] Natl Ctr Publ Hlth & Analyses, Sofia, Bulgaria

[23] Balamand Univ, Dept Psychiat & Clin Psychol, Fac Med, Beirut, Lebanon

[24] St George Hosp Univ Med Ctr, Dept Psychiat & Clin Psychol, Beirut, Lebanon

[25] IDRAAC, Beirut, Lebanon

[26] Univ Tokyo, Sch Publ Hlth, Dept Mental Hlth, Tokyo, Japan

[27] Chinese Univ Hong Kong, Dept Psychiat, Tai Po, Hong Kong, Peoples R China

[28] Serv Murciano Salud, CIBERESP, Murcia Subdireccien Gen Salud Mental Asistencia, IMIB Arrixaca, El Palmar, Spain

[29] Univ Peruana Cayetano Heredia, Inst Nacl Salud, Lima, Peru

[30] Colegio Mayor Cundinamarca Univ, Bogota, Colombia

[31] CES Univ, Ctr Excellence Res Mental Hlth, Medellin, Colombia

[32] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA

来源：

BRITISH JOURNAL OF PSYCHIATRY | 2017年 / 210卷 / 02期

基金：

巴西圣保罗研究基金会;

关键词：

WORLD-HEALTH-ORGANIZATION; MENTAL-HEALTH; COSTS; CARE; PREVALENCE; SERVICES; SUBTYPES; VERSION;

D O I：

10.1192/bjp.bp.116.188078

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background Major depressive disorder (MDD) is a leading cause of disability worldwide. Aims To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards. Method Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys. Results Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment. Conclusions Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.

引用

页码：119 / 124

页数：6

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