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Patterns of care and dropout rates from outpatient mental healthcare in low-, middle- and high-income countries from the World Health Organization's World Mental Health Survey Initiative

dc.creatorFernández, Danieles_ES
dc.creatorVigo, Danieles_ES
dc.creatorSampson, Nancy A.es_ES
dc.creatorHwang, Irvinges_ES
dc.creatorAguilar-Gaxiola, Sergioes_ES
dc.creatorAl-Hamzawi, Ali O.es_ES
dc.creatorAlonso, Jordies_ES
dc.creatorAndrade, Laura Helenaes_ES
dc.creatorBromet, Evelyn J.es_ES
dc.creatorGirolamo, Giovanni dees_ES
dc.creatorJonge, Peter dees_ES
dc.creatorFlorescu, Silviaes_ES
dc.creatorGureje, Oyees_ES
dc.creatorHinkov, Hristoes_ES
dc.creatorHu, Chiyies_ES
dc.creatorKaram, Elie G.es_ES
dc.creatorKaram, Georgeses_ES
dc.creatorKawakami, Noritoes_ES
dc.creatorKiejna, Andrzrejes_ES
dc.creatorKovess-Masfety, Vivianees_ES
dc.creatorMedina-Mora, Maria E.es_ES
dc.creatorNavarro-Mateu, Fernandoes_ES
dc.creatorOjagbemi, Akines_ES
dc.creatorO'Neill, Siobhanes_ES
dc.creatorPiazza, Marinaes_ES
dc.creatorPosada-Villa, Josees_ES
dc.creatorRapsey, Charlenees_ES
dc.creatorWilliams, David R.es_ES
dc.creatorXavier, Migueles_ES
dc.creatorZiv, Yuvales_ES
dc.creatorKessler, Ronald C.es_ES
dc.creatorHaro, Josep M.es_ES
dc.creatorWorld Health Organization World Mental Health Survey collaboratorses_ES
dc.date2021
dc.date.accessioned2023-08-18T20:06:48Z
dc.date.available2023-08-18T20:06:48Z
dc.date.issued2021
dc.identifierJC07DIEP20es_ES
dc.identifier.issn0033-2917
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/7731
dc.identifier.urihttps://doi.org/10.1017/S0033291720000884
dc.identifier.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265313/
dc.descriptionBackground: There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countries. Methods: Respondents from 13 low- or middle-income countries (N = 60 224) and 15 in high-income countries (N = 77 303) were screened for mental and substance use disorders. Cross-tabulations were used to examine the distribution of treatment and dropout rates for those who screened positive. The timing of dropout was examined using Kaplan-Meier curves. Predictors of dropout were examined with survival analysis using a logistic link function. Results: Dropout rates are high, both in high-income (30%) and low/middle-income (45%) countries. Dropout mostly occurs during the first two visits. It is higher in general medical rather than in specialist settings (nearly 60% v. 20% in lower income settings). It is also higher for mild and moderate than for severe presentations. The lack of financial protection for mental health services is associated with overall increased dropout from care. Conclusions: Extending financial protection and coverage for mental disorders may reduce dropout. Efficiency can be improved by managing the milder clinical presentations at the entry point to the mental health system, providing adequate training, support and specialist supervision for non-specialists, and streamlining referral to psychiatrists for more severe cases.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherCambridge University Presses_ES
dc.relation51(12):2104-2116
dc.rightsAcceso Cerradoes_ES
dc.titlePatterns of care and dropout rates from outpatient mental healthcare in low-, middle- and high-income countries from the World Health Organization's World Mental Health Survey Initiativees_ES
dc.contributor.affiliationParc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.
dc.contributor.emailKessler@hcp.med.harvard.edu (Ronald C. Kessler)
dc.relation.jnabreviadoPSYCHOL MED
dc.relation.journalPsychological Medicine
dc.identifier.placeInglaterra
dc.date.published2021
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.eissn1469-8978
dc.identifier.doi10.1017/S0033291720000884
dc.subject.kwDropout
dc.subject.kwWMH surveys
dc.subject.kwMental health
dc.subject.kwSurvival analysis


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