Browsing by Author "Angermeyer, Matthias C."

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Association between mental disorders and subsequent adult onset asthma
(2014) Alonso, Jordi; De Jonge, Peter; Lim, Carmen C. W.; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Liu, Zhaorui; O'Neill, Siobhan; Stein, Dan J.; Viana, Maria Carmen; Al-Hamzawi, Ali Obaid; Angermeyer, Matthias C.; Borges, Guilherme; Ciutan, Marius; De Girolamo, Giovanni; Fiestas, Fabian; Haro, Josep Maria; Hu, Chiyi; Kessler, Ronald C.; Lépine, Jean Pierre; Levinson, Daphna; Nakamura, Yosikazu; Posada-Villa, Jose; Wojtyniak, Bogdan J.; Scott, Kate M.; Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; jalonso@imim.es
Association of Childhood Adversities and Early-Onset Mental Disorders With Adult-Onset Chronic Physical Conditions
(AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60654-0946 USA, 2011) Scott, Kate M.; Von Korff, Michael; Angermeyer, Matthias C.; Benjet, Corina; Bruffaerts, Ronny; De Girolamo, Giovanni; Maria Haro, Josep; Lepine, Jean-Pierre; Ormel, Johan; Posada-Villa, José; Tachimori, Hisateru; Kessler, Ronald C.; Univ Otago, Dunedin Sch Med, Dept Psychol Med, Dunedin, New Zealand; kate.scott@otago.ac.nz
Context: The physical health consequences of childhood psychosocial adversities may be as substantial as the mental health consequences, but whether this is the case remains unclear because much prior research has involved unrepresentative samples and a selective focus on particular adversities or physical outcomes. The association between early-onset mental disorders and subsequent poor physical health in adulthood has not been investigated. Objective: To investigate whether childhood adversities and early-onset mental disorders are independently associated with increased risk of a range of adult-onset chronic physical conditions in culturally diverse samples spanning the full adult age range. Design: Cross-sectional community surveys of adults in 10 countries. Setting: General population. Participants: Adults (ie, aged >= 18 years; N=18 303), with diagnostic assessment and determination of age at onset of DSM-IV mental disorders, assessment of childhood familial adversities, and age of diagnosis or onset of chronic physical conditions. Main Outcome Measures: Risk (ie, hazard ratios) of adult-onset (ie, at age > 20 years) heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain, and chronic headache as a function of specific childhood adversities and early-onset (ie, at age < 21 years) DSM-IV depressive and anxiety disorders, with mutual adjustment. Results: A history of 3 or more childhood adversities was independently associated with onset of all 6 physical conditions (hazard ratios, 1.44 to 2.19). Controlling for current mental disorder made little difference to these associations. Early-onset mental disorders were independently associated with onset of 5 physical conditions (hazard ratios, 1.43 to 1.66). Conclusions: These results are consistent with the hypothesis that childhood adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life. They require confirmation in a prospectively designed study. The long course of these associations has theoretical and research implications.
Associations between Lifetime Traumatic Events and Subsequent Chronic Physical Conditions: A CrossNational, Cross-Sectional Study
(Public Library Science, 1160 Battery Street, STE 100, San Francisco, CA 94111 USA , 2013) Scott, Kate M.; Koenen, Karestan C.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias C.; Benjet, Corina; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; De Girolamo, Giovanni; Florescu, Silvia; Iwata, Noboru; Levinson, Daphna; Lim, Carmen C. W.; Murphy, Sam; Ormel, Johan; Posada-Villa, Jose; Kessler, Ronald C.; Department of Psychological Medicine, University of Otago, Dunedin, New Zealand; kate.scott@otago.ac.nz
Childhood Adversity, Early-Onset Depressive/Anxiety Disorders, and Adult-Onset Asthma
(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA, 2008) Scott, Kate M.; Von Korff, Michael; Alonso, Jordi; Angermeyer, Matthias C.; Benjet, Corina; Bruffaerts, Ronny; De Girolamo, Giovanni; Haro, Josep Maria; Kessler, Ronald C.; Kovess, Viviane; Ono, Yutaka; Ormel, Johan; Posada-Villa, José; Univ Otago, Dept Psychol Med, Wellington, New Zealand; kate.scott@otago.ac.nz
Objectives: To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity. Methods: Ten cross-sectional population surveys of household-residing adults (> 18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset (
Common chronic pain conditions in developed and developing countries: Gender and age differences and comorbidity with depression-anxiety disorders.
(CHURCHILL LIVINGSTONE, JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND, 2008) Tsang, Adley; Von Korff, Michael; Lee, Sing; Alonso, Jordi; Karam, Elie; Angermeyer, Matthias C.; Borges, Guilherme Luiz Guimaraes; Bromet, Evelyn J.; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Lepine, Jean-Pierre; Haro, Josep Maria; Levinson, Daphna; Oakley Browne, Mark A.; Posada-Villa, José; Seedat, Soraya; Watanabe, Makoto; Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, HKSAR, Hong Kong, PRC.; guibor@imp.edu.mx
Although there is a growing body of research concerning the prevalence and correlates of chronic pain conditions and their association with mental disorders, cross-national research on age and gender differences is limited. The present study reports the prevalence by age and gender of common chronic pain conditions (headache, back or neck pain, arthritis or joint pain, and other chronic pain) in 10 developed and 7 developing countries and their association with the spectrum of both depressive and anxiety disorders. It draws on data from 18 general adult population surveys using a common survey questionnaire (N _ 42,249). Results show that age-standardized prevalence of chronic pain conditions in the previous 12 months was 37.3% in developed countries and 41.1% in developing countries, with back pain and headache being somewhat more common in developing than developed countries. After controlling for comorbid chronic physical diseases, several findings were consistent across developing and developed countries. There was a higher prevalence of chronic pain conditions among females and older persons; and chronic pain was similarly associated with depression-anxiety spectrum disorders in developed and developing countries. However, the large majority of persons reporting chronic pain did not meet criteria for depression or anxiety disorder. We conclude that common pain conditions affect a large percentage of persons in both developed and developing countries.
Comorbidity of common mental disorders with cancer and their treatment gap: findings from the World Mental Health Surveys
(WILEY-BLACKWELL, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, 2014) Nakash, Ora; Levav, Itzhak; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; Florescu, Silvia; De Girolamo, Giovanni; Interdisciplinary Ctr iDC Herzliya, Sch Psychol, POB 167, IL-46150 Herzliyya, Israel.; onakash@idc.ac.il
Cross-National Associations Between Gender and Mental Disorders in the World Health Organization World Mental Health Surveys
(Amer Medical Assoc, 515 N State ST, Chicago, IL 60610-0946 USA, 2009) Seedat, Soraya; Scott, Kate Margaret; Angermeyer, Matthias C.; Berglund, Patricia; Bromet, Evelyn J.; Brugha, Traolach S.; Demyttenaere, Koen; De Girolamo, Giovanni; Maria Haro, Josep; Jin, Robert; Karam, Elie G.; Kovess-Masfety, Viviane; Levinson, Daphna; Medina Mora, María Elena; Ono, Yutaka; Ormel, Johan; Pennell, Beth-Ellen; Posada-Villa, José; Sampson, Nancy A.; Williams, David; Kessler, Ronald C.; Harvard Univ, Dept Hlth Care Policy, Sch Med, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu
Context: Gender differences in mental disorders, including more anxiety and mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The gender roles hypothesis suggests that these differences narrow as the roles of women and men become more equal. Objectives: To study time-space (cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the World Health Organization World Mental Health Survey Initiative and to determine if this variation is significantly related to time-space variation in female gender role traditionality as measured by aggregate patterns of female education, employment, marital timing, and use of birth control. Design: Face-to-face household surveys. Setting: Africa, the Americas, Asia, Europe, the Middle East, and the Pacific. Participants: Community-dwelling adults (N=72 933). Main Outcome Measures: The World Health Organization Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in female to male odds ratios of these disorders across cohorts defined by the following age ranges: 18 to 34, 35 to 49, 50 to 64, and 65 years and older. Structural equation analysis examined predictive effects of variation in gender role traditionality on these odds ratios. Results: In all cohorts and countries, women had more anxiety and mood disorders than men, and men had more externalizing and substance disorders than women. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder and substance disorders. This narrowing was significantly related to temporal (major depressive disorder) and spatial (substance disorders) variation in gender role traditionality. Conclusions: While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial intercohort narrowing of differences in major depression was found to be related to changes in the traditionality of female gender roles. Additional research is needed to understand why this temporal narrowing was confined to major depression.
Cumulative traumas and risk thresholds: 12-month ptsd in the world mental health (WMH) surveys
(2014) Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; De Girolamo, Giovanni; De Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne Oakley, Mark A.; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.; Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon; kck5@mail.cumc.columbia.edu
Disability and treatment of specific mental and physical disorders across the world
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2008) Ormel, Johan; Petukhova, María; Chatterji, Somnath; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias C.; Bromet, Evelyn J.; Burger, Huibert; Demyttenaere, Koen; De Girolamo, Giovanni; Maria Haro, Josep; Hwang, Irving; Karam, Elie; Kawakami, Norito; Lepine, Jean Pierre; Medina-Mora, María Elena; Posada-Villa, José; Sampson, Nancy; Scott, Kate; Uestuen, T. Bedirhan; Von Korff, Michael; Williams, David R.; Zhang, Mingyuan; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu
Background: Advocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion. Aims: To establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries. Method: Community epidemiological surveys were administered in 15 countries through the World Health organization World Mental Health (WMH) Survey Initiative. Results: Respondents in both high-income and low- and middle-income countries attributed higher disability to mental disorders than to the commonly occurring physical disorders included in the surveys. This pattern held for all disorders and also for treated disorders. Disaggregation showed that the higher disability of mental than physical disorders was limited to disability in social and personal role functioning, whereas disability in productive role functioning was generally comparable for mental and physical disorders. Conclusions: Despite often higher disability, mental disorders are under-treated compared with physical disorders in both high-income and in low- and middle-income countries.
Drop out from out-patient mental healthcare in the World Health Organization's World Mental Health Survey initiative
(Royal College of Psychiatrists, British Journal of Psychiatry 17 Belgrave Square, London SW1X 8PG, England, 2013) Wells, J. Elisabeth; Browne, Mark Oakley; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Alonso, Jordi; Angermeyer, Matthias C.; Bouzan, Colleen; Bruffaerts, Ronny; Bunting, Brendan; Caldas-de-Almeida, Jose Miguel; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Fukao, Akira; Gureje, Oye; Hinkov, Hristo Ruskov; Hu, Chiyi; Hwang, Irving; Karam, Elie G.; Kostyuchenko, Stanislav; Kovess-Masfety, Viviane; Levinson, Daphna; Liu, Zhaorui; Medina-Mora, Maria Elena; Nizamie, S. Hague; Posada-Villa, Jose; Sampson, Nancy A.; Stein, Dan J.; Viana, Maria Carmen; Kessler, Ronald C.; Univ Otago, Dept Publ Hlth & Gen Practice, Christchurch 8140, New Zealand; elisabeth.wells@otago.ac.nz
Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys
(São Paulo, SP, Brasil : Associação Brasileira de Psiquiatria, 2013) Viana, Maria Carmen; Gruber, Michael J.; Shahly, Victoria; Alhamzawi, Ali; Alonso, Jordi; Andrade, Laura H.; Angermeyer, Matthias C.; Benjet, Corina; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; De Girolamo, Giovanni; De Jonge, Peter; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo; Hu, Chiyi; Karam, Elie G.; Le´pine, Jean-Pierre; Levinson, Daphna; Posada-Villa, Jose; Sampson, Nancy A.; Kessler, Ronald C.; Department of Social Medicine, Universidade Federal do Espırito Santo (UFES), Vitoria, ES, Brazil; mcviana@uol.com.br
How well can post-traumatic stress disorder be predicted from pre-trauma risk factors? An exploratory study in the WHO World Mental Health Surveys
(Masson Italy, 2014) Kessler, Ronald C.; Rose, Sherri; Koenen, Karestan C.; Karam, Elie G.; Stang, Paul E.; Stein, Dan J.; Heeringa, Steven G.; Hill, Eric D.; Liberzon, Israel; McLaughlin, Katie A.; McLean, Samuel A.; Pennell, Beth E.; Petukhova, María; Rosellini, Anthony J.; Ruscio, Ayelet M.; Shahly, Victoria; Shalev, Arieh Y.; Silove, Derrick; Zaslavsky, Alan M.; Angermeyer, Matthias C.; Bromet, Evelyn J.; Caldas De Almeida, José Miguel; De Girolamo, Giovanni; De Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia E.; Gureje, Oye; Haro, Josep María; Hinkov, Hristo; Kawakami, Norito; Kovess-Masfety, Viviane; Lee, Sing; Medina-Mora, María Elena; Murphy, Samuel D.; Navarro-Mateu, Fernando; Piazza, Marina; Posada-Villa, Jose; Scott, Kate; Torres, Yolanda; Viana, María Carmen; Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA
Mental disorders among adults with asthma: results from the World Mental Health Surveys
(New York, Elsevier/North-Holland, 2007) Scott, Kate M; Von Korff, Michae; Ormel, Johan; Zhang, Ming-yuan; Bruffaerts, Ronny; Alonso, Jordi; Kessler, Ronald C; Tachimori, Hisateru; Karam, Elie; Levinson, Daphna; Bromet, Evelyn J.; Posada-Villa, José; Gasquet, Isabelle; Angermeyer, Matthias C.; Borges, Guilherme; De Girolamo, Giovanni; Herman, Allen; Haro, Josep Maria; Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, University of Otago, New Zealand; kate.scott@otago.ac.nz
Mental disorders among persons with heart disease - results from World Mental Health Surveys
(ELSEVIER SCIENCE INC, 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA, 2007) Ormel, Johan; Von Korff, Michael; Burger, Huibert; Scott, Kate; Demyttenaere, Koen; Huang, Yue-qin; Posada-Villa, José; Lepine, Jean Pierre; Angermeyer, Matthias C.; Levinson, Daphna; De Girolamo, Giovanni; Kawakami, Norito; Karam, Elie; Medina-Mora, María Elena; Gureje, Oye; Williams, David; Haro, Josep Maria; Bromet, Evelyn J.; Alonso, Jordi; Kessler, Ron; Univ Groningen, Med Ctr, Dept Psychiat, NL-9700 RB Groningen, Netherlands; j.ormel@med.umcg.nl
Objectives: While depression and heart disease often co-occur in Western countries, less is known about the association of anxiety and alcohol use disorders with heart disease and about the cross-cultural consistency of this association. Consistency across emotional disorders and cultures would suggest that relatively universal mechanisms underlie the association. Methods: Surveys with 18 random population samples of household-residing adults in 17 countries in Europe, the Americas, the Middle East, Africa, Asia and the South Pacific were carried out. Medically recognized heart disease was ascertained by self-report. Mental disorders were assessed with the World Mental Health Composite International Diagnostic Interview, a fully structured diagnostic interview. Results: Specific mood and anxiety disorders occurred among persons with heart disease at rates higher than those among persons without heart disease. Adjusted for sex and age, the pooled odds ratios (95% confidence interval) were 2.1 (1.9-2.5) for mood disorders, 2.2 (1.92.5) for anxiety disorders and 1.4 (1.0-1.9) for alcohol abuse/dependence among persons with versus those without heart disease. These patterns were similar across countries. Conclusions: An excess of anxiety disorders and that of mood disorders are found among persons with heart disease. These associations hold true across countries despite substantial between-country differences in culture and mental disorder prevalence rates. These results suggest that similar mechanisms underlie the association and that a broad spectrum of mood-anxiety disorders should be considered in research on the comorbidity of mental disorders and heart disease. (c) 2007 Elsevier Inc. All rights reserved.
Modified WHODAS-II provides valid measure of global disability but items increased skewness
(New York : Elsevier, 2008) Von Korff, Michael; Crane, Paul K.; Alonso, Jordi; Vilagut, Gemma; Angermeyer, Matthias C.; Bruffaerts, Ronny; De Girolamo, Giovanni; Gureje, Oye; De Graaf, Ron; Huang, Yueqin; Iwata, Noboru; Karam, Elie G.; Kovess, Viviane; Lara, Carmen; Levinson, Daphna; Posada-Villa, José; Scott, Kate M.; Ormel, Johan; Center for Health Studies; Group Health Cooperative of Puget Sound; Seattle, WA
Subthreshold posttraumatic stress disorder in the world health organization world mental health surveys
(Elsevier, 2015) McLaughlin, Katie A.; Koenen, Karestan C.; Friedman, Matthew J.; Meron Ruscio, Ayelet; Karam, Elie G.; Shahly, Victoria; Stein, Dan J.; Hill, Eric D.; Petukhova, Maria; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Borges, Guilherme; Girolamo, Giovanni de; Graaf, Ron de; Demyttenaere, Koen; Florescu, Silvia E.; Mladenova, Maya; Posada-Villa, Jose; Scott, Kate M.; Takeshima, Tadashi; Kessler, Ronald C.; Department of Psychology (KAM), University of Washington, Seattle, Washington; Kessler@hcp.med.harvard.edu (Ronald C. Kessler)
The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys
(Churchill Livingstone, Journal Production Dept, Robert Stevenson House, 1-3 Baxters Place, Leith Walk, Edinburgh EH1 3AF, Midlothian, Scotland, 2008) Gureje, Oye; Von Korff, Michael; Kola, Lola; Demyttenaere, Koen; He, Yanling; Posada-Villa, José; Lepine, Jean Pierre; Angermeyer, Matthias C.; Levinson, Daphna; De Girolamo, Giovanni; Iwata, Noboru; Karam, Aimee; Borges, Guilherme Luiz Guimaraes; De Graaf, Ron; Browne, Mark Oakley; Stein, Dan J.; Maria Haro, Josep; Bromet, Evelyn J.; Kessler, Ron C.; Alonso, Jordi; Univ Ibadan, Dept Psychiat, Ibadan, Nigeria; ogureje@comui.edu.ng
Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys
(PHYSICIANS POSTGRADUATE PRESS, P O BOX 752870, MEMPHIS, TN 38175-2870 USA, 2010) Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; De Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Medina-Mora, María Elena; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; Kessler@hcp.med.harvard.edu
Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including socio-demographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Conclusions: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. J Clin Psychiatry 2010;71(12):1617-1628 (C) Copyright 2010 Physicians Postgraduate Press, Inc.
Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys
(LANCET LTD, 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND, 2007) Wang, Philip S.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias C.; Borges, Guilherme; Bromet, Evelyn J.; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Haro, Josep Maria; Karam, Elie G.; Kessler, Ronald C.; Kovess, Viviane; Lane, Michael C.; Lee, Sing; Levinson, Daphna; Ono, Yutaka; Petukhova, María; Posada-Villa, José; Seedat, Soraya; Wells, J. Elisabeth; NIMH, Div Serv & Intervent Res, Rockville, MD 20857 USA; wangphi@mail.nih.gov
Background Mental disorders are major causes of disability worldwide, including in the low-income and middle-income countries least able to bear such burdens. We describe mental health care in 17 countries participating in the WHO world mental health (WMH) survey initiative and examine unmet needs for treatment. Methods Face-to-face household surveys were undertaken with 84850 community adult respondents in low-income or middle-income (Colombia, Lebanon, Mexico, Nigeria, China, South Africa, Ukraine) and high-income countries (Belgium, France, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Spain, USA). Prevalence and severity of mental disorders over 12 months, and mental health service use, were assessed with the WMH composite international diagnostic interview. Logistic regression analysis was used to study sociodemographic predictors of receiving any 12-month services. Findings The number of respondents using any 12-month mental health services (57 [2%; Nigeria] to 1477 [18%; USA]) was generally lower in developing than in developed countries, and the proportion receiving services tended to correspond to countries' percentages of gross domestic product spent on health care. Although seriousness of disorder was related to service use, only five (11%; China) to 46 (61%; Belgium) of patients with severe disorders received any care in the previous year. General medical sectors were the largest sources of mental health services. For respondents initiating treatments, 152 (70%; Germany) to 129 (95%; Italy) received any follow-up care, and one (10%; Nigeria) to 113 (42%; France) received treatments meeting minimum standards for adequacy. Patients who were male, married, less-educated, and at the extremes of age or income were treated less. Interpretation Unmet needs for mental health treatment are pervasive and especially concerning in less-developed countries. Alleviation of these unmet needs will require expansion and optimum allocation of treatment resources.