Browsing by Author "Heeringa, S."

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Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys
(NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, 2011) Alonso, J.; Petukhova, M.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Uestuen, T.B.; Alhamzawi, A.O.; Viana, M.C.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Florescu, S.; Gureje, O.; Haro, J.M.; Hinkov, H.; Hu, C-y; Karam, E.G.; Kovess, V.; Levinson, D.; Medina-Mora, M.E.; Nakamura, Y.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K.M.; Tsang, A.; Williams, D.R.; Kessler, R.C.; IMIM Inst Recerca Hosp del Mar, Hlth Serv Res Unit, Barcelona 08003, Spain; jalonso@imim.es
Days out of role because of health problems are a major source of lost human capital. We examined the relative importance of commonly occurring physical and mental disorders in accounting for days out of role in 24 countries that participated in the World Health Organization (WHO) World Mental Health (WMH) surveys. Face-to-face interviews were carried out with 62 971 respondents (72.0% pooled response rate). Presence of ten chronic physical disorders and nine mental disorders was assessed for each respondent along with information about the number of days in the past month each respondent reported being totally unable to work or carry out their other normal daily activities because of problems with either physical or mental health. Multiple regression analysis was used to estimate associations of specific conditions and comorbidities with days out of role, controlling by basic socio-demographics (age, gender, employment status and country). Overall, 12.8% of respondents had some day totally out of role, with a median of 51.1 a year. The strongest individual-level effects (days out of role per year) were associated with neurological disorders (17.4), bipolar disorder (17.3) and post-traumatic stress disorder (15.2). The strongest population-level effect was associated with pain conditions, which accounted for 21.5% of all days out of role (population attributable risk proportion). The 19 conditions accounted for 62.2% of all days out of role. Common health conditions, including mental disorders, make up a large proportion of the number of days out of role across a wide range of countries and should be addressed to substantially increase overall productivity. Molecular Psychiatry (2011) 16, 1234-1246; doi:10.1038/mp.2010.101; published online 12 October 2010
Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys
(2011) Alonso, J.; Petukhova, M.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Ustun, TB; Alhamzawi, A.O.; Viana, M.C.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Florescu, S.; Gureje, O.; Haro, J.M.; Hinkov, H.; Hu, C-y; Karam, E.G.; Kovess, V.; Levinson, D.; Medina-Mora, M.E.; Nakamura, Y.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K.M.; Tsang, A.; Williams, D.R.; Kessler, R.C.; Health Services Research Unit, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain; jalonso@imim.es
Including information about co-morbidity in estimates of disease burden: results from the World Health Organization World Mental Health Surveys
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2011) Alonso, J.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Schoenbaum, M.; Uestuen, T. Bedirhan; Rojas-Farreras, S.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Gureje, O.; Haro, J.M.; Karam, A.N.; Kovess, V.; Levinson, D.; Liu, Z.; Medina-Mora, M.E.; Ormel, J.; Posada-Villa, J.; Uda, H.; Kessler, R.C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; Kessler@hcp.med.harvard.edu
Background. The methodology commonly used to estimate disease burden, featuring ratings of severity of individual conditions, has been criticized for ignoring co-morbidity. A methodology that addresses this problem is proposed and illustrated here with data from the World Health Organization World Mental Health Surveys. Although the analysis is based on self-reports about one's own conditions in a community survey, the logic applies equally well to analysis of hypothetical vignettes describing co-morbid condition profiles. Method. Face-to-face interviews in 13 countries (six developing, nine developed; n = 31 067; response rate = 69.6%) assessed 10 classes of chronic physical and nine of mental conditions. A visual analog scale (VAS) was used to assess overall perceived health. Multiple regression analysis with interactions for co-morbidity was used to estimate associations of conditions with VAS. Simulation was used to estimate condition-specific effects. Results. The best-fitting model included condition main effects and interactions of types by numbers of conditions. Neurological conditions, insomnia and major depression were rated most severe. Adjustment for co-morbidity reduced condition-specific estimates with substantial between-condition variation (0.24-0.70 ratios of condition-specific estimates with and without adjustment for co-morbidity). The societal-level burden rankings were quite different from the individual-level rankings, with the highest societal-level rankings associated with conditions having high prevalence rather than high individual-level severity. Conclusions. Plausible estimates of disorder-specific effects on VAS can be obtained using methods that adjust for co-morbidity. These adjustments substantially influence condition-specific ratings.
Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys
(AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60610 USA, 2004) Demyttenaere, K.; Bruffaerts, R.; Posada-Villa, J.; Gasquet, I.; Kovess, V.; Lepine, J.P.; Angermeyer, M.C.; Bernert, S.; De Girolamo, G.; Morosini, P.; Polidori, G.; Kikkawa, T.; Kawakami, N.; Ono, Y.; Takeshima, T.; Uda, H.; Karam, E.G.; Fayyad, J.A.; Karam, A.N.; Mneimneh, Z.N.; Medina-Mora, M.E.; Borges, G.; Lara, C.; De Graaf, R.; Ormel, J.; Gureje, O.; Shen, Y.C.; Huang, Y.Q.; Zhang, M.Y.; Alonso, J.; Haro, J.M.; Vilagut, G.; Bromet, E.J.; Gluzman, S.; Webb, C.; Kessler, R.C.; Merikangas, K.R.; Anthony, J.C.; Von Korff, M.R.; Wang, P.S.; Alonso, J.; Brugha, T.S.; Aguilar-Gaxiola, S.; Lee, S.; Heeringa, S.; Pennell, B.E.; Zaslavsky, A.M.; Ustun, T.B.; Chatterji, S.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard
Context Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. Objective To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. Design, Setting, and Participants Face-to-face household surveys of 60463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. Main Outcome Measures The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview. Results The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5%.to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country. Conclusions Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases,. especially those at risk for progressing to more serious disorders.