Browsing by Author "Karam, E.G."

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Associations between subjective social status and DSM-IV mental disorders: results from the World Mental Health surveys
(2014) Scott, K.M.; Al-Hamzawi, A.O.; Andrade, L.H.; Borges, G.; Caldas-de-Almeida, J.M.; Fiestas, F.; Gureje, O.; Hu, C.Y.; Karam, E.G.; Kawakami, N.; Lee, S.; Levinson, D.; Lim, C.C.W.; Navarro-Mateu, F.; Okoliyski, M.; Posada-Villa, J.; Torres, Y.; Williams, D.R.; Zakhozha, V.; Kessler, R.C.; Department of Psychological Medicine, University of Otago, Dunedin, New Zealand; kate.scott@otago.ac.nz
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
Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys
(2013) Viana, M.C.; Gruber, M.J.; Shahly, V.; Alhamzawi, A.; Alonso, J.; Andrade, L.H.; Angermeyer, M.C.; Benjet, C.; Bruffaerts, R.; Caldas-de-Almeida, J.M.; De Girolamo, G.; De Jonge, P.; Ferry, F.; Florescu, S.; Gureje, O.; Haro, J.M.; Hinkov, H.; Hu, C.; Karam, E.G.; Lépine, J.P.; Levinson, D.; Posada-Villa, J.; Sampson, N.A.; Kessler, R.C.; Department of Social Medicine, Universidade Federal do Espirito Santo (UFES); mcviana@uol.com.br
Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2009) Lee, S.; Tsang, A.; Ruscio, A.M.; Haro, J.M.; Stein, D.J.; Alonso, J.; Angermeyer, M.C.; Bromet, E.J.; Demyttenaere, K.; De Girolamo, G.; De Graaf, R.; Gureje, O.; Iwata, N.; Karam, E.G.; Lepine, J.P.; Levinson, D.; Medina-Mora, M.E.; Oakley Browne, M.A.; Posada-Villa, J.; Kessler, R.C.; Chinese Univ Hong Kong, Dept Psychiat, Hong Kong Mood Disorders Ctr, Hong Kong, Hong Kong, Peoples R China; singlee@cuhk.edu.hk
Background. A number of western studies have suggested that the 6-month duration requirement of generalized anxiety disorder (GAD) does not represent a critical threshold in terms of onset, course, or risk factors of the disorder. No study has examined the consequences of modifying the duration requirement across a wide range of correlates in both developed and developing countries. Method. Population surveys were carried out in seven developing and 10 developed countries using the WHO Composite International Diagnostic Interview (total sample=85052). prevalence and correlates of GAD were compared across mutually exclusive GAD subgroups defined by different minimum duration criteria. Results. Lifetime prevalence estimates for GAD lasting I month, 3 months, 6 months and 12 months were 7.5%, 5.2%, 4.1% and 3.0% for developed countries and 2.7%, 1.8%, 1.5% and 1.2% for developing countries, respectively. There was little difference between GAD of 6 months' duration and GAD of shorter durations (1-2 months, 3-5 months) in age of onset, symptom severity or persistence, co-morbidity or impairment. GAD lasting >= 12 months was the most severe, persistently symptomatic and impaired subgroup. Conclusions. In both developed and developing countries, the clinical profile of GAD is similar regardless of duration. The DSM-IV 6-month duration criterion excludes a large number of individuals who present with shorter generalized anxiety episodes which may be recurrent, impairing and contributory to treatment-seeking. Future iterations of the DSM and ICD should consider modifying the 6-month duration criterion so as to better capture the diversity of clinically salient anxiety presentations.
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.
Substance misuse disguised as ADHD? Authors' reply
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2007) Kessler, R.C.; Fayyad, J.; Karam, E.G.; Alonso, J.; Demyttenaere, K.; Haro, J.M.; Lara, C.; Lepine, J.P.; Zaslavsky, A.M.; Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu
The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: results from the WHO World Mental Health Survey Initiative
(B M J PUBLISHING GROUP, BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND, 2008) De Graaf, R.; Kessler, R.C.; Fayyad, J.; Ten Have, M.; Alonso, J.; Angermeyer, M.; Borges, G.; Demyttenaere, K.; Gasquet, I.; De Girolamo, G.; Haro, J.M.; Jin, R.; Karam, E.G.; Ormel, J.; Posada-Villa, J.; Netherlands Inst Mental Hlth & Addict, NL-3521 VS Utrecht, Netherlands; rgraaf@trimbos.nl
Treatment of suicidal people around the world
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2011) Bruffaerts, R.; Demyttenaere, K.; Hwang, I.; Chiu, W-T.; Sampson, N.; Kessler, R.C.; Alonso, J.; Borges, G.; De Girolamo, G.; De Graaf, R.; Florescu, S.; Gureje, O.; Hu, C.; Karam, E.G.; Kawakami, N.; Kostyuchenko, S.; Kovess-Masfety, V.; Lee, S.; Levinson, D.; Matschinger, H.; Posada-Villa, J.; Sagar, R.; Scott, K.M.; Stein, D.J.; Tomov, T.; Viana, M.C.; Nock, M.K.; UPC KUL, Univ Hosp Gasthuisberg, Louvain, Belgium; ronny.bruffaerts@med.kuleuven.be
Background: Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment. Aims: To examine the receipt of mental health treatment and barriers to care among suicidal people around the world. Method: Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization's World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care. Results: Two-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment. Conclusions: Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.