Browsing by Author "Wang, Philip S."

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Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative
(ELSEVIER MASSON, VIA PALEOCAPA 7, 20121 MILANO, ITALY, 2007) Wang, Philip S.; Angermeyer, Matthias; Borges, Guilherme; Bruffaerts, Ronny; Chiu, Wai Tat; De Girolamo, Giovanni; Fayyad, John; Gureje, Oye; Maria Haro, Josep; Huang, Yueqin; Kessler, Ronald C.; Kovess, Viviane; Levinson, Daphna; Nakane, Yoshibumi; Browne, Mark A. Oakley; Ormel, Johan H.; Posada-Villa, José; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Lee, Sing; Heeringa, Steven; Pennell, Beth-Ellen; Chatterji, Somnath; Uestuen, T. Bedirhan; NIMH, Div Serv & Intervent Res, Bethesda, MD 20892 USA
Data are presented on patterns of failure and delay in making initial treatment contact after first onset of a mental disorder in 15 countries in the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Representative face-to-face household surveys were conducted among 76,012 respondents aged 18 and older in Belgium, Colombia, France, Germany, Israel, Italy, Japan, Lebanon, Mexico, the Netherlands, New Zealand, Nigeria, People's Republic of China (Beijing and Shanghai), Spain, and the United States. The WHO Composite International Diagnostic Interview (CIDI) was used to assess lifetime DSM-IV anxiety, mood, and substance use disorders. Ages of onset for individual disorders and ages of first treatment contact for each disorder were used to calculate the extent of failure and delay in initial help seeking. The proportion of lifetime cases making treatment contact in the year of disorder onset ranged from 0.8 to 36.4% for anxiety disorders, from 6.0 to 52.1 % for mood disorders, and from 0.9 to 18.6% for substance use disorders. By 50 years, the proportion of lifetime cases making treatment contact ranged from 15.2 to 95.0% for anxiety disorders, from 7.9 to 98.6% for mood disorders, and from 19.8 to 86.1% for substance use disorders. Median delays among cases eventually making contact ranged from 3.0 to 30.0 years for anxiety disorders, from 1.0 to 14.0 years for mood disorders, and from 6.0 to 18.0 years for substance use disorders. Failure and delays in treatment seeking were generally greater in developing countries, older cohorts, men, and cases with earlier ages of onset. These results show that failure and delays in initial help seeking are pervasive problems worldwide. Interventions to ensure prompt initial treatment contacts are needed to reduce the global burdens and hazards of untreated mental disorders.
Delay of first treatment of mental and substance use disorders in Mexico
(2007) Borges, Guilherme; Wang, Philip S.; Medina-Mora, María Elena; Lara, Carmen; Chiu, Wai Tat
Service use among Mexico City adolescents with suicidality
(ELSEVIER SCIENCE BV, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS, 2010) Borges, Guilherme; Benjet, Corina; Medina-Mora, María Elena; Orozco, Ricardo; Familiar, Itziar; Nock, Matthew K.; Wang, Philip S.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Background: We report the lifetime and 12-month prevalence and associations of mental health treatment among Mexican adolescents with suicide-related outcomes (SROs; including ideation, plans, gestures and attempts). Methods: A representative multistage probability household survey of 3005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area was carried out in 2005. Discrete-time survival analyses were used to assess the relationships between SROs and receiving treatment for emotional, alcohol, or drug problems. Results: The prevalence of lifetime service use among respondents with SROs was 35% for those with ideation only, 44% for those with ideation and plan, 49% for those with gesture and 50% for those with attempt; the prevalence of 12-month service use was 10%, 24%, 6% and 21%, respectively. Timing between onset of SRO and receiving treatment for emotional, alcohol, or drug problems showed that about 50% of adolescents will have contact with a service provider before developing any SRO. Healthcare professionals were the most likely to be consulted, followed by school-based programs. Limitations: This survey was limited to adolescents living in one of the largest metropolitan areas in the world and the analyses used data on retrospectively reported ages of onset that are subject to recall errors. Conclusions: Most suicidal adolescents do not receive treatment, and many adolescents develop their suicidality in spite of prior contacts with service providers. Interventions to increase treatment, prevention, and monitoring are sorely needed for this vulnerable population. (C) 2009 Elsevier B.V. All rights reserved.
Treatment and adequacy of treatment of mental disorders among respondents to the Mexico National Comorbidity Survey
(AMER PSYCHIATRIC PUBLISHING, INC, 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA, 2006) Borges, Guilherme; Medina-Mora, María Elena; Wang, Philip S.; Lara, Carmen; Berglund, Patricia; Walters, Ellen; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
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.