Journal Article

Undertreatment of people with major depressive disorder in 21 countries

Navarro-Mateu, Fernando, Posada-Villa, Jose, Kessler, Ronald C., Gruber, Michael, Bruffaerts, Ronny, He, Yanling, Aguilar-Gaxiola, Sergio, de Girolamo, Giovanni, Gureje, Oye, de Galvis, Yolanda Torres, Chatterji, Somnath, Thornicroft, Graham, Karam, Elie, Evans-Lacko, Sara, Borges, Guilherme, Haro, Josep Maria, Sampson, Nancy, Al-Hamzawi, Ali, Bunting, Brendan, de Almeida, Jose Miguel Caldas, Lee, Sing, Hinkov, Hristo, Alonso, Jordi, Florescu, Silvia, Kawakami, Norito, Andrade, Laura, Piazza, Marina

2017

Overview

Major depressive disorder (MDD) is a leading cause of disability worldwide. To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards. Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys. Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment. Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.

• Publisher: Cambridge University Press,Royal College of Psychiatrists
• Subject: Adequacy / Adolescent / Adult / Aged / Aged, 80 and over / Bipolar disorder / Community education / Community mental health services / Depressive Disorder, Major - epidemiology / Depressive Disorder, Major - therapy / Depressive personality disorders / Disability / Drug use / Female / Global Health - statistics & numerical data / Health care policy / Health Surveys / Humans / Interviews / Low income groups / Male / Mental depression / Mental disorders / Mental health / Mental health services / Mental Health Services - standards / Mental Health Services - statistics & numerical data / Middle Aged / Patient Acceptance of Health Care - statistics & numerical data / Polls & surveys / Prevalence / Psychiatry / Public health / Respondents / Sustainable development / Treatment needs / Young Adult