Mental health in the Americas: an overview of the treatment gap
Mental health in the Americas: an overview of the treatment gap
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DOI：
10.26633/rpsp.2018.165
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发表时间：
2018-01-01
影响因子：
2.6
通讯作者：
Vicente, Benjamin
中科院分区：
文献类型：
--
作者：
Kohn, Robert;Ali, Ali Ahsan;Vicente, Benjamin
目标。通过检查精神卫生障碍的流行情况、精神卫生服务的使用情况和全球疾病负担，了解美洲地区的精神卫生治疗差距。利用了来自阿根廷、巴西、加拿大、智利、哥伦比亚、危地马拉、墨西哥、秘鲁和美国精神障碍社区调查的数据。世界精神卫生调查公布的数据被用来估计治疗差距。对于加拿大、智利和危地马拉，治疗差距是根据数据文件计算的。估计一般成人、儿童-青少年和土著人口按严重程度和精神障碍类别划分的平均、中位数和加权治疗差距以及12个月患病率。残疾调整寿命年和残疾生活年数是根据全球疾病负担研究计算的。精神和物质使用障碍占美洲全球疾病负担的10.5%。在所有研究中，严重精神障碍的12个月患病率在2% - 10%之间。美洲中度至重度疾病的加权平均治疗差距为65.7%；北美，53.2%；拉丁美洲，74.7%；中美洲,78.7%;南美洲占73.1%。儿童和青少年严重精神障碍的治疗差距超过50%。美国三分之一的土著人口和拉丁美洲80%的土著人口没有接受治疗。精神卫生方面的治疗差距仍然是一个令人关切的公共卫生问题。患有严重精神疾病的成人、儿童和土著居民中，有很大一部分人仍未得到治疗。其结果是精神障碍患病率上升和全球疾病负担加重。
Objective. To understand the mental health treatment gap in the Region of the Americas by examining the prevalence of mental health disorders, use of mental health services, and the global burden of disease.Methods. Data from community-based surveys of mental disorders in Argentina, Brazil, Canada, Chile, Colombia, Guatemala, Mexico, Peru, and the United States were utilized. The World Mental Health Survey published data were used to estimate the treatment gap. For Canada, Chile, and Guatemala, the treatment gap was calculated from data files. The mean, median, and weighted treatment gap, and the 12-month prevalence by severity and category of mental disorder were estimated for the general adult, child-adolescent, and indigenous populations. Disability-adjusted Life Years and Years Lived with Disability were calculated from the Global Burden of Disease study.Results. Mental and substance use disorders accounted for 10.5% of the global burden of disease in the Americas. The 12-month prevalence rate of severe mental disorders ranged from 2% - 10% across studies. The weighted mean treatment gap in the Americas for moderate to severe disorders was 65.7%; North America, 53.2%; Latin America, 74.7%; Mesoamerica, 78.7%; and South America, 73.1%. The treatment gap for severe mental disorders in children and adolescents was over 50%. One-third of the indigenous population in the United States and 80% in Latin America had not received treatment.Conclusion. The treatment gap for mental health remains a public health concern. A high proportion of adults, children, and indigenous individuals with serious mental illness remains untreated. The result is an elevated prevalence of mental disorders and global burden of disease.