Mental disorders in Latin America and the Caribbean: a public health priority
Mental disorders in Latin America and the Caribbean: a public health priority
复制标题
DOI：
10.1590/s1020-49892005000900002
复制
发表时间：
2005-11-01
期刊：
影响因子：
--
通讯作者：
Saraceno, Benedetto
中科院分区：
文献类型：
--
作者：
Kohn, Robert;Levav, Itzhak;Saraceno, Benedetto
Objective.拉丁美洲和加勒比地区精神疾病的负担日益沉重，已到了不容忽视的地步。有必要更多地了解精神障碍的流行情况，以及患有精神障碍的人数与尽管存在有效治疗但仍得不到治疗的人数之间的差距。有了这些知识，就有可能改善宣传，采取更好的政策，制定创新的干预方案，并根据需要分配资源。数据来自1980年至2004年在拉丁美洲和加勒比地区发表的基于社区的精神病学流行病学研究，这些研究使用结构化诊断工具并提供流行率。拉丁美洲和加勒比地区各种疾病的粗发病率估计数是通过计算各研究中按性别分列的平均发病率和中位发病率来确定的。此外，对服务利用的数据进行了审查，以计算特定疾病的治疗差距。非情感性精神病（包括精神分裂症）的估计平均一年患病率为1.0%;重度抑郁症为4.9%;酒精滥用或依赖为5.7%。超过三分之一的非情感性精神病患者、超过一半的焦虑症患者以及大约四分之三的酗酒或依赖者没有从专业或一般卫生服务机构获得心理健康护理。结论。拉丁美洲和加勒比目前在精神卫生保健方面的治疗差距仍然很大。此外，目前的数据可能大大低估了未经治疗的人数。流行病学的转变和人口结构的变化将进一步扩大拉丁美洲和加勒比的治疗差距，除非制定或更新精神卫生政策，并扩大方案和服务。
Objective. The growing burden of mental disorders in Latin America and the Caribbean has become too large to ignore. There is a need to know more about the prevalence of mental disorders and the gap between the number of individuals with psychiatric disorders and the number of those persons who remain untreated even though effective treatments exist. Having that knowledge would make it possible to improve advocacy, adopt better policies, formulate innovative intervention programs, and apportion resources commensurate with needs.Methods. Data were extracted from community-based psychiatric epidemiological studies published in Latin America and the Caribbean from 1980 through 2004 that used structured diagnostic instruments and provided prevalence rates. Estimates of the crude rates in Latin America and the Caribbean for the various disorders were determined by calculating the mean and median rates across the studies, by gender. In addition, data on service utilization were reviewed in order to calculate the treatment gap for specific disorders.Results. Nonaffective psychosis (including schizophrenia) had an estimated mean one-year prevalence rate of 1.0%; major depression, 4.9%; and alcohol use abuse or dependence, 5.7%. Over one-third of individuals with nonaffective psychosis, over half of those with an anxiety disorder, and some three-fourths of those with alcohol use abuse or dependence did not receive mental health care from either specialized or general health services.Conclusions. The current treatment gap in mental health care in Latin America and the Caribbean remains wide. Further, current data likely greatly underestimate the number of untreated individuals. The epidemiological transition and changes in the population structure will further widen the treatment gap in Latin America and the Caribbean unless mental health policies are formulated or updated and programs and services are expanded.