Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys
Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys
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DOI：
10.1016/s0140-6736(07)61414-7
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发表时间：
2007-09-08
期刊：
影响因子：
168.9
通讯作者：
Wells, J. Elisabeth
中科院分区：
文献类型：
--
作者：
Wang, Philip S.;Aguilar-Gaxiola, Sergio;Wells, J. Elisabeth
背景精神障碍是全世界残疾的主要原因，包括在最无法承受这种负担的低收入和中等收入国家。我们描述了在17个国家参加世界卫生组织世界精神卫生（WMH）调查倡议的精神卫生保健，并检查未满足的治疗需求。方法面对面的家庭调查进行了84850社区成年受访者在低收入或中等收入（哥伦比亚、黎巴嫩、墨西哥、尼日利亚、中国、南非、乌克兰）和高收入国家（比利时、法国、德国、以色列、意大利、日本、荷兰、新西兰、西班牙、美国）。超过12个月的精神障碍的患病率和严重程度，以及精神卫生服务的使用，与WMH复合国际诊断访谈进行了评估。Logistic回归分析被用来研究接受任何12个月的服务的社会人口学预测。结果使用任何12个月的精神卫生服务的受访者人数（57 [2%;尼日利亚]至1477 [18%;美国]）在发展中国家普遍低于发达国家，接受服务的比例往往与各国用于医疗保健的国内生产总值的百分比相对应。虽然疾病的严重性与服务使用有关，但只有5名（11%;中国）至46名（61%;比利时）严重疾病患者在前一年接受了任何治疗。普通医疗部门是精神卫生服务的最大来源。在开始治疗的受访者中，152人（70%;德国）至129人（95%;意大利）接受了任何后续护理，1人（10%;尼日利亚）至113人（42%;法国）接受了符合充分性最低标准的治疗。男性，已婚，教育程度较低，在极端的年龄或收入的患者治疗less.Interpretation未满足的需求，心理健康治疗是普遍的，特别是在欠发达国家的关注。要缓解这些未得到满足的需求，就需要扩大和优化分配治疗资源。
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.