Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys.
Journal: International journal of mental health systems
Volume: 16
Issue: 1
Year of Publication:
Affiliated Institutions:
Department of Psychiatry, University of British Columbia, UBC Hospital - Detwiller Pavilion, Room , Wesbrook Mall, UBC Vancouver Campus, Vancouver, BC, VT A, Canada. daniel.vigo@ubc.ca.
Department of Psychology, Yale University, Hillhouse Avenue- , New Haven, CT, , USA.
Department of Health Care Policy, Harvard Medical School, Longwood Avenue, Boston, MA, , USA.
IMIM-Hospital del Mar Medical Research Institute, PRBB Building, Doctor Aiguader, , , Barcelona, Spain.
University of São Paulo Medical School, Núcleo de Epidemiologia Psiquiátrica - LIM , Rua Dr. Ovidio Pires de Campos, , São Paulo, CEP, -, Brazil.
Department of Psychiatry, University College Hospital, University of Ibadan, Ibadan, , PMB, Nigeria.
National Institute of Psychiatry Ramón de La Fuente Muñiz, Calzada México-Xochimilco, , Colonia San Lorenzo Huipulco, , Mexico City, DF, Mexico.
University Psychiatric Center, University of Louvain - KU Leuven, Herestraat , B-, Leuven, Belgium.
School of Psychology, Ulster University, College Avenue, Londonderry, BT JL, UK.
Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni , Brescia, Italy.
National School of Public Health, Management and Development, Vaselor Str., , Bucharest, Romania.
School of Public Health, The University of Queensland, c/o QCMHR, Locked Bag , Archerfield, QLD, , Australia.
Department of Psychiatry & Clinical Psychology, St. George Hospital University Medical Center, Beirut, , Ashrafieh, Lebanon.
EHESP-School of Public Health, Paris Descartes University, Avenue George Sand La Plaine, , Saint Denis, France.
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong, China.
Murcia Health Service, C/ Lorca, nº . -El Palmar, , Murcia, Spain.
Colegio Mayor de Cundinamarca University, Calle No. -, , Bogotá, Colombia.
Department of Psychological Medicine, University of Otago, PO Box , Dunedin, , New Zealand.
Faculty of Medicine, University of Buenos Aires, Paraguay , CABG CABA, Buenos Aires, Argentina.
Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Da Costakade Postbus , , VS, Utrecht, The Netherlands.
Department of Psychiatry, National Taiwan University Hospital & College of Medicine, National Taiwan University, No. , Chung-Shan South Road, Taipei, , Taiwan.
Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), Nova Medical School, Universidade Nova de Lisboa, Campo Mártires da Pátria, , -, Lisbon, Portugal.
Abstract summary
Most individuals with major depressive disorder (MDD) receive either no care or inadequate care. The aims of this study is to investigate potential determinants of effective treatment coverage.In order to examine obstacles to providing or receiving care, the type of care received, and the quality and use of that care in a representative sample of individuals with MDD, we analyzed data from 17 WHO World Mental Health Surveys conducted in 15 countries (9 high-income and 6 low/middle-income). Of 35,012 respondents, 3341 had 12-month MDD. We explored the association of socio-economic and demographic characteristics, insurance, and severity with effective treatment coverage and its components, including type of treatment, adequacy of treatment, dose, and adherence.High level of education (OR = 1.63; 1.19, 2.24), private insurance (OR = 1.62; 1.06, 2.48), and age (30-59yrs; OR = 1.58; 1.21, 2.07) predicted effective treatment coverage for depression in a multivariable logistic regression model. Exploratory bivariate models further indicate that education may follow a dose-response relation; that people with severe depression are more likely to receive any services, but less likely to receive adequate services; and that in low and middle-income countries, private insurance (the only significant predictor) increased the likelihood of receiving effective treatment coverage four times.In the regression models, specific social determinants predicted effective coverage for major depression. Knowing the factors that determine who does and does not receive treatment contributes to improve our understanding of unmet needs and our ability to develop targeted interventions.
Authors & Co-authors:
Vigo Daniel V DV
Kazdin Alan E AE
Sampson Nancy A NA
Hwang Irving I
Alonso Jordi J
Andrade Laura Helena LH
Ayinde Olatunde O
Borges Guilherme G
Bruffaerts Ronny R
Bunting Brendan B
de Girolamo Giovanni G
Florescu Silvia S
Gureje Oye O
Haro Josep Maria JM
Harris Meredith G MG
Karam Elie G EG
Karam Georges G
Kovess-Masfety Viviane V
Lee Sing S
Navarro-Mateu Fernando F
Posada-Villa José J
Scott Kate K
Stagnaro Juan Carlos JC
Have Margreet Ten MT
Wu Chi-Shin CS
Xavier Miguel M
Kessler Ronald C RC
Study Outcome
Source Link: Visit source