Abstract summary 

Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries.To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative.Face-to-face household surveys of 60 463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia.The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview.The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5% to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country.Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases, especially those at risk for progressing to more serious disorders.

Authors & Co-authors:  Demyttenaere Koen K Bruffaerts Ronny R Posada-Villa Jose J Gasquet Isabelle I Kovess Viviane V Lepine Jean Pierre JP Angermeyer Matthias C MC Bernert Sebastian S de Girolamo Giovanni G Morosini Pierluigi P Polidori Gabriella G Kikkawa Takehiko T Kawakami Norito N Ono Yutaka Y Takeshima Tadashi T Uda Hidenori H Karam Elie G EG Fayyad John A JA Karam Aimee N AN Mneimneh Zeina N ZN Medina-Mora Maria Elena ME Borges Guilherme G Lara Carmen C de Graaf Ron R Ormel Johan J Gureje Oye O Shen Yucun Y Huang Yueqin Y Zhang Mingyuan M Alonso Jordi J Haro Josep Maria JM Vilagut Gemma G Bromet Evelyn J EJ Gluzman Semyon S Webb Charles C Kessler Ronald C RC Merikangas Kathleen R KR Anthony James C JC Von Korff Michael R MR Wang Philip S PS Brugha Traolach S TS Aguilar-Gaxiola Sergio S Lee Sing S Heeringa Steven S Pennell Beth-Ellen BE Zaslavsky Alan M AM Ustun T Bedirhan TB Chatterji Somnath S

Study Outcome 

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