Browsing by Author "Lepine, J.P."

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Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys
(WILEY-BLACKWELL, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA, 2008) Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J.P.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Tachimori, H.; Mneimneh, Z.N.; Medina-Mora, M.E.; Ormel, J.; Scott, K.M.; Gureje, O.; Haro, J.M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R.C.; Von Korff, M.; Hosp Mar, Inst Municipal Invest Med, Hlth Serv Res Unit, PRBB, Barcelona 08003, Spain; jalonso@imim.es
Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Mental disorders were assessed with Composite International Diagnostic Interview (CIDI) 3.0. Chronic conditions were ascertained by self-report. Household-residing adults (80 737) participated in 17 population surveys in 16 countries. Results: Perceived stigma was present in 13.5% (22.1% in developing and 11.7% in developed countries). Suffering from a depressive or an anxiety disorder (vs. no mental disorder) was associated with about a twofold increase in the likelihood of stigma, while comorbid depression and anxiety was even more strongly associated (OR 3.4, 95%CI 2.7-4.2). Chronic physical conditions showed a much lower association. Conclusion: Perceived stigma is frequent and strongly associated with mental disorders worldwide. Efforts to alleviate stigma among individuals with comorbid depression and anxiety are needed.
Embarrassment when illness strikes a close relative: a World Mental Health Survey Consortium Multi-Site Study
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2013) Ahmedani, B.K.; Kubiak, S.P.; Kessler, R.C.; De Graaf, R.; Alonso, J.; Bruffaerts, R.; Zarkov, Z.; Viana, M.C.; Huang, Y.Q.; Hu, C.; Posada-Villa, J.A.; Lepine, J.P.; Angermeyer, M.C.; De Girolamo, G.; Karam, A.N.; Medina-Mora, M.E.; Gureje, O.; Ferry, F.; Sagar, R.; Anthony, J.C.; Henry Ford Hlth Syst, Ctr Hlth Policy & Hlth Serv Res, 1 Ford Pl,Suite 3A, Detroit, MI 48202 USA.; bahmeda1@hfhs.org
Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2009) Lee, S.; Tsang, A.; Ruscio, A.M.; Haro, J.M.; Stein, D.J.; Alonso, J.; Angermeyer, M.C.; Bromet, E.J.; Demyttenaere, K.; De Girolamo, G.; De Graaf, R.; Gureje, O.; Iwata, N.; Karam, E.G.; Lepine, J.P.; Levinson, D.; Medina-Mora, M.E.; Oakley Browne, M.A.; Posada-Villa, J.; Kessler, R.C.; Chinese Univ Hong Kong, Dept Psychiat, Hong Kong Mood Disorders Ctr, Hong Kong, Hong Kong, Peoples R China; singlee@cuhk.edu.hk
Background. A number of western studies have suggested that the 6-month duration requirement of generalized anxiety disorder (GAD) does not represent a critical threshold in terms of onset, course, or risk factors of the disorder. No study has examined the consequences of modifying the duration requirement across a wide range of correlates in both developed and developing countries. Method. Population surveys were carried out in seven developing and 10 developed countries using the WHO Composite International Diagnostic Interview (total sample=85052). prevalence and correlates of GAD were compared across mutually exclusive GAD subgroups defined by different minimum duration criteria. Results. Lifetime prevalence estimates for GAD lasting I month, 3 months, 6 months and 12 months were 7.5%, 5.2%, 4.1% and 3.0% for developed countries and 2.7%, 1.8%, 1.5% and 1.2% for developing countries, respectively. There was little difference between GAD of 6 months' duration and GAD of shorter durations (1-2 months, 3-5 months) in age of onset, symptom severity or persistence, co-morbidity or impairment. GAD lasting >= 12 months was the most severe, persistently symptomatic and impaired subgroup. Conclusions. In both developed and developing countries, the clinical profile of GAD is similar regardless of duration. The DSM-IV 6-month duration criterion excludes a large number of individuals who present with shorter generalized anxiety episodes which may be recurrent, impairing and contributory to treatment-seeking. Future iterations of the DSM and ICD should consider modifying the 6-month duration criterion so as to better capture the diversity of clinically salient anxiety presentations.
Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys
(AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60610 USA, 2004) Demyttenaere, K.; Bruffaerts, R.; Posada-Villa, J.; Gasquet, I.; Kovess, V.; Lepine, J.P.; Angermeyer, M.C.; Bernert, S.; De Girolamo, G.; Morosini, P.; Polidori, G.; Kikkawa, T.; Kawakami, N.; Ono, Y.; Takeshima, T.; Uda, H.; Karam, E.G.; Fayyad, J.A.; Karam, A.N.; Mneimneh, Z.N.; Medina-Mora, M.E.; Borges, G.; Lara, C.; De Graaf, R.; Ormel, J.; Gureje, O.; Shen, Y.C.; Huang, Y.Q.; Zhang, M.Y.; Alonso, J.; Haro, J.M.; Vilagut, G.; Bromet, E.J.; Gluzman, S.; Webb, C.; Kessler, R.C.; Merikangas, K.R.; Anthony, J.C.; Von Korff, M.R.; Wang, P.S.; Alonso, J.; Brugha, T.S.; Aguilar-Gaxiola, S.; Lee, S.; Heeringa, S.; Pennell, B.E.; Zaslavsky, A.M.; Ustun, T.B.; Chatterji, S.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard
Context Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. Objective 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. Design, Setting, and Participants Face-to-face household surveys of 60463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. Main Outcome Measures 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. Results 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. Conclusions 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.
Substance misuse disguised as ADHD? Authors' reply
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2007) Kessler, R.C.; Fayyad, J.; Karam, E.G.; Alonso, J.; Demyttenaere, K.; Haro, J.M.; Lara, C.; Lepine, J.P.; Zaslavsky, A.M.; Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu