Browsing by Author "Wang, P.S."

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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.
Treatment of mental disorders for adolescents in Mexico City
(WORLD HEALTH ORGANIZATION, MARKETING AND DISSEMINATION, CH-1211 GENEVA 27, SWITZERLAND, 2008) Borges, G.; Benjet, C.; Medina-Mora, M.E.; Orozco, R.; Wang, P.S.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990-1992 to 2001-2003
(AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60610 USA, 2005) Kessler, R.C.; Berglund, P.; Borges, G.; Nock, M.; Wang, P.S.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu
Context Little is known about trends in suicidal ideation, plans, gestures, or attempts or about their treatment. Such data are needed to guide and evaluate policies to reduce suicide-related behaviors. Objective To analyze nationally representative trend data on suicidal ideation, plans, gestures, attempts, and their treatment. Design, Setting, and Participants Data came from the 1990-1992 National Comorbidity Survey and the 2001-2003 National Comorbidity Survey Replication. These surveys asked identical questions to 9708 people aged 18 to 54 years about the past year's occurrence of suicidal ideation, plans, gestures, attempts, and treatment. Trends were evaluated by using pooled logistic regression analysis. Face-to-face interviews were administered in the homes of respondents, who were nationally representative samples of US English-speaking residents, Main Outcome Measure Self-reports about suicide-related behaviors and treatment in the year before interview. Results No significant changes occurred between 1990-1992 and 2001-2003 in suicidal ideation (2.8% vs 3.3%; P=.43), plans (0.7% vs 1.0%; P=.15), gestures (0.3% vs 0.2%; P=.24), or attempts (0.4%-0.6%; P=.45), whereas conditional prevalence of plans among ideators increased significantly (from 19.6% to 28.6%; P=.04), and conditional prevalence of gestures among planners decreased significantly (from 21.4% to 6.4%; P=.003). Treatment increased dramatically among ideators who made a gesture (40.3% vs 92.8%) and among ideators who made an attempt (49.6% vs 79.0%). Conclusions Despite a dramatic increase in treatment, no significant decrease occurred in suicidal thoughts, plans, gestures, or attempts in the United States during the 1990s. Continued efforts are needed to increase outreach to untreated individuals with suicidal ideation before the occurrence of attempts and to improve treatment effectiveness for such cases.