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Title: Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries
Authors: Alonso, Jordi
Liu, Zhaorui
Evans-Lacko, Sara
Sadikova, Ekaterina
Sampson, Nancy
Chatterji, Somnath
Abdulmalik, Jibril
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Andrade, Laura H
Bruffaerts, Ronny
Cardoso, Graça
Cia, Alfredo
Florescu, Silvia
de Girolamo, Giovanni
Gureje, Oye
Haro, Josep M
He, Yanling
de Jonge, Peter
Karam, Elie
Kawakami, Norito
Kovess-Masfety, Viviane
Lee, Sing
Levinson, Daphna
Medina-Mora, Maria Elena
Navarro-Mateu, Fernando
Pennell, Beth-Ellen
Piazza, Marina
Posada-Villa, José
Ten Have, Margreet
Zarkov, Zahari
Kessler, Ronald C
Thornicroft, Graham
Affiliations: Faculty of Medicine 
Keywords: Adequate treatment
Anxiety disorders
Health services
Perceived need for care
Issue Date: 2018
Publisher: National Library of Medicine
Part of: Depression and Anxiety
Volume: 35
Issue: 3
Start page: 195
End page: 208
Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12-month DSM-IV anxiety disorder in 21 countries, the proportion who: i) perceived a need for treatment; ii) received any treatment; and (iii) received possibly adequate treatment.

Data from 24 community surveys in 21 countries of the WMH surveys. DSM-IV mental disorders were assessed (WHO Composite International Diagnostic Interview, CIDI 3.0). DSM-IV included PTSD among anxiety disorders, while it is not considered so in the DSM-5. We asked if, in the previous 12 months, respondents felt they needed professional treatment and if they obtained professional treatment (specialized/general medical, complementary alternative medical, or non-medical professional) for “problems with emotions, nerves, mental health, or use of alcohol or drugs”. Possibly adequate treatment was defined as receiving pharmacotherapy (1+ months of medication and 4+ visits to a medical doctor) or psychotherapy, CAM or non-medical care (8+ visits).

Of 51,547 respondents (response=71.3%), 9.8% had a 12-month DSM-IV anxiety disorder, 27.6% of whom received any treatment, and only 9.8% received possibly adequate treatment. 41.3% of those with 12-month anxiety perceived a need for care. Lower treatment levels were found for lower income countries.

Low levels of service use and a high proportion of those receiving services not meeting adequacy standards for anxiety disorders exist worldwide. Results suggest the need for improving recognition of anxiety disorders and the quality of treatment.
ISSN: 10914269
DOI: 10.1002/da.22711
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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