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Title: Undertreatment of people with major depressive disorder in 21 countries
Authors: Thornicroft, Graham
Chatterji, Somnath
Evans-Lacko, Sara
Gruber, Michael
Sampson, Nancy
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Andrade, Laura
Borges, Guilherme
Bruffaerts, Ronny
Bunting, Brendan
de Almeida, Jose Miguel Caldas
Florescu, Silvia
de Girolamo, Giovanni
Gureje, Oye
Haro, Josep Maria
He, Yanling
Hinkov, Hristo
Karam, Elie
Kawakami, Norito
Lee, Sing
Navarro-Mateu, Fernando
Piazza, Marina
Posada-Villa, Jose
de Galvis, Yolanda Torres
Kessler, Ronald C
Affiliations: Faculty of Medicine 
Issue Date: 2017
Part of: British Journal of Psychiatry
Volume: 210
Issue: 2
Start page: 119
End page: 124

Major depressive disorder (MDD) is a leading cause of disability worldwide.


To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards.


Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys.


Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment.


Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.
ISSN: 00071250
DOI: 10.1192/bjp.bp.116.188078
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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