Prevalence and Treatment of Mental Disorders, 1990 to 2003

Kessler, Ronald C.; Demler, Olga V.; Frank, Richard G.; Olfson, Mark; Pincus, Harold Alan; Walters, Ellen E.; Wang, Philip; Wells, Kenneth B.; Zaslavsky, Alan M.

doi:10.1056/nejmsa043266

Cited by 1,740 publications

(1,216 citation statements)

References 28 publications

(19 reference statements)

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“…These disorders are a leading cause of disability globally (Steel et al, 2014). It is estimated that less than one-third of individuals in the USA and Europe and less than one-fifth in low- and middle-income countries (LMICs) receive treatment for treatable psychiatric conditions (Group, 2007; Kessler et al, 2005; Wang et al, 2007). …”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

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Background: We investigated the prevalence of and factors associated with post-traumatic stress disorder (PTSD) and common mental disorders (CMDs), which include depression and anxiety disorders, in a setting with a prevalence of high human immunodeficiency virus (HIV) within a primary care clinic, using the PTSD Checklist for DSM-5 and the 14-item Shona Symptom Questionnaire, both locally validated screening tools.Methods: A cross-sectional survey was carried out with adult patients (n = 204) from the largest primary care clinic facility in Harare, Zimbabwe, in June 2016.Results: A total of 83 patients (40.7%) met the criteria for probable PTSD, of whom 57 (69.5%) had comorbid CMDs. Among people living with HIV, 42 (55.3%) had PTSD. Probable PTSD was associated with having experienced a negative life event in the past 6 months [adjusted odds ratio (OR) 3.73, 95% confidence interval (CI) 1.49–9.34] or screening positive for one or more CMD (adjusted OR 6.48, 95% CI 3.35–2.54).Conclusion: People living with HIV showed a high prevalence of PTSD and CMD comorbidity. PTSD screening should be considered when the CMD screen is positive and there is a history of negative life events.

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Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

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“…Previous studies have suggested that undiagnosed mental illness (particularly among men and certain ethnic subgroups), lack of insurance, and low income may be predictors of the underuse of antidepressants and other mental health treatment modalities (11,14,20,23–27,30–32). We fit a multivariate logistic regression model to examine predictors of overuse, including age, gender, self-reported race-ethnicity, education level, income group, and insurance status (11,14,20,23–27,31,32).…”

Section: Methodsmentioning

confidence: 99%

“…Epidemiologic surveys have been used to bound estimates of overuse of mental health treatments. Results suggest that approximately half of respondents who obtained treatment for mental or substance use disorders in a study year did not meet criteria for any disorders assessed (23,28,29). Recent analyses suggest that these overuse estimates are likely biased upward (11).…”

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confidence: 95%

“…The problems of underdiagnosis and undertreatment of depression are a major public health concern, and measures have been taken to increase public awareness, improve systematic screening, and implement evidence-based treatment guidelines (23–26). As a consequence, increased utilization may be viewed as evidence suggesting that depression and other mental disorders are becoming better identified and treated through advances in the availability of more tolerated pharmacological treatments (8,16,27).…”

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confidence: 99%

“…We classified documented clinical indications for overuse by using sample stratification. We used multivariate regression to examine socioeconomic and subclinical predictors of overuse consistent with previous reports of underuse and overuse (11,14, 20,23–27,30–32). …”

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confidence: 99%

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Overuse of Antidepressants in a Nationally Representative Adult Patient Population in 2005

Conti¹

2011

Psychiatric Services

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Objective Concerns have been raised that antidepressants may be overused. This study aimed to provide an estimate of antidepressant overuse in a more recent, nationally representative sample of adults and with a more contemporary set of antidepressants than has been covered in prior studies. Methods The data set included adult (weighted N=23,026,608) respondents who self-reported antidepressant treatment in the household and prescription drug components of the 2005 Medical Expenditure Panel Survey. Overuse was defined as off-label antide-pressant prescribing with limited or no scientific support for use as a treatment for the diagnosis, according to the Physicians’ Desk Reference, the United States Pharmacopeia–National Formulary, and the Micromedex DrugDx data system. Stratification and multivariate logistic regression was used to examine clinical and socioeconomic predictors of overuse. Results Overuse was estimated at 20%, with the majority concentrated in newer-generation antidepressants (74% of overuse). Another 30%–40% of overuse was associated with documented diagnoses that may represent a reasonable clinical rationale for antidepressant use or suggest underdiagnosis of possible depressive and anxiety syndromes. Older age (odds ratio [OR]=.95, p=.03) and self-report of poor mental health (OR=.80, p=.02) were negatively associated with overuse. Conclusions Antidepressant overuse among adults is less common than previously reported. Our results suggest that the actual extent of overuse may be lower than 20%. To improve treatment quality and the efficiency of the U.S. health care system, nationally representative data collection efforts on prescription drug use should aim to include enhanced measures of need in order to further refine future estimates of antidepressant overuse.

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Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents

Nock¹,

Green²,

Hwang³

et al. 2013

JAMA Psychiatry

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Prevalence and Treatment of Mental Disorders, 1990 to 2003

Abstract: Background-Although the 1990s saw enormous change in the US mental health care system, little is known about changes in prevalence or treatment of mental disorders.

Cited by 1,740 publications

References 28 publications

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Overuse of Antidepressants in a Nationally Representative Adult Patient Population in 2005

Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents

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