Jun 2 2004
The World Health Organization has found mental disorders to be common throughout the world. Many people don't get treatment, but others get treatment when they may not need it. The authors conclude that reallocating treatment resources could provide needed treatment in both developed and developing countries. The findings of the new World Mental Health Surveys published in the June 2, 2004 issue of The Journal of the American Medical Association(JAMA).
The researchers found that the prevalence of having any mental disorder in the prior year varied widelyfrom 4.3 percent in Shanghai to 26.4 percent in the United States. “Between 33.1 percent (Columbia) and 80.9 percent (Nigeria) of 12-month cases were mild,” according to researchers. “Serious disorders were associated with substantial role disability [inability to carry out usual activities]."
Many of these disorders go untreated. "Although disorder severity was correlated with probability of treatment in almost all countries, 35.5 percent to 50.3 percent of serious cases in developed countries and 76.3 percent to 85.4 percent in less-developed countries received no treatment in the 12 months before the interview.”
Other people with fewer symptoms do get treatment. The researchers report that “due to the high prevalence of mild and sub-threshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country.” The term “subthreshold case” refers to people who received treatment even though they did not meet full criteria for a mental disorder.
Reallocating resources may help.The authors of this study are cautious in concluding that we can reallocate resources from people with milder symptoms to treat those untreated people with more severe disorders. They note that some people with mild symptoms might progress to severe symptoms if left untreated. They recommend that countries develop "secondary prevention programs" to treat mild symptoms early, rather than just divert money to treat people with severe problems.
Co-authors of the study, Ronald C. Kessler, Ph.D. and T. Bedirhan Ustun, M.D. (along with co-authors from The WHO World Mental Health Survey Consortium) analyzed data from 60,463 face-to-face household surveys with adults in 14 countries (6 considered less developed, 8 considered developed) to estimate the prevalence, severity, and treatment of mental disorders. The surveys were conducted from 2001 - 2003 in Columbia, Mexico, United States, Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine, Lebanon, Nigeria, Japan, and in Beijing and Shanghai in the People’s Republic of China. The six countries classified as less developed by the World Bank are China, Colombia, Lebanon, Mexico, Nigeria, and Ukraine.
Reference: JAMA. 2004;291:2581-2590.
Last updated 11/5/05
