Undertreatment of People with Major Depressive Disorder in 21 Countries

Overview

Journal Br J Psychiatry

Publisher Cambridge University Press

Specialty Psychiatry

Date 2016 Dec 3

PMID 27908899

Citations 364

Authors

Graham Thornicroft

Somnath Chatterji

Sara Evans-Lacko

Michael Gruber

Nancy Sampson

Sergio Aguilar-Gaxiola

Ali Al-Hamzawi

Jordi Alonso

Laura Andrade

Guilherme Borges

Ronny Bruffaerts

Brendan Bunting

Jose Miguel Caldas de Almeida

Silvia Florescu

Giovanni de Girolamo

Oye Gureje

Josep Maria Haro

Yanling He

Hristo Hinkov

Elie Karam

Norito Kawakami

Sing Lee

Fernando Navarro-Mateu

Marina Piazza

Jose Posada-Villa

Yolanda Torres de Galvis

Ronald C Kessler

Affiliations

Soon will be listed here.

Abstract

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

Aims: 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.

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

Results: 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.

Conclusions: 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.

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