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Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Ronald C Kessler, Harvard Medical School, Boston
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  • Alan E Kazdin, Yale University
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  • Sergio Aguilar-Gaxiola, Center for Reducing Health Disparities, University of California-Davis Health System, Sacramento.
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  • Ali Al-Hamzawi, University of Al-Qadisiya
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  • Jordi Alonso, Hospital del Mar Institute of Medical Research (IMIM PSMar)
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  • Yasmin A Altwaijri, King Faisal Specialist Hospital and Research Center
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  • Laura H Andrade, Universidade de Sao Paulo
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  • Corina Benjet, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
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  • Chrianna Bharat, University of New South Wales
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  • Guilherme Borges, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
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  • Ronny Bruffaerts, Katholieke Universiteit, Leuven
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  • Brendan Bunting, Ulster University
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  • José Miguel Caldas de Almeida, NOVA University Lisbon
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  • Graça Cardoso, NOVA University Lisbon
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  • Wai Tat Chiu, Harvard Medical School, Boston
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  • Alfredo Cía, Anxiety Disorders Research Center
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  • Marius Ciutan, National School of Public Health
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  • Louisa Degenhardt, University of New South Wales
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  • Giovanni de Girolamo, IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli
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  • Peter de Jonge, University of Groningen
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  • Ymkje Anna de Vries, University of Groningen
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  • Silvia Florescu, National School of Public Health
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  • Oye Gureje, University College Hospital, Ibadan
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  • Josep Maria Haro, Universidad de Barcelona
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  • Meredith G Harris, University of Queensland
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  • Chiyi Hu, Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital
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  • Aimee N Karam, Institute for Development Research Advocacy and Applied Care (IDRAAC)
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  • Elie G Karam, Institute for Development Research Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center
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  • Georges Karam, Institute for Development Research Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center
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  • Norito Kawakami, Univ Tokyo, University of Tokyo, IPMU
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  • Andrzej Kiejna, WSB University
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  • Viviane Kovess-Masfety, Université de Paris
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  • Sing Lee, Chinese University of Hong Kong
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  • Victor Makanjuola, University College Hospital, Ibadan
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  • John J McGrath
  • Maria Elena Medina-Mora, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
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  • Jacek Moskalewicz, Institute of Psychiatry and Neurology
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  • Fernando Navarro-Mateu, University of Murcia
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  • Andrew A Nierenberg
  • Daisuke Nishi, Univ Tokyo, University of Tokyo, IPMU
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  • Akin Ojagbemi, University College Hospital, Ibadan
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  • Bibilola D Oladeji, University College Hospital, Ibadan
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  • Siobhan O'Neill, Ulster University
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  • José Posada-Villa, Colegio Mayor de Cundinamarca University
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  • Victor Puac-Polanco, Harvard Medical School, Boston
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  • Charlene Rapsey, University of Otago
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  • Ayelet Meron Ruscio, University of Pennsylvania
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  • Nancy A Sampson, Harvard Medical School, Boston
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  • Kate M Scott, University of Otago
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  • Tim Slade, University of Sydney
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  • WHO World Mental Health Survey Collaborators

Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful.

OriginalsprogEngelsk
TidsskriftWorld Psychiatry
Vol/bind21
Nummer2
Sider (fra-til)272-286
Antal sider15
ISSN1723-8617
DOI
StatusUdgivet - jun. 2022

Bibliografisk note

© 2022 World Psychiatric Association.

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