Undertreatment of people with major depressive disorder in 21 countries

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 KaramNorito Kawakami, Sing Lee, Fernando Navarro-Mateu, Marina Piazza, Jose Posada-Villa, Yolanda Torres De Galvis, Ronald C. Kessler

Research output: Contribution to journalReview article

145 Citations (Scopus)

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. Declaration of interest In the past 3 years, R.C.K. received support for his epidemiological studies from Sanofi Aventis, was a consultant for Johnson & Johnson Wellness and Prevention and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. R.C.K. is a co-owner of DataStat Inc., a market research firm that carries out healthcare research.

Original languageEnglish (US)
Pages (from-to)119-124
Number of pages6
JournalBritish Journal of Psychiatry
Volume210
Issue number2
DOIs
StatePublished - Feb 1 2017

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Major Depressive Disorder
Therapeutics
Diagnostic and Statistical Manual of Mental Disorders
Community-Institutional Relations
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ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola, S., ... Kessler, R. C. (2017). Undertreatment of people with major depressive disorder in 21 countries. British Journal of Psychiatry, 210(2), 119-124. https://doi.org/10.1192/bjp.bp.116.188078

Undertreatment of people with major depressive disorder in 21 countries. / 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.

In: British Journal of Psychiatry, Vol. 210, No. 2, 01.02.2017, p. 119-124.

Research output: Contribution to journalReview article

Thornicroft, G, Chatterji, S, Evans-Lacko, S, Gruber, M, Sampson, N, Aguilar-Gaxiola, S, Al-Hamzawi, A, Alonso, J, Andrade, L, Borges, G, Bruffaerts, R, Bunting, B, De Almeida, JMC, Florescu, S, De Girolamo, G, Gureje, O, Haro, JM, He, Y, Hinkov, H, Karam, E, Kawakami, N, Lee, S, Navarro-Mateu, F, Piazza, M, Posada-Villa, J, De Galvis, YT & Kessler, RC 2017, 'Undertreatment of people with major depressive disorder in 21 countries', British Journal of Psychiatry, vol. 210, no. 2, pp. 119-124. https://doi.org/10.1192/bjp.bp.116.188078
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. / Undertreatment of people with major depressive disorder in 21 countries. In: British Journal of Psychiatry. 2017 ; Vol. 210, No. 2. pp. 119-124.
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AU - Thornicroft, Graham

AU - Chatterji, Somnath

AU - Evans-Lacko, Sara

AU - Gruber, Michael

AU - Sampson, Nancy

AU - Aguilar-Gaxiola, Sergio

AU - Al-Hamzawi, Ali

AU - Alonso, Jordi

AU - Andrade, Laura

AU - Borges, Guilherme

AU - Bruffaerts, Ronny

AU - Bunting, Brendan

AU - De Almeida, Jose Miguel Caldas

AU - Florescu, Silvia

AU - De Girolamo, Giovanni

AU - Gureje, Oye

AU - Haro, Josep Maria

AU - He, Yanling

AU - Hinkov, Hristo

AU - Karam, Elie

AU - Kawakami, Norito

AU - Lee, Sing

AU - Navarro-Mateu, Fernando

AU - Piazza, Marina

AU - Posada-Villa, Jose

AU - De Galvis, Yolanda Torres

AU - Kessler, Ronald C.

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N2 - 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. Declaration of interest In the past 3 years, R.C.K. received support for his epidemiological studies from Sanofi Aventis, was a consultant for Johnson & Johnson Wellness and Prevention and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. R.C.K. is a co-owner of DataStat Inc., a market research firm that carries out healthcare research.

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