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Journal Articles International Journal of Mental Health Systems Year : 2022

Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys

Alan Kazdin
  • Function : Author
Nancy Sampson
  • Function : Author
Irving Hwang
  • Function : Author
Jordi Alonso
  • Function : Author
Laura Helena Andrade
  • Function : Author
Olatunde Ayinde
  • Function : Author
Guilherme Borges
  • Function : Author
Ronny Bruffaerts
  • Function : Author
Brendan Bunting
  • Function : Author
Giovanni de Girolamo
  • Function : Author
Silvia Florescu
  • Function : Author
Oye Gureje
  • Function : Author
Josep Maria Haro
  • Function : Author
Meredith Harris
  • Function : Author
Elie Karam
  • Function : Author
Georges Karam
  • Function : Author
Sing Lee
  • Function : Author
Fernando Navarro-Mateu
  • Function : Author
José Posada-Villa
  • Function : Author
Kate Scott
  • Function : Author
Juan Carlos Stagnaro
  • Function : Author
Margreet Ten Have
  • Function : Author
Chi-Shin Wu
  • Function : Author
Miguel Xavier
  • Function : Author
Ronald Kessler
  • Function : Author

Abstract

Background: Most individuals with major depressive disorder (MDD) receive either no care or inadequate care. The aims of this study is to investigate potential determinants of effective treatment coverage. Methods: In order to examine obstacles to providing or receiving care, the type of care received, and the quality and use of that care in a representative sample of individuals with MDD, we analyzed data from 17 WHO World Mental Health Surveys conducted in 15 countries (9 high-income and 6 low/middle-income). Of 35,012 respondents, 3341 had 12-month MDD. We explored the association of socio-economic and demographic characteristics, insurance, and severity with effective treatment coverage and its components, including type of treatment, adequacy of treatment, dose, and adherence. Results: High level of education (OR = 1.63; 1.19, 2.24), private insurance (OR = 1.62; 1.06, 2.48), and age (30-59yrs; OR = 1.58; 1.21, 2.07) predicted effective treatment coverage for depression in a multivariable logistic regression model. Exploratory bivariate models further indicate that education may follow a dose-response relation; that people with severe depression are more likely to receive any services, but less likely to receive adequate services; and that in low and middle-income countries, private insurance (the only significant predictor) increased the likelihood of receiving effective treatment coverage four times. Conclusions: In the regression models, specific social determinants predicted effective coverage for major depression. Knowing the factors that determine who does and does not receive treatment contributes to improve our understanding of unmet needs and our ability to develop targeted interventions
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Dates and versions

hal-03704164 , version 1 (24-06-2022)

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Daniel Vigo, Alan Kazdin, Nancy Sampson, Irving Hwang, Jordi Alonso, et al.. Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys. International Journal of Mental Health Systems, 2022, 16 (1), pp.29. ⟨10.1186/s13033-022-00539-6⟩. ⟨hal-03704164⟩

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