Open Collections

UBC Faculty Research and Publications

Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys Vigo, Daniel V.; Kazdin, Alan E.; Sampson, Nancy A.; Hwang, Irving; Alonso, Jordi; Andrade, Laura H.; Ayinde, Olatunde; Borges, Guilherme; Bruffaerts, Ronny; Bunting, Brendan; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep M.; Harris, Meredith G.; Karam, Elie G.; Karam, Georges; Kovess-Masfety, Viviane; Lee, Sing; Navarro-Mateu, Fernando; Posada-Villa, José; Scott, Kate; Stagnaro, Juan C.; Have, Margreet t.; Wu, Chi-Shin; Xavier, Miguel; Kessler, Ronald C.

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.

Item Metadata

Title
Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys
Creator
Vigo, Daniel V.; Kazdin, Alan E.; Sampson, Nancy A.; Hwang, Irving; Alonso, Jordi; Andrade, Laura H.; Ayinde, Olatunde; Borges, Guilherme; Bruffaerts, Ronny; Bunting, Brendan; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep M.; Harris, Meredith G.; Karam, Elie G.; Karam, Georges; Kovess-Masfety, Viviane; Lee, Sing; Navarro-Mateu, Fernando; Posada-Villa, José; Scott, Kate; Stagnaro, Juan C.; Have, Margreet t.; Wu, Chi-Shin; Xavier, Miguel; Kessler, Ronald C.
Publisher
BioMed Central
Date Issued
2022-06-23
Description
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.
Subject
Mental health services; Mental health systems; Major depressive disorder; Effective coverage; Global mental health
Genre
Article
Type
Text
Language
eng
Date Available
2022-11-04
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0421783
URI
http://hdl.handle.net/2429/83125
Affiliation
Non UBC; Psychiatry, Department of
Citation
International Journal of Mental Health Systems. 2022 Jun 23;16(1):29
Publisher DOI
10.1186/s13033-022-00539-6
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

Item Media

Item Citations and Data

Rights

Attribution 4.0 International (CC BY 4.0)