Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems

Have, Margreet ten; Nuyen, Jasper; Beekman, Aartjan T.F.; Graaf, Ron de

doi:10.1017/s0033291713000135

Cited by 53 publications

(65 citation statements)

References 34 publications

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“…It was assessed with the question: 'in the past 12 months (T 0 )/since the last interview (T 1 279 alcohol or drugs problems of your own?' [13] . Included were general practitioners, company doctors, social workers, home care or district nurses, physiotherapists or haptonomists, medical specialists or other general medical care professionals, psychiatrists, psychologists, psychotherapists, and part-time or full-time psychiatric treatment.…”

Section: Treatmentmentioning

confidence: 99%

“…A long-term unmet need for treatment may thus exist and improvement of treatment access has been suggested a public health priority [8][9][10] . However, others have questioned the magnitude of the treatment gap for AUDs be-cause the prevalence of a disorder may not be sufficient to establish treatment need when its clinical significance and the natural course have not been determined [11][12][13] . Indeed, population-based research showed that AUDs, and especially alcohol abuse, are often mild and do not interfere strongly with daily activities [13][14][15] .…”

mentioning

confidence: 99%

“…However, others have questioned the magnitude of the treatment gap for AUDs be-cause the prevalence of a disorder may not be sufficient to establish treatment need when its clinical significance and the natural course have not been determined [11][12][13] . Indeed, population-based research showed that AUDs, and especially alcohol abuse, are often mild and do not interfere strongly with daily activities [13][14][15] . Moreover, AUDs in the general population are associated with high spontaneous remission rates [16][17][18][19] and thus, not all of those with an AUD diagnosis may need AUDTx.…”

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confidence: 99%

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Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

et al. 2016

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Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The Composite International Diagnostic Interview 3.0 assessed AUD and other psychiatric disorders. Results: Of 154 subjects with baseline 12-month DSM-5 AUD, 35.4% used only general treatment (GenTx) for mental problems or alcohol/drugs problems; 10.3% used specialized AUD treatment (AUDTx); and 54.3% used no treatment at all. Of these 3 groups, AUDTx users had the highest severity on AUD characteristics, comorbid psychopathology and mental functioning. Compared to non-treatment (NonTx), GenTx users more often had 12-month emotional disorders at follow-up, but AUD remission rates and functioning were similar. NonTx users functioned similarly at follow-up as people in the general population without lifetime AUD or other psychopathology. Conclusion: Adequate treatment seeking often occurs in the general population: the most severe AUD subjects use AUDTx, and most NonTx users have a mild AUD and a favorable course. Current findings suggest a smaller treatment gap than previously reported, but still one-quarter of the people with AUD do not seek AUDTx but could benefit from this, as they have a persistent AUD.

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Section: Treatmentmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

et al. 2016

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“…The barriers to mental health care are diverse [5]: On the one hand, they often involve a combination of insufficient resources and inadequate health policies. On the other hand, specialist services are often not utilised by affected individuals [11,12] because of the fear of stigmatisation [13–15] or because of gender role expectations [16,17]. In particular, men report remarkably low and delayed utilisation rates for mental health care [18,19].…”

Section: Introductionmentioning

confidence: 99%

Improving Access to Mental Health Care by Delivering Psychotherapeutic Care in the Workplace: A Cross-Sectional Exploratory Trial

et al. 2017

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ObjectiveCommon mental disorders like mood and anxiety disorders and somatoform disorders have high costs, yet under-treatment is still frequent. Many people with common mental disorders are employed, so the workplace is potentially a suitable context in which to provide early treatment. Our study investigates whether a change of setting (workplace versus standard care) improves access to treatment for common mental disorders.MethodsConditional latent profile analysis was applied to identify user profiles for work ability (WAI), clinical symptoms like depression (patient health questionnaire depression, PHQ-9), health-related quality of life (QoL, SF-12), and work-related stress (Maslach Burnout Inventory, irritation scale). Patients were recruited consecutively, via psychotherapeutic consultation in the workplace (n = 174) or psychotherapeutic consultation in outpatient care (n = 193).ResultsWe identified four user profiles in our model: ‘severe’ (n = 99), ‘moderate I—low QoL’ (n = 88), ‘moderate II—low work ability’ (n = 83), and ‘at risk’ (n = 97). The ‘at risk’ profile encompassed individuals with reduced work ability (36.0, 34.73 to 37.37), only mild clinical symptoms (PHQ-9 5.7, 4.92 to 6.53), no signs of work-related stress and good quality of life. A higher proportion of the ‘at risk’ group than of the ‘severe’ group sought help via the psychotherapeutic consultation in the workplace (OR 0.287, P < 0.01); this effect remained after controlling for gender.ConclusionsOffering secondary mental health care in the workplace is feasible and accepted by users. Offering treatment in the workplace as an alternative to standard outpatient settings is a viable strategy for improving access to treatment for common mental disorders.

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“…However, despite these similarities, a clear-cut discrepancy across countries is present in terms of both the resources and treatments availability for mental health, including MDD. In high-income countries approximately 40-50% of all people with severe MDD do not receive proper treatment 24,25 , but in low-income countries fewer than 10% of patients received adequate treatment 24 .…”

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confidence: 99%

Major depressive disorder

Otte

Gold

Penninx

et al. 2016

Nat Rev Dis Primers

1,586

970

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Major depressive disorder (MDD) is a debilitating disease that is characterized by depressed mood, diminished interests, impaired cognitive function and vegetative symptoms, such as disturbed sleep or appetite. MDD occurs about twice as often in women than it does in men and affects one in six adults in their lifetime. The aetiology of MDD is multifactorial and its heritability is estimated to be approximately 35%. In addition, environmental factors, such as sexual, physical or emotional abuse during childhood, are strongly associated with the risk of developing MDD. No established mechanism can explain all aspects of the disease. However, MDD is associated with alterations in regional brain volumes, particularly the hippocampus, and with functional changes in brain circuits, such as the cognitive control network and the affective-salience network. Furthermore, disturbances in the main neurobiological stress-responsive systems, including the hypothalamic-pituitary-adrenal axis and the immune system, occur in MDD. Management primarily comprises psychotherapy and pharmacological treatment. For treatment-resistant patients who have not responded to several augmentation or combination treatment attempts, electroconvulsive therapy is the treatment with the best empirical evidence. In this Primer, we provide an overview of the current evidence of MDD, including its epidemiology, aetiology, pathophysiology, diagnosis and treatment.

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Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems

Cited by 53 publications

References 34 publications

Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

Improving Access to Mental Health Care by Delivering Psychotherapeutic Care in the Workplace: A Cross-Sectional Exploratory Trial

Major depressive disorder

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