Cross-national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys

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Harris, Meredith G. ^{[1, 2]} ; Bharat, Chrianna ^[3] ; Glantz, Meyer D. ^[4] ; Sampson, Nancy A. ^[5] ; Al-Hamzawi, Ali ^[6] ; Alonso, Jordi ^{[7, 8, 9]} ; Bruffaerts, Ronny ^[10] ; Caldas de Almeida, Jose Miguel ^{[11, 12]} ; Cia, Alfredo H. ^[13] ; de Girolamo, Giovanni ^[14] ; Florescu, Silvia ^[15] ; Gureje, Oye ^[16] ; Haro, Josep Maria ^[17] ; Hinkov, Hristo ^[18] ; Karam, Elie G. ^{[19, 20, 21]} ; Karam, Georges ^{[20, 22]} ; Lee, Sing ^[23] ; Lepine, Jean-Pierre ^{[24, 25]} ; Levinson, Daphna ^[26] ; Makanjuola, Victor ^{[27, 28]} ; McGrath, John ^{[29, 30, 31]} ; Mneimneh, Zeina ^[32] ; Navarro-Mateu, Fernando ^[33] ; Piazza, Marina ^[34] ; Posada-Villa, Jose ^[35] ; Rapsey, Charlene ^[36] ; Tachimori, Hisateru ^[37] ; ten Have, Margreet ^[38] ; Torres, Yolanda ^[39] ; Viana, Maria Carmen ^[40] ; Chatterji, Somnath ^[41] ; Zaslaysky, Alan M. ^[5] ; Kessler, Ronald C. ^[5] ; Degenhardt, Louisa ^[3] ; S, World Hlth Org World Mental Hlth

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^[1] Univ Queensland, Sch Publ Hlth, Level 3, Dawson House, Herston, Qld - Australia

^[2] Queensland Ctr Mental Hlth Res, Pk Ctr Mental Hlth, Herston, Qld - Australia

^[3] Univ New South Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW - Australia

^[4] NIDA, Dept Epidemiol, Serv Prevent Res DESPR, NIH, Bethesda, MD 20892 - USA

^[5] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA 02115 - USA

^[6] Al Qadisya Univ, Coll Med, Diwaniya Governorate - Iraq

^[7] CIBERESP, Barcelona - Spain

^[8] Pompeu Fabra Univ, Barcelona - Spain

^[9] IMIM Hosp Mar del Med Res Inst, Hlth Serv Res Unit, Barcelona - Spain

^[10] UPC KUL, Campus Gasthuisbeg, Leuven - Belgium

^[11] Univ Nova Lisboa, Fac Ciencias Med, NOVA Med Sch, Lisbon Inst Global Mental Hlth, Lisbon - Portugal

^[12] Univ Nova Lisboa, Fac Ciencias Med, NOVA Med Sch, Chron Dis Res Ctr CEDOC, Lisbon - Portugal

^[13] Anxiety Disorders Ctr, Buenos Aires, DF - Argentina

^[14] IRCCS Ist Ctr San Giovanni Dio Fatebenefratelli, Brescia - Italy

^[15] Natl Sch Publ Hlth Management & Dev, Bucharest - Romania

^[16] Univ Coll Hosp, Dept Psychiat, Ibadan - Nigeria

^[17] Univ Barcelona, CIBERSAM, Parc Sanitari St Joan de Deu, Barcelona - Spain

^[18] Natl Ctr Publ Hlth & Anal, Sofia - Bulgaria

^[19] Balamand Univ, Fac Med, Dept Psychiat & Clin Psychol, Beirut - Lebanon

^[20] IDRAAC, Beirut - Lebanon

^[21] St George Hosp Univ, Dept Psychiat & Clin Psychol, Med Ctr, Beirut - Lebanon

^[22] Balamand Univ, Dept Psychiat & Clin Psychol, St George Hosp Univ, Med Ctr, Fac Med, Beirut - Lebanon

^[23] Chinese Univ Hong Kong, Dept Psychiat, Hong Kong - Peoples R China

^[24] INSERM, UMR S 1144, Paris - France

^[25] Univ Pais Descartes Paris Didetrot, Hop Lariboisie Fernand Widal, AP HP, Paris - France

^[26] Minist Hlth, Mental Heath Serv, Jerusalem - Israel

^[27] Univ Coll Hosp, Ibadan - Nigeria

^[28] Univ Ibadan, Dept Psychiat, Coll Med, Ibadan - Nigeria

^[29] Aarhus Univ, Natl Ctr Register based Res, Aarhus - Denmark

^[30] Queensland Ctr Mental Hlth Res, Part Ctr Mental Hlth, Wacol, Qld - Australia

^[31] Univ Queesland, Queensland Brain Inst, St Lucia, Qld - Australia

^[32] Univ Michigan, Survey Res Ctr, Inst Social Res, Ann Arbor, MI 48109 - USA

^[33] CIBFRESP, UDIF SM, Subdirecc Gen Planificac Innovac & Cronicidad, Serv Murciano Salud, IMIB Arrixaca, Murciamurcia - Spain

^[34] Univ Cayetano Heredia, Lima - Peru

^[35] Colegio Mayor de Cundiramarca Univ, Fac Social Sci, Bogota - Colombia

^[36] Univ Otago, Dept Psychol Med, Dunedin Sch Med, Otago - New Zealand

^[37] Natl Ctr Neurol & Psychiat, Natl Inst Mental Hlth, Kodaira, Tokyo - Japan

^[38] Netherlands Inst Mental Hlth & Addict, Trimbos Inst, Utrecht - Netherlands

^[39] CES Univ, Ctr Excellence Res Mental Hlth, Medellin - Colombia

^[40] Univ Fed Espirito Santo, Dept Social Med, Postgrad Program Publ Hlth, Vitoria, ES - Brazil

^[41] WHO, Dept Informat Evidence & Res, Geneva - Switzerland

• Tipo de documento: Artigo Científico
• Fonte: ADDICTION; v. 114, n. 8, p. 1446-1459, AUG 2019.
• Citações Web of Science: 1

Resumo

Aims To examine cross-national patterns of 12-month substance use disorder (SUD) treatment and minimally adequate treatment (MAT), and associations with mental disorder comorbidity. Design Cross-sectional, representative household surveys. Setting Twenty-seven surveys from 25 countries of the WHO World Mental Health Survey Initiative. Participants A total of 2446 people with past-year DSM-IV SUD diagnoses (alcohol or illicit drug abuse and dependence). Measurements Outcomes were SUD treatment, defined as having either received professional treatment or attended a self-help group for substance-related problems in the past 12 months, and MAT, defined as having either four or more SUD treatment visits to a health-care professional, six or more visits to a non-health-care professional or being in ongoing treatment at the time of interview. Covariates were mental disorder comorbidity and several socio-economic characteristics. Pooled estimates reflect country sample sizes rather than population sizes. Findings Of respondents with past-year SUD, 11.0% {[}standard error (SE) = 0.8] received past 12-month SUD treatment. SUD treatment was more common among people with comorbid mental disorders than with pure SUDs (18.1%, SE = 1.6 versus 6.8%, SE = 0.7), as was MAT (84.0%, SE = 2.5 versus 68.3%, SE = 3.8) and treatment by health-care professionals (88.9%, SE = 1.9 versus 78.8%, SE = 3.0) among treated SUD cases. Adjusting for socio-economic characteristics, mental disorder comorbidity doubled the odds of SUD treatment {[}odds ratio (OR) = 2.34; 95% confidence interval (CI) = 1.71-3.20], MAT among SUD cases (OR = 2.75; 95% CI = 1.90-3.97) and MAT among treated cases (OR = 2.48; 95% CI = 1.23-5.02). Patterns were similar within country income groups, although the proportions receiving SUD treatment and MAT were higher in high- than low-/middle-income countries. Conclusions Few people with past-year substance use disorders receive adequate 12-month substance use disorder treatment, even when comorbid with a mental disorder. This is largely due to the low proportion of people receiving any substance use disorder treatment, as the proportion of patients whose treatment is at least minimally adequate is high. (AU)

• Processo FAPESP: 03/00204-3 - Estudo epidemiológico dos transtornos psiquiátricos na região metropolitana de São Paulo: prevalências, fatores de risco e sobrecarga social e econômica
• Beneficiário: Laura Helena Silveira Guerra de Andrade
• Modalidade de apoio: Auxílio à Pesquisa - Temático