dc.contributor.author |
Benjet, C. |
|
dc.contributor.author |
Borges, G. |
|
dc.contributor.author |
Orozco, R. |
|
dc.contributor.author |
Aguilar-Gaxiola, S. |
|
dc.contributor.author |
Andrade, L.H. |
|
dc.contributor.author |
Cia, A. |
|
dc.contributor.author |
Hwang, I. |
|
dc.contributor.author |
Kessler, R.C. |
|
dc.contributor.author |
Piazza Ferrand, Marina Julia |
|
dc.contributor.author |
Posada-Villa, J. |
|
dc.contributor.author |
Sampson, N. |
|
dc.contributor.author |
Stagnaro, J.C. |
|
dc.contributor.author |
Torres, Y. |
|
dc.contributor.author |
Viana, M.C. |
|
dc.contributor.author |
Vigo, D. |
|
dc.contributor.author |
Medina-Mora, M.-E. |
|
dc.date.accessioned |
2022-06-01T13:53:57Z |
|
dc.date.available |
2022-06-01T13:53:57Z |
|
dc.date.issued |
2022 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/11740 |
|
dc.description.abstract |
Objective: To estimate structural and attitudinal reasons for premature discontinuation of mental health treatment, socio-demographic and clinical correlates of treatment dropout due to these reasons, and to test country differences from the overall effect across the region of the Americas. Methods: World Health Organization-World Mental Health (WMH) surveys were carried out in six countries in the Americas: Argentina, Brazil, Colombia, Mexico, Peru and USA. Among the 1991 participants who met diagnostic criteria (measured with the Composite International Diagnostic Interview (WMH–CIDI)) for a mental disorder and were in treatment in the prior 12-months, the 236 (12.2%) who dropped out of treatment before the professional recommended were included. Findings: In all countries, individuals more frequently reported attitudinal (79.2%) rather than structural reasons (30.7%) for dropout. Disorder severity was associated with structural reasons; those with severe disorder (versus mild disorder) had 3.4 (95%CI=1.1–11.1) times the odds of reporting a structural reason. Regarding attitudinal reasons, those with lower income (versus higher income) were less likely to discontinue treatment because of getting better (OR=0.4; 95%CI= 0.2–0.9). Country specific variations were found. Limitations: Not all countries, or the poorest, in the region were included. Some estimations couldn´t be calculated due to cell size. Causality cannot be assumed. Conclusion: Clinicians should in the first sessions address attitudinal factors that may lead to premature termination. Public policies need to consider distribution of services to increase convenience. A more rational use of resources would be to offer brief therapies to individuals most likely to drop out of treatment prematurely. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Elsevier |
|
dc.relation.ispartofseries |
Journal of Affective Disorders |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Treatment dropout |
en_US |
dc.subject |
Treatment adherence |
en_US |
dc.subject |
Latin America |
en_US |
dc.subject |
Treatment barriers |
en_US |
dc.title |
Dropout from treatment for mental disorders in six countries of the Americas: A regional report from the World Mental Health Surveys |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1016/j.jad.2022.02.019 |
|
dc.relation.issn |
1573-2517 |
|