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Dropout from treatment for mental disorders in six countries of the Americas: A regional report from the World Mental Health Surveys

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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


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