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

Gureje, O.; Hinkov, H.; Piazza Ferrand, Marina Julia; Glantz, M.D.; McGrath, J.; Navarro-Mateu, F.; de Girolamo, G.; Torres, Y.; Bruffaerts, R.; Makanjuola, V.; Viana, M.C.; Rapsey, C.; Al-Hamzawi, A.; Harris, M.G.; Karam, E.G.; Cia, A.H.; Kessler, R.C.; Lee, S.; Zaslavsky, A.M.; Degenhardt, L.; Florescu, S.; Mneimneh, Z.; Haro, J.M.; Posada-Villa, J.; ten Have, M.; Bharat, C.; Caldas de Almeida, J.M.; WHO World Mental Health Survey; Alonso, J.; Karam, G.; Lépine, J.-P.; Levinson, D.; Sampson, N.A.; Tachimori, H.; Chatterji, S.

dc.contributor.author	Harris, M.G.
dc.contributor.author	Bharat, C.
dc.contributor.author	Glantz, M.D.
dc.contributor.author	Sampson, N.A.
dc.contributor.author	Al-Hamzawi, A.
dc.contributor.author	Alonso, J.
dc.contributor.author	Bruffaerts, R.
dc.contributor.author	Caldas de Almeida, J.M.
dc.contributor.author	Cia, A.H.
dc.contributor.author	de Girolamo, G.
dc.contributor.author	Florescu, S.
dc.contributor.author	Gureje, O.
dc.contributor.author	Haro, J.M.
dc.contributor.author	Hinkov, H.
dc.contributor.author	Karam, E.G.
dc.contributor.author	Karam, G.
dc.contributor.author	Lee, S.
dc.contributor.author	Lépine, J.-P.
dc.contributor.author	Levinson, D.
dc.contributor.author	Makanjuola, V.
dc.contributor.author	McGrath, J.
dc.contributor.author	Mneimneh, Z.
dc.contributor.author	Navarro-Mateu, F.
dc.contributor.author	Piazza Ferrand, Marina Julia
dc.contributor.author	Posada-Villa, J.
dc.contributor.author	Rapsey, C.
dc.contributor.author	Tachimori, H.
dc.contributor.author	ten Have, M.
dc.contributor.author	Torres, Y.
dc.contributor.author	Viana, M.C.
dc.contributor.author	Chatterji, S.
dc.contributor.author	Zaslavsky, A.M.
dc.contributor.author	Kessler, R.C.
dc.contributor.author	Degenhardt, L.
dc.contributor.author	WHO World Mental Health Survey
dc.date.accessioned	2019-08-08T15:23:43Z
dc.date.available	2019-08-08T15:23:43Z
dc.date.issued	2019
dc.identifier.uri	https://hdl.handle.net/20.500.12866/7118
dc.description.abstract	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. © 2019 Society for the Study of Addiction	en_US
dc.description.sponsorship	Este trabajo fue financiado en el marco del Peruvian World Mental Health Study por el Instituto Nacional de Salud del Ministerio de Salud del Perú.	es_PE
dc.language.iso	eng
dc.publisher	Wiley
dc.relation.ispartofseries	Addiction
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	treatment	en_US
dc.subject	Comorbidity	en_US
dc.subject	World Mental Health Surveys	en_US
dc.subject	mental disorders	en_US
dc.subject	minimally adequate treatment	en_US
dc.subject	substance use disorders	en_US
dc.title	Cross-national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1111/add.14599
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.24
dc.relation.issn	1360-0443