Crossâ national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys
Harris, Meredith G.; Bharat, Chrianna; Glantz, Meyer D.; Sampson, Nancy A.; Al‐hamzawi, Ali; Alonso, Jordi; Bruffaerts, Ronny; Caldas De Almeida, José Miguel; Cia, Alfredo H.; Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo; Karam, Elie G.; Karam, Georges; Lee, Sing; Lépine, Jean‐pierre; Levinson, Daphna; Makanjuola, Victor; McGrath, John; Mneimneh, Zeina; Navarro‐mateu, Fernando; Piazza, Marina; Posada‐villa, José; Rapsey, Charlene; Tachimori, Hisateru; Have, Margreet; Torres, Yolanda; Viana, Maria Carmen; Chatterji, Somnath; Zaslavsky, Alan M.; Kessler, Ronald C.; Degenhardt, Louisa
2019-08
Citation
Harris, Meredith G.; Bharat, Chrianna; Glantz, Meyer D.; Sampson, Nancy A.; Al‐hamzawi, Ali ; Alonso, Jordi; Bruffaerts, Ronny; Caldas De Almeida, José Miguel ; Cia, Alfredo H.; Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo; Karam, Elie G.; Karam, Georges; Lee, Sing; Lépine, Jean‐pierre ; Levinson, Daphna; Makanjuola, Victor; McGrath, John; Mneimneh, Zeina; Navarro‐mateu, Fernando ; Piazza, Marina; Posada‐villa, José ; Rapsey, Charlene; Tachimori, Hisateru; Have, Margreet; Torres, Yolanda; Viana, Maria Carmen; Chatterji, Somnath; Zaslavsky, Alan M.; Kessler, Ronald C.; Degenhardt, Louisa (2019). "Crossâ national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys." Addiction 114(8): 1446-1459.
Abstract
AimsTo examine crossâ national patterns of 12â month substance use disorder (SUD) treatment and minimally adequate treatment (MAT), and associations with mental disorder comorbidity.DesignCrossâ sectional, representative household surveys.SettingTwentyâ seven surveys from 25 countries of the WHO World Mental Health Survey Initiative.ParticipantsA total of 2446 people with pastâ year DSMâ IV SUD diagnoses (alcohol or illicit drug abuse and dependence).MeasurementsOutcomes were SUD treatment, defined as having either received professional treatment or attended a selfâ help group for substanceâ related problems in the past 12Â months, and MAT, defined as having either four or more SUD treatment visits to a healthâ care professional, six or more visits to a nonâ healthâ care professional or being in ongoing treatment at the time of interview. Covariates were mental disorder comorbidity and several socioâ economic characteristics. Pooled estimates reflect country sample sizes rather than population sizes.FindingsOf respondents with pastâ year SUD, 11.0% [standard error (SE)Â =Â 0.8] received past 12â month SUD treatment. SUD treatment was more common among people with comorbid mental disorders than with pure SUDs (18.1%, SEÂ =Â 1.6 versus 6.8%, SEÂ =Â 0.7), as was MAT (84.0%, SEÂ =Â 2.5 versus 68.3%, SEÂ =Â 3.8) and treatment by healthâ care professionals (88.9%, SEÂ =Â 1.9 versus 78.8%, SEÂ =Â 3.0) among treated SUD cases. Adjusting for socioâ economic characteristics, mental disorder comorbidity doubled the odds of SUD treatment [odds ratio (OR)Â =Â 2.34; 95% confidence interval (CI)Â =Â 1.71â 3.20], MAT among SUD cases (ORÂ =Â 2.75; 95% CIÂ =Â 1.90â 3.97) and MAT among treated cases (ORÂ =Â 2.48; 95% CIÂ =Â 1.23â 5.02). Patterns were similar within country income groups, although the proportions receiving SUD treatment and MAT were higher in highâ than lowâ /middleâ income countries.ConclusionsFew people with pastâ year substance use disorders receive adequate 12â 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.Publisher
Cambridge University Press Wiley Periodicals, Inc.
ISSN
0965-2140 1360-0443
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