RESUMO
BACKGROUND: No national data on lifetime prevalence and risk factors for DSM-IV psychiatric disorders are available in Mexico. AIMS: To present data on lifetime prevalence and projected lifetime risk, age at onset and demographic correlates of DSM-IV psychiatric disorders assessed in the Mexican National Comorbidity Survey. METHOD: The survey was based on a multistage area probability sample of non-institutionalised people aged 18-65 years in urban Mexico. The World Mental Health Survey version of the Composite International Diagnostic Interview was administered by lay interviewers. RESULTS: Of those surveyed, 26.1% had experienced at least one psychiatric disorder in their life and 36.4% of Mexicans will eventually experience one of these disorders. Half of the population who present with a psychiatric disorder do so by the age of 21 and younger cohorts are at greater risk for most disorders. CONCLUSIONS: Our results suggest an urgent need to re-evaluate the resources allocated for the detection and treatment of psychiatric illnesses in Mexico.
Assuntos
Transtornos Mentais/epidemiologia , Adolescente , Adulto , Idade de Início , Idoso , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores SocioeconômicosRESUMO
OBJECTIVE: This study described the rate and adequacy of mental health service use among participants in the Mexico National Comorbidity Survey and the correlates of any 12-month treatment and of adequate treatment. METHOD: The authors conducted face-to-face household surveys of a probability sample of individuals ages 18 to 65 years in the noninstitutionalized population living in urban areas of Mexico from 2001 to 2002. The use of mental health services and 12-month DSM-IV disorders was assessed with the World Mental Health version of the World Health Organization Composite International Diagnostic Interview. The rates and correlates of any service use and the adequacy of treatment were identified in logistic regression analyses, taking into account the complex sample design and weighting process. RESULTS: The data reported here were based on 2,362 interviews. Fewer than one in five respondents with any psychiatric disorder during the last 12 months used any service during the prior year. The rates of service use by those with mood disorders were somewhat higher. About one in every two respondents who used services received minimally adequate care. CONCLUSIONS: The authors found large unmet needs for mental health services among those with psychiatric disorders. Those with mental illness and those who deliver or seek to improve mental health care in Mexico face enormous challenges.
Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/normas , Adolescente , Adulto , Idoso , Atenção à Saúde/normas , Feminino , Acessibilidade aos Serviços de Saúde/normas , Pesquisa sobre Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/diagnóstico , Serviços de Saúde Mental/estatística & dados numéricos , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Qualidade da Assistência à SaúdeRESUMO
Absence of a common diagnostic interview has hampered cross-national syntheses of epidemiological evidence on major depressive episodes (MDE). Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face-to-face were carried out in 10 countries in North America (Canada and the US), Latin America (Brazil, Chile, and Mexico), Europe (Czech Republic, Germany, the Netherlands, and Turkey), and Asia (Japan). The total sample size was more than 37,000. Lifetime prevalence estimates of hierarchy-free DSM-III-R/DSM-IV MDE varied widely, from 3% in Japan to 16.9% in the US, with the majority in the range of 8% to 12%. The 12-month/lifetime prevalence ratio was in the range 40% to 55%, the 30-day/12-month prevalence ratio in the range 45% to 65%, and median age of onset in the range 20 to 25 in most countries. Consistent socio-demographic correlates included being female and unmarried. Respondents in recent cohorts reported higher lifetime prevalence, but lower persistence than those in earlier cohorts. Major depressive episodes were found to be strongly co-morbid with, and temporally secondary to, anxiety disorders in all countries, with primary panic and generalized anxiety disorders the most powerful predictors of the first onset of secondary MDE. Major depressive episodes are a commonly occurring disorder that usually has a chronic-intermittent course. Effectiveness trials are needed to evaluate the impact of early detection and treatment on the course of MDE as well as to evaluate whether timely treatment of primary anxiety disorders would reduce the subsequent onset, persistence, and severity of secondary MDE.