Cross-national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys.
Comorbidity
World Mental Health Surveys
mental disorders
minimally adequate treatment
substance use disorders
treatment
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
30
07
2018
revised:
03
10
2018
accepted:
22
02
2019
pubmed:
6
3
2019
medline:
22
7
2020
entrez:
6
3
2019
Statut:
ppublish
Résumé
To examine cross-national patterns of 12-month substance use disorder (SUD) treatment and minimally adequate treatment (MAT), and associations with mental disorder comorbidity. Cross-sectional, representative household surveys. Twenty-seven surveys from 25 countries of the WHO World Mental Health Survey Initiative. A total of 2446 people with past-year DSM-IV SUD diagnoses (alcohol or illicit drug abuse and dependence). 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. 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. 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.
Identifiants
pubmed: 30835879
doi: 10.1111/add.14599
pmc: PMC7408310
mid: NIHMS1614375
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1446-1459Subventions
Organisme : National Health and Medical Research Council
ID : 1099709
Pays : International
Organisme : National Health and Medical Research Council
ID : 1081984
Pays : International
Organisme : FIC NIH HHS
ID : R03 TW006481
Pays : United States
Organisme : National Health and Medical Research Council
ID : 1007677
Pays : International
Organisme : Australian National Health and Medical Research Council
ID : 1081984
Pays : International
Organisme : Ortho-McNeil Pharmaceutical Inc.
Pays : International
Organisme : John D. and Catherine T. MacArthur Foundation
Pays : International
Organisme : NIMH NIH HHS
ID : U01 MH060220
Pays : United States
Organisme : Australian Government Department of Health under the Drug and Alcohol Program
Pays : International
Organisme : NIDA NIH HHS
ID : R01 DA044170
Pays : United States
Organisme : GlaxoSmithKline
Pays : International
Organisme : Pan American Health Organization
Pays : International
Organisme : Eli Lilly and Company
Pays : International
Organisme : NIDA NIH HHS
ID : R01 DA016558
Pays : United States
Organisme : Bristol-Myers Squibb
Pays : International
Organisme : NIMH NIH HHS
ID : R01 MH069864
Pays : United States
Organisme : Pfizer Foundation
Pays : International
Organisme : NIMH NIH HHS
ID : R01 MH070884
Pays : United States
Organisme : National Health and Medical Research Council
ID : 1135991
Pays : International
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : NIMH NIH HHS
ID : R13 MH066849
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 Society for the Study of Addiction.
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