TY - JOUR
T1 - Treatment adequacy of anxiety and depressive disorders
T2 - Primary versus specialised care in Spain
AU - Fernández, Anna
AU - Haro, Josep Maria
AU - Codony, Miquel
AU - Vilagut, Gemma
AU - Martínez-Alonso, Montserrat
AU - Autonell, Jaume
AU - Salvador-Carulla, Luis
AU - Ayuso-Mateos, José Luis
AU - Fullana, Miquel Angel
AU - Alonso, Jordi
N1 - Funding Information:
This project was funded by the European Commission (Contract QLG5-1999-01042), the Piedmont Region (Italy), Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnologia, Spain (SAF 2000-158-CE), Departament de Sanitat, Generalitat de Catalunya, Spain, and other local agencies and by an unrestricted educational grant from GlaxoSmithKline.
Funding Information:
ESEMeD is carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. We thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis. These activities were supported by the John D. and Catherine T.MacArthur Foundation, the Pfizer Foundation, the U.S. Public Health Service (1R13MH066849, R01-MH069864, and R01DA016558), Eli Lilly and Company, GlaxoSmithKline, Ortho-McNeil Pharmaceuticals and the Pan American Health Organization. A complete list of WMH publication can be found at http://www.hcp.ned.harvard.edu/wmh .
Funding Information:
We thank Alejandra Pinto-Meza PhD and Susana Ochoa PhD for their helpful comments on drafts. This research was supported by the grant 03/10109 from the Carlos III Health Institute, Spain. This study was also partially supported by the funds from Instituto de Salud Carlos III (networks of excellence Red IRYSS G03/202 and Red RIRAG G03/061).
PY - 2006/11
Y1 - 2006/11
N2 - Background: Literature suggests that a high proportion of the population with mental disorders remains either untreated or poorly treated. This study aimed to describe the adequacy of treatment for Anxiety and Depressive disorders in Spain, how this differs between providers (primary versus specialised care) and which factors are associated with appropriate care. Method: Data were derived from the Spanish sample (N = 5473) of the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross sectional study in a representative sample of adults. The subsample analyzed was composed by the 133 subjects with a mental disorder in the year prior to the interview who received treatment. Treatment adequacy was evaluated in two different ways: (1) considering definitions of minimally adequate treatment evidence based guidelines and criteria used in other epidemiological studies; (2) considering experts rating of treatment appropriateness based on the information contained in the case vignettes created from the CIDI answers. Generalised Estimating Equation (GEE) models and simple logistic regression were conducted to assess the correlates of adequate treatment. Results: Similar proportions of patients in specialty and general medical treatment received a minimally adequate treatment (31.8% and 30.5%, respectively). Associated factors to appropriateness were living in a large city, having a high educational level, and having a good self rated health state. Limitations: Treatment adequacy was based on simple information and criteria. Conclusions: Only one third of the mental health treatment in Spain met minimal adequacy criteria. More research is needed in order to find out reasons for these low rates.
AB - Background: Literature suggests that a high proportion of the population with mental disorders remains either untreated or poorly treated. This study aimed to describe the adequacy of treatment for Anxiety and Depressive disorders in Spain, how this differs between providers (primary versus specialised care) and which factors are associated with appropriate care. Method: Data were derived from the Spanish sample (N = 5473) of the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross sectional study in a representative sample of adults. The subsample analyzed was composed by the 133 subjects with a mental disorder in the year prior to the interview who received treatment. Treatment adequacy was evaluated in two different ways: (1) considering definitions of minimally adequate treatment evidence based guidelines and criteria used in other epidemiological studies; (2) considering experts rating of treatment appropriateness based on the information contained in the case vignettes created from the CIDI answers. Generalised Estimating Equation (GEE) models and simple logistic regression were conducted to assess the correlates of adequate treatment. Results: Similar proportions of patients in specialty and general medical treatment received a minimally adequate treatment (31.8% and 30.5%, respectively). Associated factors to appropriateness were living in a large city, having a high educational level, and having a good self rated health state. Limitations: Treatment adequacy was based on simple information and criteria. Conclusions: Only one third of the mental health treatment in Spain met minimal adequacy criteria. More research is needed in order to find out reasons for these low rates.
KW - Clinical guidelines
KW - Primary care
KW - Specialized mental health care
KW - Treatment adequacy
UR - http://www.scopus.com/inward/record.url?scp=33750001402&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2006.05.005
DO - 10.1016/j.jad.2006.05.005
M3 - Short Survey/Scientific Report
C2 - 16793140
AN - SCOPUS:33750001402
SN - 0165-0327
VL - 96
SP - 9
EP - 20
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-2
ER -