The prevalence of treated and untreated mental disorders in five countries.

We analyzed survey data from Canada, Chile, Germany, The Netherlands, and the United States to study the prevalence and treatment of mental and substance abuse disorders. Total past-year prevalence estimates range between 17.0 percent (Chile) and 29.1 percent (U.S.). Many cases are mild. Although disorder severity is strongly related to treatment, one- to two-thirds of serious cases receive no treatment each year. Most treatment goes to minor and mild cases. Undertreatment of serious cases is most pronounced among young poorly educated males. Outreach is needed to reduce barriers to care among serious cases and young people at risk of serious disorders.

[1]  Olga V. Demler,et al.  Adequacy of treatment for serious mental illness in the United States. , 2002, American journal of public health.

[2]  J Lellouch,et al.  The cross-national epidemiology of panic disorder. , 1997, Archives of general psychiatry.

[3]  R. Kessler.  The World Health Organization International Consorthm in Psychiatric Epidemiology (ICPE): initial work and future directions ‐ the NAPE Lecture 1998 a , 1999 .

[4]  D. Regier,et al.  Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates. , 2002, Archives of general psychiatry.

[5]  Lee N. Robins,et al.  Psychiatric Disorders in America: The Epidemiologic Catchment Area Study , 1990 .

[6]  Hans-Ulrich Wittchen,et al.  The changing rate of major depression. Cross-national comparisons. Cross-National Collaborative Group. , 1992, JAMA.

[7]  M. Opler,et al.  My name is legion , 1960 .

[8]  R. Kessler,et al.  The social consequences of psychiatric disorders, III: probability of marital stability. , 1998, The American journal of psychiatry.

[9]  Annick Manuel,et al.  The Chilean health system: 20 years of reforms. , 2002, Salud publica de Mexico.

[10]  A. Stewart,et al.  The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. , 1989, JAMA.

[11]  R. Kessler,et al.  Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US national comorbidity survey (NCS) , 1998 .

[12]  Alan D. Lopez,et al.  The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020. , 1996 .

[13]  R. Spitzer,et al.  Lowered estimates--but of what? , 2002, Archives of general psychiatry.

[14]  S. Parikh,et al.  Mental Health Treatment in Ontario: Selected Comparisons between the Primary Care and Specialty Sectors , 1997, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[15]  Thomas P. Kobylski,et al.  Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised , 1988 .

[16]  H. Wittchen.  Reliability and validity studies of the WHO--Composite International Diagnostic Interview (CIDI): a critical review. , 1994, Journal of psychiatric research.

[17]  S. H. Long,et al.  Challenges of state health reform: variations in ten states. , 1998, Health Affairs.

[18]  H. Wittchen,et al.  Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI) , 1998, Social Psychiatry and Psychiatric Epidemiology.

[19]  R. Kessler,et al.  The Effects of Chronic Medical Conditions on Work Loss and Work Cutback , 2001, Journal of occupational and environmental medicine.

[20]  R. Kessler,et al.  Social consequences of psychiatric disorders, I: Educational attainment. , 1995, The American journal of psychiatry.

[21]  L. Robins,et al.  National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. , 1981, Archives of general psychiatry.

[22]  R M Groves,et al.  Advances in strategies for minimizing and adjusting for survey nonresponse. , 1995, Epidemiologic reviews.

[23]  R. Kessler,et al.  Differences in the use of psychiatric outpatient services between the United States and Ontario. , 1997, The New England journal of medicine.

[24]  H. Hwu,et al.  Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule , 1989, Acta psychiatrica Scandinavica.

[25]  R. Kessler,et al.  Mild disorders should not be eliminated from the DSM-V. , 2003, Archives of general psychiatry.