Universidad de Buenos Aires,Facultad de Medicina,Buenos Aires,Argentina.
Anxiety Clinic and Research Center,Buenos Aires,Argentina.
Epidemiol Psychiatr Sci. 2019 Apr;28(2):240-250. doi: 10.1017/S2045796018000094. Epub 2018 Mar 15.
While there are effective treatments for psychiatric disorders, many individuals with such disorders do not receive treatment and those that do often take years to get into treatment. Information regarding treatment contact failure and delay in Argentina is needed to guide public health policy and planning. Therefore, this study aimed to provide data on prompt treatment contact, lifetime treatment contact, median duration of treatment delays and socio-demographic predictors of treatment contact after the first onset of a mental disorder.
The Argentinean Study of Mental Health Epidemiology (EAESM) is a multistage probability sample representative of adults (aged 18+) living in large urban areas of Argentina. A total of 2116 participants were evaluated with the World Mental Health Composite International Diagnostic Interview to assess psychiatric diagnosis, treatment contact and delay.
Projections of cases that will make treatment contact by 50 years taken from a survival curve suggest that the majority of individuals with a mood (100%) or anxiety disorder (72.5%) in Argentina whose disorder persist for a sufficient period of time eventually make treatment contact while fewer with a substance disorder do so (41.6%). Timely treatment in the year of onset is rare (2.6% for a substance disorder, 14.6% for an anxiety disorder and 31.3% of those with a mood disorder) with mean delays between 8 years for mood disorders and 21 years for anxiety disorders. Younger cohorts are more likely to make treatment contact than older cohorts, whereas those with earlier ages of disorder onset are least likely to make treatment contact. Those with anxiety disorders and major depressive disorder are more likely to make treatment contact when they have comorbid disorders, whereas those with substance use disorders are less likely.
Argentina needs to implement strategies to get individuals with substance use disorders into treatment, and to reduce treatment delays for all, but particularly to target early detection and treatment among children and adolescents.
尽管有针对精神障碍的有效治疗方法，但许多患有此类障碍的人并未接受治疗，而那些接受治疗的人往往需要数年时间才能接受治疗。为了指导公共卫生政策和规划，有必要提供有关阿根廷治疗接触失败和延迟的信息。因此，本研究旨在提供关于精神障碍首次发作后的即时治疗接触、终身治疗接触、治疗延迟中位数持续时间以及治疗接触的社会人口预测因素的数据。
阿根廷精神健康流行病学研究（EAESM）是一项多阶段概率样本，代表阿根廷大城市地区的成年人（18 岁及以上）。共有 2116 名参与者接受了世界精神健康综合国际诊断访谈评估，以评估精神科诊断、治疗接触和延迟。
从生存曲线预测，在阿根廷，大多数患有心境（100%）或焦虑障碍（72.5%）的患者，只要障碍持续足够长的时间，最终会接受治疗接触，而患有物质障碍的患者则较少（41.6%）。在发病当年及时治疗的情况很少见（物质障碍为 2.6%，焦虑障碍为 14.6%，心境障碍为 31.3%），平均延迟时间从心境障碍的 8 年到焦虑障碍的 21 年不等。年轻的队列比年长的队列更有可能接受治疗接触，而发病年龄较早的队列则最不可能接受治疗接触。患有焦虑障碍和重度抑郁症的患者更有可能在合并其他疾病时接受治疗，而患有物质使用障碍的患者则不太可能。
阿根廷需要实施策略，让患有物质使用障碍的人接受治疗，并减少所有人的治疗延迟，但特别是要针对儿童和青少年进行早期发现和治疗。
