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Prevalence and treatment of 12-month DSM-IV disorders in the Northern Ireland study of health and stress

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Abstract

Purpose

Prior to the current Northern Ireland Study of Health and Stress there have been no epidemiological studies which estimate the prevalence and treatment of mental health disorders across Northern Ireland based on validated diagnostic criteria. This paper provides the first nationally representative estimates of 12-month DSM-IV anxiety, mood, impulse-control and substance disorders. Severity, demographic correlates, treatment and treatment adequacy of 12-month disorders are also examined.

Methods

Data were derived from a nationally representative face-to-face household survey of 4,340 participants (2,441 females and 1,899 males) aged 18 years and older living in Northern Ireland using the World Health Organization Composite International Diagnostic Interview. Analyses were implemented using the SUDAAN software system.

Results

12-month prevalence estimates were anxiety 14.6 %; mood 9.6 %; impulse control 3.4 %; substance 3.5 %; any disorder 23.1 %. Of the 12-month cases, 28.8 % were classified as serious; 33.4 % as moderate; and 37.8 % as mild. Females were more likely to have anxiety and mood disorders (p < 0.05) while males were more likely to have impulse-control and substance disorders. Just 40 % of individuals with any 12-month DSM-IV disorder received treatment in the previous 12 months. 78.6 % of those with a mental disorder who sought treatment received minimally adequate treatment.

Conclusions

12-month DSM-IV disorders are highly prevalent in Northern Ireland. A large proportion of those with mental health problems did not seek treatment. Further research is required to investigate the reasons behind low levels of treatment contact.

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References

  1. Ferry F, Bolton D, Bunting B, Devine B, McCann S, Murphy S (2008) Trauma, health and conflict in Northern Ireland. A study of the epidemiology of trauma related disorders and qualitative investigation of the impact of trauma on the individual. Northern Ireland Centre for Trauma and Transformation and University of Ulster Psychology Research Institute, Londonderry

    Google Scholar 

  2. Muldoon O, Schmid K, Downes C, Kremer J, Trew K (2003) The legacy of the troubles: experience of the troubles, mental health and social attitudes. Queen’s University, Belfast

    Google Scholar 

  3. Fay MT, Morrissey M, Smyth M, Wong T (1999) The cost of the troubles study: report on the Northern Ireland survey. The experience and impact of the troubles. INCORE, Derry/Londonderry

  4. O’Reilly D, Stevenson M (2003) Mental health in Northern Ireland: have the “troubles” made it worse? J Epidemiol Commun Health 57:488–492

    Article  Google Scholar 

  5. Department of Health and Social Services and Public Safety (DHSSPS) (2005) The Bamford review of mental health and learning disability (N. Ireland): a strategic framework for adult mental health services (AMH) report. http://www.rmhldni.gov.uk/index/published-reports.htm. Accessed 14 Jan 2011

  6. Department of Health and Social Services and Public Safety (DHSSPS) (2005) The Bamford review of mental health and learning disability (N. Ireland): mental health improvement and wellbeing- a personal, public and political issue. http://www.rmhldni.gov.uk/index/published-reports.htm. Accessed 31 Jan 2012

  7. World Health Organisation (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. WHO, Geneva

    Google Scholar 

  8. McConnell P, Bebbington P, McClelland R, Gillespie K, Houghton S (2002) Prevalence of psychiatric disorder and the need for psychiatric care in Northern Ireland: population study in the district of Derry. Br J Psychiatry 181:214–219

    Article  PubMed  Google Scholar 

  9. Northern Ireland Statistics and Research Agency (2006) Mental health and social wellbeing survey. http://www.ninis.nisra.gov.uk/mapxtreme/DataCatalogue.asp?button=Health. Accessed 14 Jan 2011

  10. Northern Ireland Statistics and Research Agency (2008) GP data mood and anxiety disorders. http://www.ninis.nisra.gov.uk/mapxtreme/DataCatalogue.asp?button=Health. Accessed 14 Jan 2011

  11. Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Twelve-month use of mental health services in the United States; results from the national comorbidity survey replication. Arch Gen Psychiatry 62:629–640

    Article  PubMed  Google Scholar 

  12. Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bruffaerts R et al (2008) Delay and failure in treatment seeking after first onset of mental disorders in the world mental health survey initiative. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 522–533

    Google Scholar 

  13. American Psychiatry Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  14. Kessler RC, Üstün TB (2008) The world health organization composite international diagnostic interview. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 58–90

    Google Scholar 

  15. Sheehan DV, Harnett-Sheehan K, Raj BA (1996) The measurement of disability. Int Clin Psychopharmacol 11:89–95

    Article  PubMed  Google Scholar 

  16. American Psychiatric Association (2002) Practice guideline for treatment of patients with bipolar disorder, 2nd edn. American Psychiatric Association Press, Washington, DC

    Google Scholar 

  17. Katon WJ, Roy-Byrne P, Russo J, Cowley D (2002) Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder. Arch Gen Psychiatry 59:1098–1104

    Article  PubMed  Google Scholar 

  18. Wells KB, Sherbourne C, Schoenbaum M, Duan N, Meredith L, Unutzer J et al (2000) Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. JAMA 283:212–220

    Article  PubMed  CAS  Google Scholar 

  19. American Psychiatric Association (1998) Practice guideline for treatment of patients with panic disorder. American Psychiatric Association Press, Washington, DC

    Google Scholar 

  20. National Committee for Quality Assurance (1997) Narrative: what’s in it and why it matters. National Committee for Quality Assurance, Washington, DC

    Google Scholar 

  21. Katon W, Von Korff M, Lin E, Walker E, Simon GE, Bush T et al (1995) Collaborative management to achieve treatment guidelines: impact on depression in primary care. JAMA 273:1026–1031

    Article  PubMed  CAS  Google Scholar 

  22. Wolter KM (1985) Introduction to variance estimation. Springer, New York

    Google Scholar 

  23. SUDAAN (2002) Version 8.01. Research Triangle Institute, Research Triangle Park, NC

  24. Hosmer DW, Lemeshow S (eds) (1989) Applied logistic regression. Wiley, New York

    Google Scholar 

  25. Gunn J, Maden A, Swinton M (1991) Treatment needs of prisoners with psychiatric disorders. BMJ 303:338–341

    Article  PubMed  CAS  Google Scholar 

  26. Lamb HR, Weinberger LE (1998) Persons with severe mental illness in jails and prisons: a review. Psychiatr Serv 49(4):483–492

    PubMed  CAS  Google Scholar 

  27. Brown MN, Lapane KL, Luisi AF (2002) The management of depression in older nursing home residents. J Am Geriatr Soc 50:69–76

    Article  PubMed  Google Scholar 

  28. Kessler RC, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ et al (2008) Prevalence of mental disorders in the world mental health survey initiative. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 534–540

    Google Scholar 

  29. Kessler RC, Berglund PA, Chiu WT, Demlar O, Glantz M, Lane MC et al (2008) The national comorbidity survey replication (NCS-R): the cornerstone in improving mental health and mental health care in the United States. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 165–210

    Google Scholar 

  30. National Collaborating Centre for Mental Health (2009) Depression in adults. Depression: the treatment and management of depression in adults. The British Psychological Society and Gaskell, Leister

  31. Herman AA, Williams D, Stein DJ, Seedat S, Heeringa SG, Moomal H (2008) The South African health and stress study (SASH): a foundation for improving mental health care in South Africa. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 238–264

    Google Scholar 

  32. Alonso J, Kessler RC (2008) Prevalence and treatment of mental disorders in Germany: results from the European study of epidemiology of mental disorders (ESEMeD) survey. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 331–345

    Google Scholar 

  33. Arababzadeh-Bouchez S, Gasquet I, Kovess-Masfety V, Negres-Pages L, Lépine J-P (2008) The prevalence of mental disorders and service use in France: results from a national survey 2001–2002. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 305–330

    Google Scholar 

  34. Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H (2000) Psychiatric morbidity among adults living in private households. TSO, London

    Google Scholar 

  35. Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ et al (2008) Recent treatment of mental health disorders in the world mental health survey initiative. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 511–521

    Google Scholar 

  36. Seedat S, Stein DJ, Herman A, Kessler R, Sonnega J, Heeringa S et al (2008) Twelve-month treatment of psychiatric disorders in the South African stress and health survey (world mental health survey initiative). Soc Psychiatry Psychiatr Epidemiol 43(11):889–897

    Article  PubMed  Google Scholar 

  37. Shen YC, Zhang M-Y, Huang Y-Q, He Y-L, Liu Z-R, Cheng H et al (2006) Twelve month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med 36(2):257–267

    Article  PubMed  Google Scholar 

  38. Alonso J, Angermeyer M, Bernert S, Bruffaerts R, Brugha TS, Bryson H et al (2004) Use of mental health services in Europe: results from the European study on epidemiology of mental disorders (ESEMeD) Project. Acta Psychiatr Scand 109(Suppl 420):47–54

    Google Scholar 

  39. Department of Health and Social Services and Public Safety (DHSSPS) (2006) The Bamford review of mental health and learning disability (N.Ireland): mental health promotion report. http://www.rmhldni.gov.uk/index/published-reports.htm. Accessed 14 Jan 2011

  40. Meltzer H, Bebbington P, Brugha T, Farrell M, Jenkins R, Lewis G (2003) The reluctance to seek treatment for neurotic disorders. Int Rev Psychiatry 15(1–2):123–128

    Article  PubMed  CAS  Google Scholar 

  41. Mojtabai R (2010) Mental illness stigma and willingness to seek mental health care in the European Union. Soc Psychiatry Psychiatr Epidemiol 45(7):705–712

    Article  PubMed  Google Scholar 

  42. Ten Have M, de Graaf R, Ormel J, Vialgut G, Kovess V, Alonso J (2010) Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders. Soc Psychiatry Psychiatr Epidemiol 45(2):153–163

    Article  PubMed  Google Scholar 

  43. Naganuma Y, Tachimori H, Kawakami N, Takeshima T, Ono Y, Uda H et al (2006) Twelve-month use of mental health services in four areas in Japan: findings from the world mental health Japan survey. Psychiatry Clin Neurosci 60(2):240–248

    Article  PubMed  Google Scholar 

  44. Levinson D, Lerner Y, Zilber N, Grinshpoon A, Levav I (2007) Twelve-month service utilization rates for mental health reasons: data from the Israel national health survey. Isr J Psychiatry Relat Sci 44(2):114–125

    PubMed  Google Scholar 

  45. Wang PS, Aguilar-Gaxiola S, Alonso J, Bromet EJ, Angermeyer MC, Borges G et al (2008) Recent treatment of mental disorders in the world mental health survey initiative. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 541–554

    Google Scholar 

  46. Cunningham JA, Sobell LC, Sobell MB, Agrawal S, Toneatto T (1993) Barriers to treatment: why alcohol and drug abusers delay or never seek treatment. Addict Behav 18(3):347–353

    Article  PubMed  CAS  Google Scholar 

  47. Saunders S, Zygowicz K, D’Angelo B (2006) Person-related and treatment-related barriers to alcohol treatment. J Subst Abuse Treat 30(3):261–270

    Article  PubMed  Google Scholar 

  48. Oakley-Browne MA, Wells JE, Scott KM (2008) Te Rau Hinengaro: the New Zealand mental health survey. In: Kessler RC, Üstün TB (eds) The WHO world mental health surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, New York, pp 486–510

    Google Scholar 

  49. Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J, Fleiz C et al (2005) Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican national comorbidity survey. Psychol Med 35(12):1773–1783

    Article  PubMed  Google Scholar 

  50. Kelly CM, Jorm AF (2007) Stigma and mood disorders. Curr Opin Psychiatry 20(1):13–16

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. A complete list of all within-country and cross-national WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/. The NISHS was supported by a grant from R&D Division Northern Ireland. The survey was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative which is supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb. None of the funders had any role in the design, analysis, interpretation of results, or preparation of this paper. All researchers involved in the study are independent from the sponsor.

Ethical approval

This study was approved by the University of Ulster Research Ethics and Governance Committee. All participants in the NISHS gave written informed consent before taking part.

Conflict of interest

BB, SM, SO’N and FF have support from Research and Development (R&D) Division Northern Ireland and the WMH Survey Initiative for the submitted work. BB, SM, SO’N and FF have no relationships with R&D Division Northern Ireland that might have an interest in the submitted work in the previous 3 years. Their spouses, partners, or children have no financial relationships that may be relevant to the submitted work; and BB, SM, SO’N and FF have no non-financial interests that may be relevant to the submitted work.

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Correspondence to Brendan Bunting.

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Bunting, B., Murphy, S., O’Neill, S. et al. Prevalence and treatment of 12-month DSM-IV disorders in the Northern Ireland study of health and stress. Soc Psychiatry Psychiatr Epidemiol 48, 81–93 (2013). https://doi.org/10.1007/s00127-012-0518-5

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  • DOI: https://doi.org/10.1007/s00127-012-0518-5

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