Epidemiology of psychiatric and alcohol disorders in Ukraine
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This study presents the lifetime, 12-month, and 1-month prevalence estimates of nine psychiatric and alcohol disorders in Ukraine assessed as part of the World Health Organization (WHO) World Mental Health (WMH) research program. The Ukraine WMH survey is the first psychiatric epidemiologic study in a former Soviet Union country to administer a structured psychiatric interview to a nationally representative sample.
In 2002, a national probability sample of 4,725 respondents ages 18 and older were interviewed with the WMH version of the Composite International Diagnostic Interview (WMH-CIDI). Prevalence estimates, age-of-onset curves, comorbidity, demographic and geographic risk factors, and treatment seeking were examined.
Close to one third of the population experienced at least one Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) disorder in their lifetime, 17.6% experienced an episode in the past year, and 10.6% had a current disorder. There was no gender difference in the overall prevalence rates. In men, the most common diagnoses were alcohol disorders (26.5% lifetime) and mood disorders (9.7% lifetime); in women, they were mood disorders (20.8% lifetime) and anxiety disorders (7.9% lifetime). The odds ratios for most pairs of disorders were highly significant. Age of onset was primarily in the teens and early 20s. Age, education, and living in the Eastern region of Ukraine were significant risk factors across disorders, with respondents older than 50 years having the highest prevalence of mood disorder and the lowest prevalence of alcoholism and intermittent explosive disorder. Only a minority of respondents talked to a professional about their symptoms.
Prevalence estimates of alcoholism among men and recent depression among women were higher in Ukraine than in comparable European surveys. The results argue for the need to develop and implement educational programs focused on the recognition and treatment of mental and alcohol disorders for the general population, psychiatrists, and general medical providers, who are the main source of mental health care.
KeywordsUkraine Mental disorders alcoholism epidemiology WMH survey Former Soviet Union prevalence risk factors
This study was funded by the National Institute of Mental Health (MH61905). The survey was conducted as part of the WHO World Mental Health Survey consortium directed by Ronald C. Kessler, Ph.D. (Harvard University) and T. Bedirhan Ustun, M.D. (WHO). We thank them, as well as Jordi Alonso, M.D. (Institut Municipal d'Investigacio Medica, Barcelona, Spain), for their very helpful comments on an earlier draft of this manuscript. The authors also thank Valeriy Khmelko, Ph.D. (Kiev International Institute of Sociology), and Julia Pievskaya (Ukrainian Psychiatric Association) for their invaluable assistance in conducting the field work; Inna Korchak, M.A., Roksolana Mykhaylyk, Ph.D., Margaret Bloom, J.D., and Svetlana Stepukhovich, Ph.D., for their excellent translations of the various components of the study; Ellen Walters for continuing statistical support; and Irina Gavrilovskaya, M.D., Ph.D., Dr. Sci., for her insights about the findings. Special thanks go to the interviewers and participants for their dedication and diligence.
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