Common Mental Disorder Diagnosis and Need for Treatment are Not the Same: Findings from the NEMESIS Study
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The study aimed to determine whether some depressive, anxiety, and substance-use (DAS) disorders are mild, transient cases that remit without treatment. The first two waves of the first Netherlands Mental Health Survey and Incidence Study were used (age 18–64 years at baseline; wave two N = 5618). Mental disorders were assessed using CIDI 1.1. Past-year and past-month measures of DAS disorders, health service use, and quality of life were assessed at both waves. Individuals with a past-year DAS disorder who received no prior lifetime treatment were significantly more likely than those who received treatment to: (1) remit from their index disorder(s) without subsequent treatment, (2) be free of comorbid disorders, and (3) not have attempted suicide during follow-up (remission rates: 68.5 versus 32.0 %, respectively, p < 0.001). However, these individuals had lower quality of life compared to healthy individuals. Results were similar for past-month measures. Results show that many people who meet criteria for a DAS disorder remit without treatment. However, the lowered quality of life scores in this group nonetheless underscores the negative impact on the presence of residual symptoms.
KeywordsMental health service use Need for treatment Quality of life Anxiety Depression Substance use
Preparation for this article was supported by a Canadian Institutes of Health Research (CIHR) operating (#273657) and, a Manitoba Health Research Council (MHRC) Chair award to Dr. Sareen. The NEMESIS was conducted by the Netherlands Institute of Mental Health and Addiction (Trimbos Institute) in Utrecht. Financial support for the NEMESIS has been received from the Netherlands Ministry of Health, Welfare and Sport (VWS) and the National Institute for Public Health and Environment (RIVM).
Compliance with Ethical Standards
Conflict of Interest
No ethical approval was needed for this particular study, as the data was already collected and available to all authors. The original NEMESIS was conducted with the approval of the ethics committee of the Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands. Respondents also provided informed consent according to the Dutch Law of 1996.
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