Skip to main content

Advertisement

Log in

Common Mental Disorder Diagnosis and Need for Treatment are Not the Same: Findings from the NEMESIS Study

Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Acarturk, C., de Graaf, R., van Straten, A., ten Have, M. T., & Cuijpers, P. (2008). Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking: a population-based study. Social Psychiatry and Psychiatric Epidemiology, 43, 273–279.

    Article  CAS  PubMed  Google Scholar 

  • Afifi, T. O., Enns, M. W., Cox, B. J., de Graaf, R., ten Have, M., & Sareen, J. (2007). Child abuse and health-related quality of life in adulthood. Journal of Nervous and Mental Disease, 195, 797–804.

    Article  PubMed  Google Scholar 

  • Aoun, S., Pennebaker, D., & Wood, C. (2004). Assessing population need for mental health care: A review of approaches and predictors. Mental Health Services Research, 6, 33–46.

    Article  PubMed  Google Scholar 

  • Bijl, R. V., van Zessen, G., Rvaelli, A., de Rijk, C., & Langendoen, Y. (1998). The Netherlands Mental Health Survey and incidence Study (NEMESIS): objectives and design. Social Psychiatry and Psychiatric Epidemiology, 33, 581–586.

    Article  CAS  PubMed  Google Scholar 

  • Buist-Bouwman, M. A., Ormel, J., de Graaf, R., & Vollebergh, W. A. (2004). Functioning after a major depressive episode: Complete or incomplete recovery? Journal of Affective Disorders, 82, 363–371.

    PubMed  Google Scholar 

  • Corso, P. S., Edwards, V. J., Fang, X., & Mercy, J. A. (2008). Health-related quality of life among adults who experienced maltreatment during childhood. American Journal of Public Health, 98, 1094–1100.

    Article  PubMed  PubMed Central  Google Scholar 

  • de Graaf, R., Bijl, R. V., Smit, F., Ravelli, A., & Vollebergh, W. A. M. (2000). Psychiatric and sociodemographic predictors of attrition in a longitudinal study: The Netherlands Mental Health Survey and Incidence Study (NEMESIS). American Journal of Epidemiology, 152, 1039–1047.

    Article  PubMed  Google Scholar 

  • Druss, B. G., Wang, P. S., Sampson, N. A., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2007). Understanding mental health treatment in persons without mental diagnoses: results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 64, 1196–1203.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ghesquiere, A. (2013–2014). I was just trying to stick it out until I realized that I couldn’t: a phenomenological investigation of support seeking among older adults with complicated grief. Omega (Westport), 68, 1–22.

  • Hedden, S. L., & Gfroerer, J. C. (2011). Correlates of perceiving a need for treatment among adults with substance use disorder: results from a national survey. Addictive Behaviors, 36, 1213–1222.

    Article  PubMed  Google Scholar 

  • Kangas, M., Milross, C., Taylor, A., & Bryant, R. A. (2013). A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients. Psychooncology, 22, 1665–1673.

    Article  PubMed  Google Scholar 

  • Kendler, K. S., Gallagher, T. J., Abelson, J. M., & Kessler, R. C. (1996). Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Archives of General Psychiatry, 53, 1022–1031.

    Article  CAS  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005a). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., et al. (2005b). Prevalence and treatment of mental disorders, 1990–2003. New England Journal of Medicine, 352, 2515–2523.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kessler, R. C., Merikangas, K. R., Berglund, P., Eaton, W. W., Koretz, D. S., & Walters, E. E. (2003). Mild disorders should not be eliminated from the DSM-V. Archives of General Psychiatry, 60, 1117–1122.

    Article  PubMed  Google Scholar 

  • Krpan, K. M., Kross, E., Berman, M. G., Deldin, P. J., Askren, M. K., & Jonides, J. (2013). An everyday activity as a treatment for depression: the benefits of expressive writing for people diagnosed with major depressive disorder. Journal of Affective Disorders, 150, 1148–1151.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mechanic, D. (2003). Is the prevalence of mental disorders a good measure of the need for services? Health Affairs (Millwood), 22, 8–20.

    Article  Google Scholar 

  • Mojtabai, R., Olfson, M., & Mechanic, D. (2002). Perceived need and help-seeking in adults with mood, anxiety or substance use disorders. Archives of General Psychiatry, 59, 77–84.

    Article  PubMed  Google Scholar 

  • Narrow, W. E., Rae, D. S., Robins, L. N., & Regier, D. A. (2002). Revised prevalence estimates of mental disorders in the United States: Using a clinical significance criterion to reconcile 2 surveys’ estimates. Archives of General Psychiatry, 59, 115–123.

    Article  PubMed  Google Scholar 

  • Ormel, J., Oldehinkel, A. J., Nolen, W. A., & Vollebergh, W. (2004). Psychosocial disability before, during, and after a major depressive episode: A 3-wave population-based study of state, scar, and trait effects. Archives of General Psychiatry, 61, 387–392.

    Article  PubMed  Google Scholar 

  • Pagura, J., Katz, L. Y., Mojtabai, R., Druss, B. G., Cox, B., & Sareen, J. (2011). Antidepressant use in the absence of common mental disorders in the general population. Journal of Clinical Psychiatry, 74, 494–501.

    Article  Google Scholar 

  • Regier, D. A., Kaelber, C. T., Rae, D. S., Farmer, M. E., Knauper, B., Kessler, R. C., & Norguist, G. S. (1998). Limitations of diagnostic criteria and assessment instruments for mental disorders: implications for research and policy. Archives of General Psychiatry, 55, 109–115.

    Article  CAS  PubMed  Google Scholar 

  • Sareen, J., Cox, B. J., Afifi, T. O., Clara, I., & Yu, B. N. (2005a). Perceived need for mental health treatment in a national representative Canadian sample. Canadian Journal of Psychiatry, 50, 447–455.

    Google Scholar 

  • Sareen, J., Fleisher, W., Cox, B. J., Hassard, S., & Stein, M. B. (2005b). Childhood adversity and perceived need for mental health care: findings from a Canadian community sample. Journal of Nervous and Mental Disease, 193, 396–404.

    Article  PubMed  Google Scholar 

  • Sareen, J., Henriksen, C. A., Stein, M. B., Afifi, T. O., Lix, L. M., & Enns, M. W. (2013). Common mental disorder diagnosis and need for treatment are not the same: findings from a population-based longitudinal survey. Psychological Medicine, 49, 1941–1951.

    Article  Google Scholar 

  • Shah, B. V., Barnswell, B. G., & Bieler, G. S. (1995). SUDAAN user’s manual: Software for analysis of correlated data. Research Triangle Park : Research Traingle Institute.

    Google Scholar 

  • Smeets, R. W. M., & Dingemans, P. M. A. J. (1993). Composite International Diagnostic Interview (CIDI), version 1.1. Geneva: WHO.

    Google Scholar 

  • Spijker, J., de Graaf, R., Bijl, R. V., Beekman, A. T., Ormel, J., & Nolen, W. A. (2002). Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). British Journal of Psychiatry, 181, 208–213.

    Article  PubMed  Google Scholar 

  • SUDAAN. (2000). SUDAAN: Software for the statistical analysis of correlated data, release 75. Research Triangle Park: Research Triangle Institute.

    Google Scholar 

  • ten Have, M., de Graaf, R., van Dorsselaer, S., & Beekman, A. (2013a). Lifetime treatment contact and delay in treatment seeking after first onset of a mental disorder. Psychiatric Services, 64, 981–989.

    Article  PubMed  Google Scholar 

  • ten Have, M., Nuyen, J., Beekman, A., & de Graaf, R. (2013b). Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems. Psychological Medicine, 43, 2203–2215.

    Article  PubMed  Google Scholar 

  • Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., et al. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO World Mental Health Surveys. Lancet, 370, 841–850.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang, P. S., Berglund, P., Olson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 603–613.

    Article  PubMed  Google Scholar 

  • Ware, J. E, Jr. (2000). SF-36 health survey update. Spine, 25(24), 3130–3139.

    Article  PubMed  Google Scholar 

  • Wittchen, H. U., Robins, L. N., Cottler, L. B., Sartorius, N., Burke, D., & Regier, D. A. (1991). Cross-cultural feasibility, reliability and resources of variance of the Composite International Diagnostic Interview (CIDI). British Journal of Psychiatry, 159, 645–653.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

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).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jitender Sareen.

Ethics declarations

Conflict of Interest

None.

Ethical Approval

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, Y., Henriksen, C.A., ten Have, M. et al. Common Mental Disorder Diagnosis and Need for Treatment are Not the Same: Findings from the NEMESIS Study. Adm Policy Ment Health 44, 572–581 (2017). https://doi.org/10.1007/s10488-016-0745-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-016-0745-2

Keywords

Navigation