Epidemiology of mental disorders, use of service, and treatment gap in Chile

摘要

The World Health Organization (WHO) estimates place Chile among the countries with the highest burden of disease from neuropsychiatric illnesses (23.2 percent) in the world. Major depression and alcohol use disorders rank first and second in attributed disability among adults. Nearly one-third of the population over 15 years of age has had a psychiatric disorder in their lifetime and 22.2 percent have had one in the past year. Anxiety disorders are the most prevalent, followed by major depression and alcohol use disorders. Only 38.5 percent of those with a diagnosis receive any kind of mental health service, whether from a specialist or primary care physician. In children and adolescents, the prevalence of any psychiatric disorder is 22.5 percent (19.3 percent for boys and 25.8 percent for girls). These are mainly anxiety and disruptive disorders. Their prevalence is higher among 4 to 11 year olds (27.8 percent) than 12 to 18 year olds (16.5 percent). This difference is mainly a result of disruptive disorders. The prevalence of anxiety disorders is the second highest cause but is less associated with impairment, whereas most children and adolescents with affective disorders are impaired. Only around one-fifth of the subjects in need of services seek some form of assistance. Nearly one-quarter of those using services do not present a psychiatric diagnosis in the past year. Comorbidity occurs in 27 percent of those with a disorder, but only 7 percent have three or more diagnoses. Not addressing the treatment gap in mental health has serious public health implications.