NEW YORK — Most mental health disorders begin in childhood and adolescence, but the early onset of these disorders makes it less likely that individuals will promptly seek treatment, initial findings of the World Health Organization's World Mental Health Survey Initiative show.
“Mental disorders worldwide are basically disorders of the young,” said Dr. Philip Wang, director of the Division of Services and Interventional Research at the National Institute of Mental Health, who presented the survey findings at the annual meeting of the American Psychopathological Association.
For example, worldwide about 50% of cases of anxiety disorders have an onset before age 15. For mood disorders, 50% of survey respondents reported onset by age 25. Among respondents who reported substance abuse disorders, 50% said the condition appeared by age 20.
The survey also found that most professionally diagnosed cases of chronic mental disorders eventually get some kind of treatment, although not necessarily administered in a professional setting. But treatment delays are pervasive, and treatment quality is often inadequate. The treatment, which is very broadly defined, can be anything from buying a self-help book to formal mental health care, may not be intensive enough or simply ineffective, Dr. Wang said.
Worldwide, 70%–90% of respondents diagnosed with panic disorder said they had received some form of treatment, but the median time to receiving treatment was 1–4 years. In generalized anxiety disorder (GAD), about 60%–82% of respondents reported receiving care, but it took about 4–6 years to receive treatment.
The treatment delays are longer for major depression and addictive disorders. In major depression, 63%–92% of respondents said they received treatment, but not until 5–8 years after their diagnosis. For addictive disorders, 35%–51% reported receiving treatment, but the median delay was about 10–14 years.
In panic and GAD, help seeking is the fastest, Dr. Wang said, which accounts for those disorders having the shortest delays to treatment. But even those among those patients, they are waiting years from the onset of the “full blown” disorder, he said.
The initial results of the survey also indicate that the speed with which someone seeks treatment is modified by the age of onset of the disorder. In phobias, for example, if the disorder begins at age 30 or older, it takes about 5 years before 50% of individuals have sought some form of care. But if the onset of the phobia comes when the patients are in their 20s, it takes about 20 years before half of patients have sought any kind of treatment.
The World Mental Health Survey Initiative is aimed at assessing psychopathology and service use worldwide. It involves 28 countries, and a total of 200,000 face-to-face interviews have either been conducted or are being planned.