TABLE 2-1 12-Month Treatment of Physical and Mental Disorders in High-Income and Low- and Middle-Income Participants in the World Mental Health Survey

Conditions

 

Treatment Prevalence Among Participants (%)

 

High-Income Countries

Low- and Middle-Income Countries

Physical disorders

Arthritis

50.9

46.6

 

Asthma

51.0

61.4

 

Cancer

51.8

59.6

 

Diabetes

94.4

76.6

 

High blood pressure

90.2

69.8

Mental disorders

Bipolar disorder

29.1

13.4

 

Depression

29.3

8.1

 

GAD

31.6

7.2

 

Panic disorder

33.1

9.4

 

PTSD

29.5

8.1

NOTE: GAD = generalized anxiety disorder; PTSD = posttraumatic stress disorder.

SOURCE: Gureje, 2009.

Patel pointed out that in the poorest countries in the world, up to 90 percent of individuals with the most severe mental disorders—such as serious depression, psychosis, and epilepsy—do not even receive the most basic care (WHO, 2001). He said this does not mean individuals do not access care, it means that when they do access care, 90 percent do not receive the treatments known to be effective. Therefore, when patients present themselves for treatment, the symptoms may be treated, but the underlying cause is ignored. For example, if a patient presents with sleeplessness, fatigue, or soreness—all common symptoms associated with depression—the patient is often treated with hypnotics, tonics, or analgesics rather than being evaluated for the underlying cause of these symptoms.

In Tanzania, only 5 to 10 percent of individuals with epilepsy receive appropriate and adequate therapy. The treatment gap for epilepsy in developing countries has been mainly attributed to inadequately skilled personnel, cost of treatment, cultural beliefs, and unavailability of antiepileptic drugs, although lack of accessible health facilities has also been noted (Baskind and Birbeck, 2005; Mbuba et al., 2008). Other age-related MNS disorders on the rise in Tanzania, such as Alzheimer’s disease and Parkinson’s disease, are also poorly recognized by healthcare



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