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Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems

Published online by Cambridge University Press:  07 February 2013

M. ten Have ,
J. Nuyen ,
A. Beekman  and
R. de Graaf
M. ten Have*
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
J. Nuyen
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
A. Beekman
Affiliation:
Vrije Universiteit Amsterdam, The Netherlands
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
*
*Address for correspondence: M. ten Have, Ph.D., Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands. (Email: mhave@trimbos.nl)
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Abstract

Background

Detailed population-based survey information on the relationship between the severity of common mental disorders (CMDs) and treatment for mental health problems is heavily based on North American research. The aim of this study was to replicate and expand existing knowledge by studying CMD severity and its association with treatment contact and treatment intensity in The Netherlands.

Method

Data were obtained from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 18–64 years (n = 6646, response rate = 65.1%). DSM-IV diagnoses and disorder severity were assessed with the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0). Treatment contact refers to at least one contact for mental health problems made in the general medical care (GMC) or mental health care (MHC) sector. Four levels of treatment intensity were assessed, based on type and duration of therapy received.

Results

Although CMD severity was related to treatment contact, only 39.0% of severe cases received MHC. At the same time, 40.3% of MHC users did not have a 12-month disorder. Increasing levels of treatment intensity ranged from 51.6% to 13.0% in GMC and from 81.4% to 51.1% in MHC. CMD severity was related to treatment intensity in MHC but not in GMC. Sociodemographic characteristics were not significantly related to having experienced the highest level of treatment intensity in MHC.

Conclusions

Mental health treatment in the GMC sector should be improved, especially when policy is aimed at increasing the role of primary care in the management of mental health problems.

Keywords

Severity of common mental disorderstreatment contacttreatment intensity
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2203 - 2213
Copyright
Copyright © Cambridge University Press 2013 

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