Treatment and prevention of mental disorders in low-income and middle-income countries.

By Vikram Patel, R. Araya, S. Chatterjee, D. Chisholm, Alex S. Cohen, Mary J. De Silva, C. Hosman, H. McGuire, G. Rojas, Mark van Ommeren. The Lancet, 2007

854 citations recorded by the source corpus.

We review the evidence on effectiveness of interventions for the treatment and prevention of selected mental disorders in low-income and middle-income countries. Depression can be treated effectively in such countries with low-cost antidepressants or with psychological interventions (such as cognitive-behaviour therapy and interpersonal therapies). Stepped-care and collaborative models provide a framework for integration of drug and psychological treatments and help to improve rates of adherence to treatment. First-generation antipsychotic drugs are effective and cost effective for the treatment of schizophrenia; their benefits can be enhanced by psychosocial treatments, such as community-based models of care. Brief interventions delivered by primary-care professionals are effective for management of hazardous alcohol use, and pharmacological and psychosocial interventions have some benefits for people with alcohol dependence. Policies designed to reduce consumption, such as increased taxes and other control strategies, can reduce the population burden of alcohol abuse. Evidence about the efficacy of interventions for developmental disabilities is inadequate, but community-based rehabilitation models provide a low-cost, integrative framework for care of children and adults with chronic mental disabilities. Evidence for mental health interventions for people who are exposed to conflict and other disasters is still weak-especially for interventions in the midst of emergencies. Some trials of interventions for prevention of depression and developmental delays in low-income and middle-income countries show beneficial effects. Interventions for depression, delivered in primary care, are as cost effective as antiretroviral drugs for HIV/AIDS. The process and effectiveness of scaling up mental health interventions has not been adequately assessed. Such research is needed to inform the continuing process of service reform and innovation. However, we recommend that policymakers should act on the available evidence to scale up effective and cost-effective treatments and preventive interventions for mental disorders.

Subfields: Clinical Psychology, Psychiatry and Mental health, Social Psychology

View Paper: https://www.semanticscholar.org/paper/a14560e11b019e97756a57c15fa37d03aeaadf71

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Clinical Psychology

1. A. Mancini
2. G. Bonanno
3. Maren Westphal
4. A. Ferrari
5. H. Whiteford
6. A. Masten
7. Fred Luthans
8. John T. Jost

In Psychiatry and Mental health

1. G. Bonanno

In Social Psychology

1. G. Bonanno
2. A. Mancini
3. Maren Westphal
4. A. Ferrari
5. H. Whiteford

Citations in the corpus

• The future of mental health care: peer-to-peer support and social media (2016, neutral): “This may be especially important in fragmented health care systems in low and middle income countries where access to mental health services is limited and even nonexistent (Patel et al. 2007).”
• Resilience to loss and potential trauma. (2011, background): “Because most data on feasibility and effectiveness of interventions designed to prevent mental disorders in adults come from studies conducted in high-income countries (Patel et al. 2007), little is known about the appropriateness and effectiveness of interventions in different cultural contexts.”
• Early Life Circumstance and Adult Mental Health (2019, background): “…the cost effectiveness ratio of treatment of mental disorders in low-income settings to beUS$500–$1,000 per averted disability-adjusted life-year (Patel et al. 2007), roughly commensurate with treatment and prevention of chronic illness such as HIV/AIDS and diabetes, policies to protect…”
• A systematic review and meta-regression of the prevalence and incidence of perinatal depression. (2017, background): “In low income countries, interventions for MDD that are culturally feasible, effective, and affordable do exist (Patel et al., 2007; Patel et al., 2016); however, the extent to which they can target women during the perinatal period is still being explored.”