Perceived helpfulness of treatment for specific phobia: Findings from the World Mental Health Surveys.
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de Vries Ymkje Anna, Harris Meredith G, Vigo Daniel, Chiu Wai Tat, Sampson Nancy A, Al-Hamzawi Ali, Alonso Jordi, Andrade Laura H, Benjet Corina, Bruffaerts Ronny, Bunting Brendan, Caldas de Almeida José Miguel, de Girolamo Giovanni, Florescu Silvia, Gureje Oye, Haro Josep Maria, Hu Chiyi, Karam Elie G, Kawakami Norito, Kovess-Masfety Viviane, Lee Sing, Moskalewicz Jacek, Navarro-Mateu Fernando, Ojagbemi Akin, Posada-Villa José, Scott Kate, Torres Yolanda, Zarkov Zahari, Nierenberg Andrew, Kessler Ronald C, de Jonge Peter, WHO World Mental Health Survey collaborators
Аннотация
METHODS: Cross-sectional population-based WHO World Mental Health (WMH) surveys in 24 countries (n=112,507) assessed lifetime specific phobia. Respondents who met lifetime criteria were asked whether they ever received treatment they considered helpful and the number of professionals seen up to the time of receiving helpful treatment. Discrete-event survival analysis was used to calculate conditional-cumulative probabilities of obtaining helpful treatment across number of professionals seen and of persisting in help-seeking after prior unhelpful treatment.
RESULTS: 23.0% of respondents reported receiving helpful treatment from the first professional seen, whereas cumulative probability of receiving helpful treatment was 85.7% after seeing up to 9 professionals. However, only 14.7% of patients persisted in seeing up to 9 professionals, resulting in the proportion of patients ever receiving helpful treatment (47.5%) being much lower than it could have been with persistence in help-seeking. Few predictors were found either of perceived helpfulness or of persistence in help-seeking after earlier unhelpful treatments.
LIMITATIONS: Retrospective recall and lack of information about either types of treatments received or objective symptomatic improvements limit results.
CONCLUSIONS: Despite these limitations, results suggest that helpfulness of specific phobia treatment could be increased, perhaps substantially, by increasing patient persistence in help-seeking after earlier unhelpful treatments. Improved understanding is needed of barriers to help-seeking persistence.