Skip to main content

Advertisement

Log in

Delays in seeking treatment for mental disorders in the Belgian general population

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objectives

To provide data on rates and predictors of lifetime treatment for mental disorders in Belgium from the European Study on the Epidemiology of Mental Disorders (ESEMeD).

Material and method

This is a cross-sectional population study of 1,043 non-institutionalized adult (18+) inhabitants from Belgium, The third version of the Composite International Diagnostic Interview (CIDI-3.0) was administered to assess lifetime mental disorders according to the Diagnostic and Statistical Manual, 4th version (DSM-IV), failure and delay of treatment for mental disorders, the duration of the delay between onset of the disorder and first treatment contact, and the proportion of persons seeking help in the same year as the onset of the disorder.

Results

Cumulative lifetime probability curves show that the vast majority of persons with mental disorders will eventually make a first treatment contact, although more so for mood (93.7%) and anxiety disorders (84.5%) than for alcohol disorders (61.2%). Median duration of delay in treatment was lowest for mood disorders (1 year), but peaked for anxiety (16 years) and alcohol disorders (18 years). Both older cohorts and late age of onset of the disorder predicted a higher probability of lifetime treatment.

Conclusion

Although most disorders are eventually treated, the delays between onset of the disorder and first treatment contact are impressive, despite the high-density and high accessibility of primary and specialized care in Belgium.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig 1

Similar content being viewed by others

References

  1. Alonso J, Ferrer M, Romera B, Vilagut G, Anyermeyer M, Bernert S, Brugha T, Taub N, McColgen Z, De Girolamo G, Polidori G, Mazzi F, De Graaf R, Vollebergh W, Bouwman MA, Demyttenaere K, Gasquet I, Haro MJ, Palacin C, Autonell J, Katz SJ, Kessler R, Kovess V, Lépine JP, Arbabzedeh-Bouchez S, Ormel J, Bruffaerts R (2002) The European Study of the Epidemiology of Mental Disorders (ESEMeD/MHEDEA 2000) Project: rationale and methods. Int J Methods Psychiatr Res 11:55–67

    Article  PubMed  CAS  Google Scholar 

  2. Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, de Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lepine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martinez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacin C, Romera B, Taub N, Vollebergh WA (2004) Sampling and methods of the European Study of Epidemiology of Mental Disorders (ESEMeD) Project. Acta Psychiatr Scand 109(suppl 420):8–20

    Google Scholar 

  3. Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, de Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lepine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martinez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacin C, Romera B, Taub N, Vollebergh WA (2004) 12-month comorbidity patterns and associated factors in Europe: results from the European study on Epidemiology of Mental Disorders (ESEMeD) Project. Acta Psychiatr Scand 109(suppl 420):28–37

    Google Scholar 

  4. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. Fourth Edition. Washington DC, American Psychiatric Association

    Google Scholar 

  5. Angermeyer MC, Dietrich S (2006) Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatr Scand 113:163–179

    Article  PubMed  CAS  Google Scholar 

  6. Bebbington PE, Brugha TS, Meltzer H, Jenkins R, Ceresa C, Farrell M, Lewis G (2000) Neurotic disorders and the receipt of psychiatric treatment. Psychol Med 30:1369–1376

    Article  PubMed  CAS  Google Scholar 

  7. Bonnewyn A, Bruffaerts R, Vilagut G, Almansa J, Demyttenaere K (2007) Lifetime risk of mental disorders in the Belgian general population. Soc Psychiatry Psychiatr Epidemiol 42:522–529

    Article  PubMed  Google Scholar 

  8. Bruffaerts R, Bonnewyn A, Demyttenaere K (2006) Epidemiologische ontwikkelingen op het vlak van de geestelijke gezondheidszorg in België: situatieschets en aandachtspunten voor de toekomst. Acta Hospitalia 46:7–23

    Google Scholar 

  9. Christiana JM, Gilman SE, Guardina M, Kessler RC, Mickelson K, Morselli PL, Olfson M (2000) Duration between onset and time of obtaining initial treatment among people with anxiety and mood disorders: an international survey of members of mental health advocate groups. Psychol Med 30:693–703

    Article  PubMed  CAS  Google Scholar 

  10. De Graaf R, Bijl R, Smit F, Ravelli A, Vollebergh WA (2000) Psychiatric and sociodemographic predictors of attrition in a longitudinal study: The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Am J Epidemiol 152:1039–1047

    Article  PubMed  Google Scholar 

  11. Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, Haro JM, Vilagut G, Bromet EJ, Gluzman S, Webb C, Kessler RC, Merikangas KR, Anthony JC, Von Korff MR, Wang PS, Brugha TS, Aguilar-Gaxiola S, Lee S, Heeringa S, Pennell BE, Zaslavsky AM, Ustun TB, Chatterji S (2004) Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health (WMH) Surveys. JAMA 291:2581–2590

    Article  PubMed  Google Scholar 

  12. Depression Guideline Panel (1993) Depression in primary care: Volume 2. Treatment of major depression. Clinical practice guideline, number 5. Rockville, MD. U.S. Department of health and human services, Public health service, Agency for health care policy and research. AHCPR Publication Number 93-0551

  13. Eaton WW, Anthony JC, Tepper S, Dryman A (1992) Psychopathology and attrition in the epidemiologic catchment area surveys. Am J Epidemiol 135:1051–1059

    PubMed  CAS  Google Scholar 

  14. Fondation Julie Renson (2005) Mémento de la santé mentale. Bruxelles: Fondation Julie Renson

    Google Scholar 

  15. Giuffra LA, Risch N (1994) Diminished recall and the cohort effect of major depression: a simulation study. Psychol Med 24:375–383

    Article  PubMed  CAS  Google Scholar 

  16. Hall S, Rao K (1992) Advanced techniques of population analysis. Plenum, New York, NY

    Google Scholar 

  17. Haro J, Arbabzadeh-Bouchez S, Brugha T, de Girolamo G, Guyer M, Jin R (2006) Concordance of the composite international diagnostic interview version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. Int J Methods Psychiatr Res 15:167–180

    Article  PubMed  Google Scholar 

  18. Kaplan EL PM (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:8–19

    Article  Google Scholar 

  19. Kaskutas LA, Weisner C, Caetano R (1997) Predictors of help seeking among a longitudinal sample of the general population, 1984–1992. J Stud Alcohol 58:155–161

    PubMed  CAS  Google Scholar 

  20. Kendler KS, Thornton IM, Gardner CO (2000) Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the ‘kindling’ hypothesis. Am J Psychiatry 157:1243–1251

    Article  PubMed  CAS  Google Scholar 

  21. Kessler RC, Olfson M, Berglund P (1998) Patterns and predictors of treatment contact after first onset of psychiatric disorders. Am J Psychiatry 155:62–69

    PubMed  CAS  Google Scholar 

  22. Kessler RC, Zhao S, Katz S, Kouzis A, Frank RG, Edlund M, Leaf Ph (1999) Past-year outpatient services for psychiatric problems in the National Comorbidity Survey. Am J Psychiatry 156:115–123

    PubMed  CAS  Google Scholar 

  23. Kessler RC, Ustun TB (2004) The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13:93–121

    Article  PubMed  Google Scholar 

  24. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:593–602

    Article  PubMed  Google Scholar 

  25. Kesteloot K (2002) Hervormingen in de gezondheidszorg. Economische achtergrond en ethische implicaties. In: Raymaekers B, Van De Putte A, Van Riel G (eds) Moeten, mogen, kunnen. Lessen voor de éénentwintigste eeuw. Leuven: Universitaire Pers, pp 159–185

  26. Killeen TK, Brady KT, Gold PB, Tyson C, Simpsom KN (2004) Comparison of self-report versus agency records of service utilization in a community sample of individuals with alcohol use disorders. Drug Alcohol Depend 73:141–147

    Article  PubMed  Google Scholar 

  27. Kisely S, Scott A, Denney J, Simon G (2006) Duration of untreated symptoms in common mental disorders: association with outcomes. Br J Psychiatry 189:79–80

    Article  PubMed  Google Scholar 

  28. Kovess-Masfety V, Alonso J, Brugha TS, Angermeyer MC, Haro JM, Sevilla-Dedieu C; ESEMeD/MHEDEA 2000 Investigators (2007) Differences in lifetime use of services for mental health problems in six European countries. Psychiatr Serv 58:213–220

    Article  Google Scholar 

  29. Lassey ML, Lassey WR, Jinks MJ (1997) Health care systems around the world: Characteristics, issues, reforms. New Jersey, Prentice Hall

    Google Scholar 

  30. Manderscheid RW, Henderson MJ (2002) Mental health, United States, 2000. Rockville: Center for Mental Health Services

    Google Scholar 

  31. Olfson M, Kessler RC, Berglund PA, Lin E (1998) Psychiatric disorder onset and first treatment contact in the United States and Ontario. Am J Psychiatry 155:1415–1422

    PubMed  CAS  Google Scholar 

  32. Pickels A, Pickering K, Simonoff E, Silberg J, Meyer J, Maes H (1998) Genetic “clocks” and “soft” events: a twin model for pubertal development and other recalled sequences of developmental milestones, transitions, and ages of onset. Behav Genet 28:243–253

    Article  Google Scholar 

  33. Simon GE, VonKorff M (1995) Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiol Rev 17:221–227

    PubMed  CAS  Google Scholar 

  34. Solbergsdottir E, Bjornsson G, Gudmundsson LS, Tyrfingsson T, Kristinsson J (2004) Validity of self-reports and drug use among young people seeking treatment for substance abuse or dependence. J Addict Dis 23:29–38

    Article  PubMed  Google Scholar 

  35. Shah BV, Barnwell BG, GS B (1997) Sudaan user’s manual release 8.0.1., Research Triangle Park, NC: Research Triangle Institute

  36. Wang PS, Berglund P, Olfson M, Kessler RC (2004) Delays in initial treatment contact after first onset of a mental disorder. Health Serv Res 39:393–415

    Article  PubMed  Google Scholar 

  37. Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey. Arch Gen Psychiatry 62:603–613

    Article  PubMed  Google Scholar 

  38. Wittchen HU (1994) Reliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84

    Article  PubMed  CAS  Google Scholar 

  39. World Health Organization (2005) WHO resource book on mental health, human rights, and legislation. Dare to care. Geneva: World Health Organization

    Google Scholar 

  40. World Health Organisation (2005) World Mental Health Atlas. Geneva: World Health Organization

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ronny Bruffaerts PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bruffaerts, R., Bonnewyn, A. & Demyttenaere, K. Delays in seeking treatment for mental disorders in the Belgian general population. Soc Psychiat Epidemiol 42, 937–944 (2007). https://doi.org/10.1007/s00127-007-0239-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-007-0239-3

Keywords

Navigation