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Journal article

Global Mental Health 3: Treatment and prevention of mental disorders in low-income and middle-income countries

Patel V, Araya R, Chatterjee S, Chisholm D, al E ...see all

The Lancet, vol. 370, issue 9591 (2007) pp. 991-1005 Published by Elsevier Limited

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Abstract

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. [PUBLICATION ABSTRACT]

Author-supplied keywords

  • Alcohol use
  • Antidepressants
  • Antidepressive Agents
  • Antidepressive Agents -- therapeutic use
  • Antipsychotic Agents
  • Antipsychotic Agents -- therapeutic use
  • Attention deficit disorder
  • Chronic illnesses
  • Cognition & reasoning
  • Cost-Benefit Analysis
  • Data analysis
  • Female
  • Health care policy
  • Health services
  • Humans
  • Income
  • Intervention
  • Male
  • Medical Sciences
  • Mental Disorders -- classification
  • Mental Disorders -- prevention & control
  • Mental Disorders -- therapy
  • Mental Health Services -- economics
  • Mental Health Services -- statistics & numerical d
  • Mental Health Services -- utilization
  • Mental disorders
  • Mental health care
  • Mental retardation
  • Preventive Health Services -- organization & admin
  • Preventive Health Services -- statistics & numeric
  • Preventive Health Services -- utilization
  • Psychology
  • Psychotherapy, Brief -- statistics & numerical dat
  • Psychotropic drugs
  • Randomized Controlled Trials as Topic -- economics
  • Randomized Controlled Trials as Topic -- statistic
  • Schizophrenia
  • Social networks

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Authors

  • Vikram Patel

  • Ricardo Araya

  • Sudipto Chatterjee

  • Dan Chisholm

  • et al

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