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The prevalence and service utilisation associated with mental and substance use disorders in Lao People’s Democratic Republic: findings from a cross-sectional survey

Published online by Cambridge University Press:  24 July 2017

F. Charlson ,
S. Diminic ,
C. Choulamany ,
D. Santomauro ,
S. Raja  and
H. Whiteford
F. Charlson*
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
S. Diminic
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia
C. Choulamany
Affiliation:
BasicNeeds, 158A Parade, Leamington Spa, Warwickshire CV32 4AE, UK
D. Santomauro
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
S. Raja
Affiliation:
BasicNeeds, 158A Parade, Leamington Spa, Warwickshire CV32 4AE, UK
H. Whiteford
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
*
*Address for correspondence: F. Charlson, Policy and Epidemiology Group, Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Locked Bag 500, Archerfield QLD 4108 Australia. (Email: [email protected])
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Abstract

Aims.

An epidemiological survey was conducted to determine the prevalence of the mental and substance use disorders and ascertain patterns of mental health services utilisation in Lao People's Democratic Republic (Lao PDR) with the aim of evaluating existing gaps and opportunities in the provision of mental health services.

Methods.

This study was a cross-sectional, household survey of adults living within Vientiane Capital province, Lao PDR. We collected data on participant demographics, mental and physical health status, family history of mental illness and exposure to potential risk factors. It also collected data on mental health service utilisation patterns, types of health professionals and treatment being accessed, barriers to treatment and perceived need for care. The MINI International Neuropsychiatric Interview (MINI v.6.0) was also administered to assess mental disorder prevalence.

Results.

Age- and sex-standardised current prevalence of any disorder was estimated at 15.2% (95% CI 11.0–20.7). Alcohol dependence (5.5% (95% CI 3.2–9.6)), was the most prevalent followed by anxiety disorders (5.2% (95% CI 3.2–8.3)) and mood disorders (2.5% (95% CI 1.5–4.4)). 11.0% (95% CI 5.8–20.1) of participants with a mental and/or substance use disorder suffered from other comorbid disorders. A number of variables demonstrated significant effects in final logistic regression models, including family history, education and employment for mental disorders; and gender, numbers of hours worked per week and number of dependants for substance use disorders. Having a mental or substance use disorder was associated with an OR of 11.6 of suicidality over participants without a mental or substance use disorder (95% CI 2.8–58.5). Of the 101 participants who met criteria for a current mental or substance use disorder, only two (2.1% (95% CI 0.5–8.0)) had accessed services for their mental health in the past 12 months. No participants who had seen a health professional in the past 12 months reported getting as much help as they needed. The vast majority (89.2% (95% CI 76.5–95.4)) of participants meeting criteria for a current mental or substance use disorder reported that they had not experienced mental health problems in the past 12 months.

Conclusions.

This study presents the first epidemiological estimates for a range of mental and substance use disorders in the general population of the most populous province in Lao PDR. A large treatment gap exists for mental and substance use disorders in Lao PDR. This research adds value for health care and has been an important precursor to developing informed and targeted mental health policy, services and health system reform in Lao PDR.

Keywords

Lao PDRsubstance useepidemiologymental healthpopulation survey
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 1 , February 2019 , pp. 54 - 65
Copyright
Copyright © Cambridge University Press 2017 

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References

BasicNeeds (2016). BasicNeeds Lao PDR [Online]. http://www.basicneeds.org/where-we-work/lao-pdr/ [accessed].Google Scholar
Bertrand, D, Choulamany, C (2002). Mental health in the Lao PDR. Juth Pakai 5, 6–10.Google Scholar
Boyd, A, Van De Velde, S, Vilagut, G, De Graaf, R, O'Neill, S, Florescu, S, Alonso, J, Kovess-Masfety, V (2015). Gender differences in mental disorders and suicidality in Europe: results from a large cross-sectional population-based study. Journal of Affective Disorders 173, 245–254.Google Scholar
Bromet, E, Andrade, LH, Hwang, I, Sampson, NA, Alonso, J, De Girolamo, G, De Graaf, R, Demyttenaere, K, Hu, C, Iwata, N, Karam, AN, Kaur, J, Kostyuchenko, S, Lepine, JP, Levinson, D, Matschinger, H, Mora, ME, Browne, MO, Posada-Villa, J, Viana, MC, Williams, DR, Kessler, RC (2011). Cross-national epidemiology of DSM-IV major depressive episode. BMC Medicine 9, 90.Google Scholar
Burgess, PM, Pirkis, JE, Slade, TN, Johnston, AK, Meadows, GN, Gunn, JM (2009). Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry 43, 615–623.Google Scholar
Clement, S, Schauman, O, Graham, T, Maggioni, F, Evans-Lacko, S, Bezborodovs, N, Morgan, C, Rüsch, N, Brown, J, Thornicroft, G (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine 45, 11–27.Google Scholar
Cross-Disorder Group of the Psychiatric Genomics, C. (2013). Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. The Lancet 381, 1371–1379.Google Scholar
Ferrari, AJ, Charlson, FJ, Norman, RE, Flaxman, AD, Patten, SB, Vos, T, Whiteford, HA (2013). The epidemiological modelling of major depressive disorder: application for the Global Burden of Disease Study 2010. PLoS ONE 8, e69637.Google Scholar
Glantz, MD, Medina-Mora, ME, Petukhova, M, Andrade, LH, Anthony, JC, De Girolamo, G, De Graaf, R, Degenhardt, L, Demyttenaere, K, Florescu, S (2014). Alcohol abuse in developed and developing countries in the World Mental Health Surveys: socially defined consequences or psychiatric disorder? The American Journal on Addictions 23, 145–155.Google Scholar
Lao PDR Ministry of Health (2012). National mental health strategy by 2020. Ministry of Health: Vientiane Capital.Google Scholar
Lecrubier, Y, Sheehan, DV, Weiller, E, Amorim, P, Bonora, I, Sheehan, KH, Janavs, J, Dunbar, GC (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry 12, 224–231.Google Scholar
Lumley, T (2010). Complex Surveys: a Guide to Analysis Using R. John Wiley & Sons, Inc.: Hoboken, New Jersey.Google Scholar
Lumley, T (2014). Survey: analysis of complex survey samples. R package version 3.30.Google Scholar
Lund, C, Tomlinson, M, Patel, V (2016). Integration of mental health into primary care in low- and middle-income countries: the PRIME mental healthcare plans. The British Journal of Psychiatry 208, s1–s3.Google Scholar
Murray, CJ, Vos, T, Lozano, R, Naghavi, M, Flaxman, AD, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S (2013). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet 380, 2197–2223.Google Scholar
Nock, MK, Borges, G, Bromet, EJ, Alonso, J, Angermeyer, M, Beautrais, A, Bruffaerts, R, Chiu, WT, De Girolamo, G, Gluzman, S, De Graaf, R, Gureje, O, Haro, JM, Huang, Y, Karam, E, Kessler, RC, Lepine, JP, Levinson, D, Medina-Mora, ME, Ono, Y, Posada-Villa, J, Williams, D (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry 192, 98–105.Google Scholar
Phillips, MR, Zhang, J, Shi, Q, Song, Z, Ding, Z, Pang, S, Li, X, Zhang, Y, Wang, Z (2009). Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. The Lancet 373, 2041–2053.Google Scholar
R Core Team (2015). R: a Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria.Google Scholar
RStudio Team (2015). RStudio: Integrated Development for R. RStudio, Inc.: Boston, MA.Google Scholar
Thornicroft, G, Mehta, N, Clement, S, Evans-Lacko, S, Doherty, M, Rose, D, Koschorke, M, Shidhaye, R, O'Reilly, C, Henderson, C (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet 387, 1123–1132.Google Scholar
United Nations Children's Fund (2005). Conducting the Fieldwork. Multiple Indicator Cluster Survey Manual. UNICEF: New York.Google Scholar
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bromet, EJ, Bruffaerts, R, De Girolamo, G, De Graaf, R, Gureje, O (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet 370, 841–850.Google Scholar
Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, Charlson, FJ, Norman, RE, Flaxman, AD, Johns, N (2013). Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The Lancet 382, 1575–1586.Google Scholar
World Health Organization (2008). mhGAP: Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders [Online]. WHO Press: Geneva. http://www.who.int/mental_health/mhgap/en/ [accessed].Google Scholar
World Health Organization (2014). Mental Health Atlas 2014 [Online]. Geneva, Switzerland. http://www.who.int/mental_health/evidence/atlas/mental_health_atlas_2014/en/ [accessed 29 September 2015].Google Scholar
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