Author
Benedetto Saraceno
Other affiliations: Mario Negri Institute for Pharmacological Research, University of Geneva, University of Lisbon ...read more
Bio: Benedetto Saraceno is an academic researcher from Universidade Nova de Lisboa. The author has contributed to research in topics: Mental health & Health policy. The author has an hindex of 37, co-authored 118 publications receiving 7168 citations. Previous affiliations of Benedetto Saraceno include Mario Negri Institute for Pharmacological Research & University of Geneva.
Papers published on a yearly basis
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TL;DR: The treatment gap for mental disorders is universally large, though it varies across regions, and it is likely that the gap reported here is an underestimate due to the unavailability of community-based data from developing countries where services are scarcer.
Abstract: Mental disorders are highly prevalent and cause considerable suffering and disease burden. To compound this public health problem, many individuals with psychiatric disorders remain untreated although effective treatments exist. We examine the extent of this treatment gap. We reviewed community-based psychiatric epidemiology studies that used standardized diagnostic instruments and included data on the percentage of individuals receiving care for schizophrenia and other non-affective psychotic disorders, major depression, dysthymia, bipolar disorder, generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), and alcohol abuse or dependence. The median rates of untreated cases of these disorders were calculated across the studies. Examples of the estimation of the treatment gap for WHO regions are also presented. Thirty-seven studies had information on service utilization. The median treatment gap for schizophrenia, including other non-affective psychosis, was 32.2%. For other disorders the gap was: depression, 56.3%; dysthymia, 56.0%; bipolar disorder, 50.2%; panic disorder, 55.9%; GAD, 57.5%; and OCD, 57.3%. Alcohol abuse and dependence had the widest treatment gap at 78.1%. The treatment gap for mental disorders is universally large, though it varies across regions. It is likely that the gap reported here is an underestimate due to the unavailability of community-based data from developing countries where services are scarcer. To address this major public health challenge, WHO has adopted in 2002 a global action programme that has been endorsed by the Member States.
1,412 citations
Harvard University1, University of Cape Town2, King's College London3, Makerere University4, Johns Hopkins University5, University of Washington6, Carter Center7, Emory University8, University of London9, University of Melbourne10, World Psychiatric Association11, Rutgers University12, Al-Quds University13, Peking University14, University of Amsterdam15, University of Health Sciences Lahore16, Dow University of Health Sciences17, University of Ibadan18, University of Liverpool19, Public Health Foundation of India20, Wellcome Trust21, University of Oxford22, Groote Schuur Hospital23, South African Medical Research Council24
1,356 citations
TL;DR: Barriers to progress in improvement of mental health services can be overcome by generation of political will for the organisation of accessible and humane mental health care, a qualitative survey of international mental health experts and leaders suggests.
881 citations
TL;DR: This paper reviewed the evidence for the types of human rights violations experienced by people with mental and psychosocial disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD).
358 citations
TL;DR: For instance, this article found that the prevalence of trastornos mentales in America Latina and the Caribe is demasiado large, pese a the existence of tratamientos eficaces.
Abstract: OBJETIVO: La creciente carga de trastornos mentales que afecta a las poblaciones de America Latina y el Caribe es demasiado grande para hacer caso omiso de ella. Por lo tanto, es una necesidad impostergable conocer la prevalencia de los trastornos mentales y la brecha de tratamiento, que esta dada por la diferencia entre las tasas de prevalencia verdadera y las de las personas que han sido tratadas, que en algunos casos es grande pese a la existencia de tratamientos eficaces. Si se dispone de mayor informacion, se hace mas factible 1) abogar mejor por los intereses de las personas que necesitan atencion, 2) adoptar politicas mas eficaces, 3) formular programas de intervencion innovadores y 4) adjudicar recursos en conformidad con las necesidades observadas. METODOS: Los datos se obtuvieron de estudios comunitarios publicados en America Latina y el Caribe entre 1980 y 2004. En esas investigaciones epidemiologicas se usaron instrumentos diagnosticos estructurados y se estimaron tasas de prevalencia. Las tasas brutas de diversos trastornos psiquiatricos en America Latina y el Caribe se estimaron a partir de las tasas media y mediana extraidas de los estudios, desglosadas por sexo. Tambien se extrajeron los datos correspondientes al uso de servicios de salud mental para poder calcular la brecha en el tratamiento segun trastornos especificos. RESULTADOS: Las psicosis no afectivas (entre ellas la esquizofrenia) tuvieron una prevalencia media estimada durante el ano precedente de 1,0%; la depresion mayor, de 4,9%; y el abuso o la dependencia del alcohol, de 5,7%. Mas de la tercera parte de las personas afectadas por psicosis no afectivas, mas de la mitad de las afectadas por trastornos de ansiedad, y cerca de tres cuartas partes de las que abusaban o dependian del alcohol no habian recibido tratamiento psiquiatrico alguno, sea en un servicio especializado o en uno de tipo general. CONCLUSIONES: La actual brecha en el tratamiento de los trastornos mentales en America Latina y el Caribe sigue siendo abrumadora. Ademas, las tasas actuales probablemente subestiman el numero de personas sin atencion. La transicion epidemiologica y los cambios en la composicion poblacional acentuaran aun mas la brecha en la atencion en America Latina y el Caribe, a no ser que se formulen nuevas politicas de salud mental o que se actualicen las existentes, procurando incluir en ellas la extension de los programas y servicios.
246 citations
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TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.
7,021 citations
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) as discussed by the authors was used to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs).
4,753 citations
Valery L. Feigin1, Amanuel Alemu Abajobir2, Kalkidan Hassen Abate3, Foad Abd-Allah4 +267 more•Institutions (138)
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors (GBD) study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions as discussed by the authors.
Abstract: Summary Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services. Funding Bill & Melinda Gates Foundation.
2,995 citations
TL;DR: Mental health affects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS.
2,943 citations
TL;DR: Examination of prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors.
Abstract: Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.
2,147 citations