Twelve-month prevalence rates of mental disorders and service use in the Argentinean Study of Mental Health Epidemiology.

PURPOSE: Community surveys of mental disorders and service use are important for public health policy and planning. There is a dearth of information for Latin America. This is the first representative community survey in the Argentinean population. The purpose is to estimate the 12-month prevalence and severity of mental disorders, socio-demographic correlates and service use in a general population survey of adults from urban areas of Argentina. METHODS: The World Mental Health Composite International Diagnostic Interview was administered to 3927 individuals aged 18 years and older participating in a multistage clustered area probability household survey. The response rate was 77%. RESULTS: The 12-month prevalence of any disorder was 14.8%, and a quarter of those disorders were classified as severe. Younger participants and those with lower education had greater odds of any disorder and most classes of disorder. 11.6% of the total population received treatment in the prior 12 months and only 30.2% of those with a severe disorder. Women and those never married were more likely to receive or seek treatment, whereas those with low and low-average education were less likely. CONCLUSION: Most individuals with a mental disorder in the past year, even those with a severe disorder, have not received treatment. Because low education is a barrier to treatment, initiatives aimed at mental health education might help timely detection and treatment of these disorders in Argentina.

Lifetime prevalence and age-of-onset of mental disorders in adults from the Argentinean Study of Mental Health Epidemiology.

PURPOSE: Although the Global Burden of Disease Study estimated that depressive disorders and anxiety disorders are the second and fifth leading causes of disability in Argentina, these estimates were based on imputations rather than epidemiological data. The policy implications of these results for the necessary expansion of mental health services in Argentina are sufficiently great that more direct estimates of the population burdens of common mental disorders are needed. Therefore, the purpose is to present the first results regarding lifetime prevalence, projected lifetime risk up to age 75, age-of-onset, cohort effects and socio-demographic correlates of DSM-IV mental disorders among adults (18+) from the general population of urban areas of Argentina. METHOD: A multistage clustered area probability household survey was administered to 3927 individuals using the World Mental Health Composite International Diagnostic Interview. RESULTS: Lifetime prevalence of any disorder was 29.1% and projected lifetime risk at age 75 was 37.1%. Median age-of-onset of any disorder was 20 years of age. Disorders with highest lifetime prevalence were major depressive disorder (8.7%), alcohol abuse (8.1%), and specific phobia (6.8%). Anxiety disorders were the most prevalent group of disorder (16.4%) followed by mood (12.3%), substance (10.4%), and disruptive behavior disorders (2.5%). Women had greater odds of anxiety and mood disorders; men had greater odds of substance disorders. Age-at-interview was inversely associated with lifetime risk of any disorder. DISCUSSION: The results provide direct evidence for high lifetime societal burdens of common mental disorders in Argentina due to a combination of high prevalence and early age-of-onset.

[Epidemiological study of mental health in the general population of Argentina]. / Estudio epidemiológico de salud mental en población general de la República Argentina.

In this paper we report the findings of the first "Epidemiological study of mental health in the general population of Argentina" in the framework of the World Mental Health Survey Initiative WHO / Harvard, in collaboration with the Faculty of Medicine of the University of Buenos Aires and the Asociación de Psiquiatras Argentinos (APSA) with funding from the Ministry of Health. Methodology: A multistage probabilistic household survey was conducted using the Composite International Diagnostic Interview (CIDI). The survey was conducted on 3,927 people aged 18 and over (no age limit), with fixed residence in one of the eight largest urban areas in the country (Buenos Aires, Córdoba, Corrientes-Resistencia, Mendoza, Neuquén, Rosario, Salta and Tucumán), representing approximately 50.1% of the adults living in the country. The response rate was 77%. Results: The lifetime prevalence of any mental disorder in the general population of Argentina over 18 years of age was 29.1% and the projected life risk up to 75 years of age was 37.1%. The disorders with the highest life prevalence were Major Depressive Disorder (8.7%), Alcohol Abuse Disorder (8.1%) and Specific Phobia (6.8%). Anxiety Disorders were the most prevalent group (16.4%), followed by Mood Disorders (12.3%), Substance Disorders (10.4%), and Impulse Control Disorders (2.5%). The prevalence in the last 12 months of any mental disorder was 14.8%, a quarter of wich were classified as severe. 11.6% received treatment in the previous 12 months and only 30.2% of those who suffered a severe disorder received it. The results provide essential data for health planning and implementation and the training of the mental health workforce.

Twelve-month utilization rates and adequacy of treatment for mental health and substance use disorders in Argentina.

OBJECTIVE: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). METHODS: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. RESULTS: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. CONCLUSIONS: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.

Consumos de drogas sintéticas y discursos cerebrales en la movida electrónica de Buenos Aires / Consumption of synthetic drugs and brain discourses in the electronic music movement in Buenos Aires / Consumo de drogas sintéticas e discursos cerebrais no movimento eletrônico de Buenos Aires

Resumen (analítico): El presente artículo analiza las diferentes formas en que jóvenes que asisten a fiestas electrónicas en la Ciudad Autónoma de Buenos Aires (CABA) hacen uso de discursos y terminologías en torno a procesos vinculados a las neurociencias para dar cuenta de sus consumos recreativos de drogas sintéticas, sus formas de sociabilidad y las formas de entenderse a sí mismos. Se realizaron entrevistas a un informante, y un grupo de discusión con jóvenes que forman parte de la movida. En los relatos de los jóvenes se exponen alusiones que remiten a una individualidad somática cerebral como gramática que permite hacer inteligible los procesos de subjetivación. Estas referencias se presentan en forma de mutaciones, donde fuentes biomédicas de diferente orden coexisten: desde el campo psi a las neurociencias.

Abstract (analytical): This article aims to analyze the different ways in which young people attending electronic music events in Buenos Aires use discourses and terminologies related to neuroscience to account for their recreational consumption of synthetic drugs, their forms of sociability and the various approaches they use to understand themselves. Interviews were conducted with an informant and a discussion group was organised with a group of young people who attend electronic music events. The author suggests that the narratives of these young people refer to a somatic cerebral individuality as a form of grammar that makes their processes subjectivization intelligible. However, these references occur in the form of mutations, where different biomedical sources coexist ranging from psychology to the neurosciences.

Resumo (analítico): O presente artigo analisa as diferentes formas nas quais os jovens que frequentam festas electrónicas na Cidade Autônoma de Buenos Aires fazem uso de discursos e terminologias em torno de processos relacionados com as neurociências para explicar seus consumos recreativos de drogas sintéticas, suas formas de sociabilidade, e de compreender à si mesmos. Foram realizadas entrevistas com um informante chave, e uma reunião de discussão com um grupo de jovens que frequentam festas eletrônicas. Nas narraçoes destes jovens é possível observar alusões que se referem a uma individualidade somática cerebral como gramática que permite fazer inteligível processos de subjetivação. No entanto, estas referências apresentam se na forma de mutações, onde coexistem fontes biomédicas de diferentes ordem: desde o campo psi até as neurociências.

Twelve-month utilization rates and adequacy of treatment for mental health and substance use disorders in Argentina

Objective: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). Methods: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. Results: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. Conclusions: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.

Hacer bien una fecha: entre el cuidado y la maximización del placer en consumidores de drogas sintéticas / Doing right the fest: between care and maximization of pleasure in synthetic drugs users / Fazendo a festa: entre o cuidado e a maximização do prazer em usuários de drogas sintéticas

Resumen En este artículo analizamos los procesos de vulnerabilidad y las prácticas de cuidado individuales y grupales en relación a los consumos de drogas de jóvenes que asisten a fiestas electrónicas en la Ciudad Autónoma de Buenos Aires, Argentina. Los resultados provienen de una investigación cualitativa más amplia en la que realizamos entrevistas individuales a jóvenes de entre 18 y 25 años y grupos focales que estuvieron conformados por grupos preexistentes de amigos. En contraposición a la idea de un "descontrol generalizado" y a cierta banalización del consumo de sustancias, el análisis de las experiencias de los jóvenes nos permitió observar el desarrollo de estrategias de control de los riesgos que son inherentes a estos consumos. Estas estrategias concurren, en muchas ocasiones, con la maximización de las experiencias sensoriales placenteras. Partiendo de algunos conceptos de la Salud Colectiva y la Teoría Social, analizamos las experiencias de consumo de drogas sintéticas de los jóvenes para abordar los sentidos asociados a las instancias de cuidado y las demandas por cuidado emergentes; las estrategias que emplean para la maximización del placer; y las sabidurías prácticas que despliegan y el diálogo de éstas con los conocimientos del campo de la biomedicina.

Abstract In this article we analyze the vulnerability processes and the individual and group care practices related to drug consumption on young people that go to electronic music festivals in Buenos Aires, Argentina. The findings come from a wider qualitative research project. For the construction of the empirical evidence, we interviewed young people from 18 to 25 years and we conducted focus groups with preexistent groups of friends that hang out together. In opposition to the idea of a generalized lack of control and a certain banalization of drug use, the analysis of young people experiences showed how they develop strategies to control the risks that are inherent to this drug use. These strategies frequently go together with the maximization of pleasurable sensorial experiences. Employing some theoretical concepts from the Collective Health and the Social Theory, we analyze the experiences of synthetic drug use by young people to approach the meanings that are associated with care practices and the emerging demands for care; the strategies that they employ to maximize the pleasure; and the practical knowledge that they develop and its dialogue with the knowledge that comes from the field of the biomedicine.

Resumo Neste artigo analisamos os processos de vulnerabilidade e as práticas de cuidado individual e grupal relacionados ao consumo de drogas em jovens que frequentam festivais de música eletrônica em Buenos Aires, Argentina. Os resultados vêm de um projeto de pesquisa qualitativa mais amplo. Para a construção da evidência empírica, entrevistamos jovens de 18 a 25 anos e conduzimos grupos focais com grupos preexistentes de amigos que saem juntos. Em oposição à ideia de um descontrole generalizado e de certa banalização do uso de drogas, a análise das experiências dos jovens mostrou como eles desenvolvem estratégias para controlar os riscos inerentes a esse uso de drogas. Essas estratégias frequentemente acompanham a maximização de experiências sensoriais prazerosas. Empregando alguns conceitos teóricos da Saúde Coletiva e da Teoria Social, analisamos as experiências do uso de drogas sintéticas pelos jovens para abordar os significados que estão associados às práticas de cuidado e às demandas emergentes por cuidado; as estratégias que eles empregam para maximizar o prazer; e o conhecimento prático que desenvolvem e o diálogo com o conhecimento que vem do campo da biomedicina.