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.

[Institutions, subjectivity, and psychiatry]. / Institución, subjetividad y psiquiatría.

The common denominator is the interactive intersubjectivity in the biological, psychological, social, and cultural contexts. Contemporary subjective distress is rooted in these last two areas. It is important to consider that social and cultural factors are relevant in the process of subjectivity, that is, the way desire and fantasy are arranged. Therefore, the modifications in subjectivity generate new spatialities and temporalities. Space and time are not simply physical containers of human action but represent, at once, the container and contents of social practices. The fact that subjects are present at birth as both actors and carriers of institutions constitutes the foundation of these institutions in relation to subjectivity. The relational frames in which the subject is immersed are never a single element, but they express joint successive institutional and social spheres. The challenge is to think current demand differently, not only in the way it should be addressed, but mainly by the different characteristics of how subjectivity and the nature of social representations are expressed. Nowadays a clinical procedure that only takes into account the social factor is not enough - a clinical procedure for a social and interactive subject is required. The objective is to build a historicized subjectivity to enable taking action on the present. New social realities affect our clinical practice and form a new social and cultural context that forces us to reflect on these changes and think about the necessary adjustments in our practice and knowledge.

Institución, subjetividad y psiquiatría / [Institutions, subjectivity, and psychiatry].

The common denominator is the interactive intersubjectivity in the biological, psychological, social, and cultural contexts. Contemporary subjective distress is rooted in these last two areas. It is important to consider that social and cultural factors are relevant in the process of subjectivity, that is, the way desire and fantasy are arranged. Therefore, the modifications in subjectivity generate new spatialities and temporalities. Space and time are not simply physical containers of human action but represent, at once, the container and contents of social practices. The fact that subjects are present at birth as both actors and carriers of institutions constitutes the foundation of these institutions in relation to subjectivity. The relational frames in which the subject is immersed are never a single element, but they express joint successive institutional and social spheres. The challenge is to think current demand differently, not only in the way it should be addressed, but mainly by the different characteristics of how subjectivity and the nature of social representations are expressed. Nowadays a clinical procedure that only takes into account the social factor is not enough - a clinical procedure for a social and interactive subject is required. The objective is to build a historicized subjectivity to enable taking action on the present. New social realities affect our clinical practice and form a new social and cultural context that forces us to reflect on these changes and think about the necessary adjustments in our practice and knowledge.