Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries /

Konstantinos N Fountoulakis; Gregory Karakatsoulis; Seri Abraham; Kristina Adorjan; Helal Uddin Ahmed; Renato D Alarcón; Kiyomi Arai; Sani Salihu Auwal; Michael Berk; Sarah Levaj; Julio Bobes; Teresa Bobes-Bascaran; Julie Bourgin-Duchesnay; Cristina Ana Bredicean; Laurynas Bukelskis; Akaki Burkadze; Indira Indiana Cabrera Abud; Ruby Castilla-Puentes; Marcelo Cetkovich; Hector Colon-Rivera; Ricardo Corral; Carla Cortez-Vergara; Piirika Crepin; Domenico De Berardis; Sergio Zamora Delgado; David De Lucena; Avinash De Sousa; Ramona Di Stefano; Seetal Dodd; Livia Priyanka Elek; Anna Elissa; Berta Erdelyi-Hamza; Gamze Erzin; Martin J Etchevers; Peter Falkai; Adriana Farcas; Ilya Fedotov; Viktoriia Filatova; Nikolaos K Fountoulakis; Iryna Frankova; Francesco Franza; Pedro Frias; Tatiana Galako; Cristian J Garay; Leticia Garcia-Álvarez; Maria Paz García-Portilla; Xenia Gonda; Tomasz M Gondek; Daniela Morera González; Hilary Gould; Paolo Grandinetti; Arturo Grau; Violeta Groudeva; Michal Hagin; Takayuki Harada; Tasdik M Hasan; Salmi Razali; Jan Hilbig; Sahadat Hossain; Rossitza Iakimova; Mona Ibrahim; Felicia Iftene; Yulia Ignatenko; Matias Irarrazaval; Zaliha Ismail; Jamila Ismayilova; Asaf Jakobs; Miro Jakovljević; Nenad Jakšić; Afzal Javed; Helin Yilmaz Kafali; Sagar Karia; Olga Kazakova; Doaa Khalifa; Olena Khaustova; Steve Koh; Svetlana Kopishinskaia; Korneliia Kosenko; Nikolett Beata Vadon; Alisha Lalljee; Justine Liewig; Abdul Majid; Evgeniia Malashonkova; Khamelia Malik; Najma Iqbal Malik; Gulay Mammadzada; Bilvesh Mandalia; Donatella Marazziti; Darko Marčinko; Stephanie Martinez; Eimantas Matiekus; Gabriela Mejia; Roha Saeed Memon; Xarah Elenne Meza Martínez; Dalia Mickevičiūtė; Roumen Milev; Muftau Mohammed; Alejandro Molina-López; Petr Morozov; Nuru Suleiman Muhammad; Filip Mustač; Mika S Naor; Amira Nassieb; Alvydas Navickas; Tarek Okasha; Milena Pandova; Anca-Livia Panfil; Liliya Panteleeva; Ion Papava; Alexey Pavlichenko; Bojana Pejuskovic; Mariana Pinto da Costa; Mikhail Popkov; Dina Popovic; Nor Jannah Nasution Raduan; Francisca Vargas Ramírez; Elmars Rancans; Nurul Azreen Hashim; Federico Rebok; Anna Rewekant; Elena Ninoska Reyes Flores; María Teresa Rivera-Encinas; Pilar Saiz; Manuel Sánchez de Carmona; David Saucedo Martínez; Jo Anne Saw; Görkem Saygili; Patricia Schneidereit; Bhumika Shah; Tomohiro Shirasaka; Ketevan Silagadze; Satti Sitanggang; Oleg Skugarevsky; Anna Spikina; Sridevi Sira Mahalingappa; Maria Stoyanova; Anna Szczegielniak; Simona Claudia Tamasan; Giuseppe Tavormina; Maurilio Giuseppe Maria Tavormina; Mauricio Tohen; Eva Maria Tsapakis; Dina Tukhvatullina; Irfan Ullah; Ratnaraj Vaidya; Johann M Vega-Dienstmaier; Jelena Vrublevska; Olivera Vukovic; Olga Vysotska; Natalia Widiasih; Anna Yashikhina; Daria Smirnova

doi:10.1016/j.psychres.2025.116459

Title	Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries /
Authors	Fountoulakis, Konstantinos N ; Karakatsoulis, Gregory ; Abraham, Seri ; Adorjan, Kristina ; Ahmed, Helal Uddin ; Alarcón, Renato D ; Arai, Kiyomi ; Auwal, Sani Salihu ; Berk, Michael ; Levaj, Sarah ; Bobes, Julio ; Bobes-Bascaran, Teresa ; Bourgin-Duchesnay, Julie ; Bredicean, Cristina Ana ; Bukelskis, Laurynas ; Burkadze, Akaki ; Abud, Indira Indiana Cabrera ; Castilla-Puentes, Ruby ; Cetkovich, Marcelo ; Colon-Rivera, Hector ; Corral, Ricardo ; Cortez-Vergara, Carla ; Crepin, Piirika ; De Berardis, Domenico ; Delgado, Sergio Zamora ; De Lucena, David ; De Sousa, Avinash ; Stefano, Ramona Di ; Dodd, Seetal ; Elek, Livia Priyanka ; Elissa, Anna ; Erdelyi-Hamza, Berta ; Erzin, Gamze ; Etchevers, Martin J ; Falkai, Peter ; Farcas, Adriana ; Fedotov, Ilya ; Filatova, Viktoriia ; Fountoulakis, Nikolaos K ; Frankova, Iryna ; Franza, Francesco ; Frias, Pedro ; Galako, Tatiana ; Garay, Cristian J ; Garcia-Álvarez, Leticia ; García-Portilla, Maria Paz ; Gonda, Xenia ; Gondek, Tomasz M ; González, Daniela Morera ; Gould, Hilary ; Grandinetti, Paolo ; Grau, Arturo ; Groudeva, Violeta ; Hagin, Michal ; Harada, Takayuki ; Hasan, Tasdik M ; Razali, Salmi ; Hilbig, Jan ; Hossain, Sahadat ; Iakimova, Rossitza ; Ibrahim, Mona ; Iftene, Felicia ; Ignatenko, Yulia ; Irarrazaval, Matias ; Ismail, Zaliha ; Ismayilova, Jamila ; Jakobs, Asaf ; Jakovljević, Miro ; Jakšić, Nenad ; Javed, Afzal ; Kafali, Helin Yilmaz ; Karia, Sagar ; Kazakova, Olga ; Khalifa, Doaa ; Khaustova, Olena ; Koh, Steve ; Kopishinskaia, Svetlana ; Kosenko, Korneliia ; Vadon, Nikolett Beata ; Lalljee, Alisha ; Liewig, Justine ; Majid, Abdul ; Malashonkova, Evgeniia ; Malik, Khamelia ; Malik, Najma Iqbal ; Mammadzada, Gulay ; Mandalia, Bilvesh ; Marazziti, Donatella ; Marčinko, Darko ; Martinez, Stephanie ; Matiekus, Eimantas ; Mejia, Gabriela ; Memon, Roha Saeed ; Martínez, Xarah Elenne Meza ; Mickevičiūtė, Dalia ; Milev, Roumen ; Mohammed, Muftau ; Molina-López, Alejandro ; Morozov, Petr ; Muhammad, Nuru Suleiman ; Mustač, Filip ; Naor, Mika S ; Nassieb, Amira ; Navickas, Alvydas ; Okasha, Tarek ; Pandova, Milena ; Panfil, Anca-Livia ; Panteleeva, Liliya ; Papava, Ion ; Pavlichenko, Alexey ; Pejuskovic, Bojana ; da Costa, Mariana Pinto ; Popkov, Mikhail ; Popovic, Dina ; Raduan, Nor Jannah Nasution ; Ramírez, Francisca Vargas ; Rancans, Elmars ; Hashim, Nurul Azreen ; Rebok, Federico ; Rewekant, Anna ; Flores, Elena Ninoska Reyes ; Rivera-Encinas, María Teresa ; Saiz, Pilar ; de Carmona, Manuel Sánchez ; Martínez, David Saucedo ; Saw, Jo Anne ; Saygili, Görkem ; Schneidereit, Patricia ; Shah, Bhumika ; Shirasaka, Tomohiro ; Silagadze, Ketevan ; Sitanggang, Satti ; Skugarevsky, Oleg ; Spikina, Anna ; Mahalingappa, Sridevi Sira ; Stoyanova, Maria ; Szczegielniak, Anna ; Tamasan, Simona Claudia ; Tavormina, Giuseppe ; Tavormina, Maurilio Giuseppe Maria ; Tohen, Mauricio ; Tsapakis, Eva Maria ; Tukhvatullina, Dina ; Ullah, Irfan ; Vaidya, Ratnaraj ; Vega-Dienstmaier, Johann M ; Vrublevska, Jelena ; Vukovic, Olivera ; Vysotska, Olga ; Widiasih, Natalia ; Yashikhina, Anna ; Smirnova, Daria
DOI	10.1016/j.psychres.2025.116459
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Is Part of	Psychiatry research.. Elsevier B.V.. 2025, vol. 348, art. no. 116459, p. [1-17].. ISSN 0165-1781. eISSN 1872-7123
Keywords [eng]	disability ; epidemiology ; mental health ; metabolic syndrome ; outcomes ; psychiatry ; treatment
Abstract [eng]	Introduction: This study registered rates of specific treatment options for mental disorders as well as their long-term outcome. Material and methods: The history of mental disorders was used as a proxy for diagnosis. The data came from the COMET-G study (40 countries; 54,826 subjects, 64.73 % females, 35.45±13.51 years old). The analysis included descriptive statistics, Risk Ratios, t-tests, and ANCOVA's. Results: 24.14 % reported a history of any mental disorder (depression >12 %, non-affective psychosis and Bipolar disorder 1 % each, >20 % self-injury, >10 % had attempted suicide, 7.17 % illegal substance abuse). Most patients were not under any kind of treatment (59.44 %) and most were not receiving treatment as recommended (e.g. 90 % of Bipolar and 2/3 of psychotic patients). No treatment at all and psychotherapy as monotherapy were consistently related to poorer outcomes. In anxiety or depression, only antidepressant monotherapy and benzodiazepines, in Bipolar disorder only antipsychotic monotherapy in males and antidepressant monotherapy in females and in non-affective psychosis antipsychotics and psychotherapy in females only, were related to good outcomes. No treatment modality was related to a good outcome in those with a history of self-harm, suicidal attempts, or illegal substance use. Only depression and treatment with antidepressants were related to metabolic syndrome. Discussion: In the community, the overwhelming majority of mental patients do not receive appropriate treatment or, even worse, no treatment at all. The outcome is unfavourable for the majority and only a few selective treatment options seem to make a difference.
Published	Elsevier B.V
Type	Journal article
Language	English
Publication date	2025
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„Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries /“