Improving the Detection of Mood Disorders in Primary Care Settings of Resource Poor Countries.
Health Research in low-income and scarce settings: how to mind the gap" There is growing
international evidence about the importance of mental health as a development issue in
countries with low income . This evidence suggests that people with mental conditions
constitute a vulnerable population in urgent need of targeting for development
assistance. International organiz... read moreations have subscribed that mental health problems have
huge social and economic costs and therefore it is crucial to determine what kind of
interventions are needed to break the cycle of poverty and mental illness in these
countries . Whether interventions to promote mental health in poor populations should
begin with economic intervention to increase financial status or with efforts to improve
primary health outcomes (i.e. targeting early detection of symptoms and disabilities
associated with mental illness) remains an unsettled question. A recent study indicated
that improving health outcomes (intervening in the social drift pathway) and thereby
increasing the capabilities of mentally ill patients could be more productive towards
bettering their economic outcomes than solely increasing access to financial resources
. Although there is robust research questioning whether interventions for early
detection and treatment of mental disorders could be sufficiently effective, most of
such evidence has been derived from high-income countries . Because of sociocultural
and health system differences, the generalizability of such findings are therefore
limited. The present monograph, in two papers, aimed to address ways in which
economically scarce settings can provide good research evidence, focusing more
specifically on mood disorders detection in low-income primary care settings. The first
paper describes how screening tests could outperform typical assessment of mood
disorders administered by general practitioners. The second paper reports how an easily
applicable clinical predictive score might help physicians at this level of care to
detect people with high risk of having a mood disorder. With improved ability to detect
the presence of mood disorders, treatment of these disorders could be improved
considerably, leading ultimately to greater economic outcomes for these low-income
mentally ill patients. References 1. WHO. Mental health and development: targeting
people with mental health conditions as a vulnerable group. Geneva: world Health
Organization and Mental Health and Poverty Project, 2010) report 2. UN. UN General
Assembly Resolution on Global Health. A/65/l.27. N York: United Nations, 2010. 3. Lund
C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, Knapp M, Patel V. Poverty and
mental disorders: breaking the cycle in low-income and middle-income countries. Lancet.
2011 Oct 22;378(9801):1502-14. 4. Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A,
De Silva M, Hosman C, McGuire H, Rojas G, van Ommeren M.Treatment and prevention of
mental disorders in low-income and middle-income countries. Lancet. 2007 Sep
Thesis (M.S.)--Tufts University, 2012.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: David Kent.
Committee: Nassir Ghaemi, and Tanya Logvinenko.
Keywords: Medicine, Mental health, and Public health.read less