U.S. has the highest rate of mental illness

by THE ASSOCIATED PRESS Tuesday, Jun. 08, 2004 at 3:00 PM

June 2, 2004 CHICAGO - Mental illnesses including anxiety disorders and depression are common and undertreated in many countries, both developed and developing, with the highest rate found in the United States, according to a study of 14 countries.

Based on face-to-face diagnostic surveys in the homes of 60,463 adults, the study found that mental ailments affect more than 10 percent of people queried in more than half the countries surveyed.

Nigerians appeared to have the lowest prevalence of mental illness, 4.7 percent, but the researchers think the actual number is probably much higher as residents of the violence-prone West African nation may be hesitant to confide in strangers. The highest rate was found in the United States, with 26.4 percent.

"In every country there is a hidden or unhidden stigma," said co-researcher Dr. T. Bedirhan Ustun of the World Health Organization. "People are reluctant to admit that they have mental problems." This may be slightly less true in the United States, so the U.S. rate may not be that much higher than in other countries surveyed, Ustun said.

Ronald Kessler, a Harvard Medical School researcher who led the study, said it's plausible that the U.S. rate would be higher because of "higher expectations" of success that can lead to frustration when people can't live up to them.

Interviewers spent about two hours asking questions, using a mental health survey that has been shown to be an effective diagnostic tool. The study was done in 2001-2003 in Belgium, China, Colombia, France, Germany, Italy, Japan, Lebanon, Mexico, the Netherlands, Nigeria, Spain, Ukraine and the United States. Results appear in today's Journal of the American Medical Association.

The most common ailments everywhere except Ukraine were anxiety disorders, which include panic attacks, phobias and post-traumatic stress disorder. In Ukraine, where unemployment is rampant as the country struggles with westernization, mood disorders including depression topped the list.

According to the researchers, in developed countries about 36 percent to 50 percent of people with serious symptoms were untreated in the previous year. In developing nations, between 76 percent and 85 percent of serious cases were untreated.

Kessler said reasons for undertreatment include lack of access to health care. Ustun said that, in many countries, insurance doesn't adequately cover mental health treatment and doctors who fail to detect it are not considered as neglectful as those who fail to diagnose physical ailments such as high blood pressure.

Original: U.S. has the highest rate of mental illness