Abstract
BackgroundMental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital.MethodsFrom among the 2,443 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI)) in the 12 months pre-interview. These individuals were selected for cluster analysis.ResultsAnalysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services.ConclusionThe study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs for subgroups of individuals with mental and/or dependence disorders. Strategies aimed at changing low service users' attitude (youths and males) or instituting specialised programs for that particular clientele should be promoted. Finally, as concomitant disorders are frequent among individuals with mental disorder, psychological services and/or addiction programs must be prioritised as components of integrated services when planning treatment.
Highlights
Mental disorder is a leading cause of morbidity worldwide
Description of the sample: predisposing, enabling and needs factors Among the 2,433 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder in the 12 months pre-interview according to the Composite International Diagnostic Interview (CIDI) and were selected for the analyses described below
Our results show that anxiety [1] and depressive disorders [6] are more prevalent among females, and dependence disorders, principally alcohol dependence, and concurrent disorders more common among males [3]
Summary
Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital. Risk factors and correlates to mental or substance use disorders have been extensively investigated [5,6,7,8]. A systematic literature review showed that anxiety disorders were approximately twice as prevalent among females [1]. Studies reveal a generally greater prevalence among males and youths [3]
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