This study registered rates of specific treatment options for mental disorders as
well as their long-term outcome.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.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.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.
