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. 2023 Jun 6;2(2):e109.
doi: 10.1002/pcn5.109. eCollection 2023 Jun.

Evaluating the maturation of mental health systems in developing countries

Akihiro Nishio  1   2 , Toshiyuki Marutani  3
Affiliations

Evaluating the maturation of mental health systems in developing countries

Akihiro Nishio et al. PCN Rep. .

Abstract

Background: Given the need for a simple tool to evaluate mental healthcare provision at the local level, we compared the duration of untreated mental illness (DUM) and duration of untreated psychosis (DUP) between rural and urban areas in Cambodia, and Cambodia's DUP was also compared with that of other countries.

Methods: DUM and background data were obtained at the first consultation from 940 participants in Phnom Penh (PP), the capital city, and Siem Reap province (SR) in 2016-2017. DUP data were obtained from DUM by excluding individuals with nonpsychotic mental illnesses (e.g., mood disorders, neurotic disorders, substance use, epilepsy). Student's t-test was used to compare DUM and DUP, and analysis of variance was conducted to identify associations.

Results: Mean DUM significantly differed between PP (0.6 [SD 2.3] years) and SR (4.2 [5.9] years). Mean DUP was also significantly different (0.5 [2.2] years in PP vs. 4.3 [6.7] years in SR). DUM was strongly associated with DUP. The prevalence of the various disorders differed between rural and urban areas. DUM also varied by diagnosis, indicating that DUP is a better index than DUM. However, in some cases DUM can be used, given its strong association with DUP. DUP in PP was almost the same as in developed countries and was about four times longer in SR.

Conclusion: DUP in rural areas is much longer than in urban areas in developing countries. Although DUP is an effective index, more data from other places and before/after interventions are required to verify it further.

Keywords: Cambodia; developing countries; duration of untreated mental illness; duration of untreated psychosis; local; mental health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Histogram of duration of untreated psychosis (DUP) in Phnom Penh and Siem Reap. Some extremely long DUP durations were observed.
Figure 2
Figure 2
Modified version of histogram of duration of untreated psychosis (DUP) in Phnom Penh and Siem Reap. After removing 5% of extremely long DUP, the graph looks more reasonable distribution.
See this image and copyright information in PMC

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