title: [Mental disorders in Latin America and the Caribbean: a public health priority].
abstract: OBJECTIVE
  The growing burden of mental disorders in Latin America and the Caribbean has become too large to ignore. There is a need to know more about the prevalence of mental disorders and the gap between the number of individuals with psychiatric disorders and the number of those persons who remain untreated even though effective treatments exist. Having that knowledge would make it possible to improve advocacy, adopt better policies, formulate innovative intervention programs, and apportion resources commensurate with needs.
  
  
  METHODS
  Data were extracted from community-based psychiatric epidemiological studies published in Latin America and the Caribbean from 1980 through 2004 that used structured diagnostic instruments and provided prevalence rates. Estimates of the crude rates in Latin America and the Caribbean for the various disorders were determined by calculating the mean and median rates across the studies, by gender. In addition, data on service utilization were reviewed in order to calculate the treatment gap for specific disorders.
  
  
  RESULTS
  Nonaffective psychosis (including schizophrenia) had an estimated mean one-year prevalence rate of 1.0%; major depression, 4.9%; and alcohol use abuse or dependence, 5.7%. Over one-third of individuals with nonaffective psychosis, over half of those with an anxiety disorder, and some three-fourths of those with alcohol use abuse or dependence did not receive mental health care from either specialized or general health services.
  
  
  CONCLUSIONS
  The current treatment gap in mental health care in Latin America and the Caribbean remains wide. Further, current data likely greatly underestimate the number of untreated individuals. The epidemiological transition and changes in the population structure will further widen the treatment gap in Latin America and the Caribbean unless mental health policies are formulated or updated and programs and services are expanded.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island 02906, USA. Robert_Kohn@brown.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Kohn
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levav
authors.forename: José Miguel Caldas
authors.initials: JM
authors.lastname: de Almeida
authors.forename: Benjamín
authors.initials: B
authors.lastname: Vicente
authors.forename: Laura
authors.initials: L
authors.lastname: Andrade
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Caraveo-Anduaga
authors.forename: Shekhar
authors.initials: S
authors.lastname: Saxena
authors.forename: Benedetto
authors.initials: B
authors.lastname: Saraceno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017691:Caribbean Region / Q000453:epidemiology; D002648:Child; D005260:Female; D006292:Health Priorities; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D008875:Middle Aged; D015995:Prevalence; D011634:Public Health