{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T08:46:55Z","timestamp":1791708415404,"version":"4.3.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100021068","name":"Universidad de Las Am\u00e9ricas Ecuador","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100021068","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Depression and anxiety are significant public health challenges, adversely affecting productivity, healthcare costs, and quality of life. While extensive research has been conducted in high-income countries, data on mental health service utilization in Ecuador remains scarce. Understanding consultation patterns is essential for identifying disparities and improving access to mental health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to analyze outpatient mental health care utilization patterns for depression and anxiety in Ecuador during 2021, with a focus on demographic characteristics, diagnostic distribution, and disparities in healthcare access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This ecological study analyzed all outpatient mental health appointments for depression and anxiety recorded in Ecuador\u2019s public healthcare system in 2021. Data sources included Ministry of Public Health and the National Institute of Statistics and Censuses. Descriptive statistics and Poisson regression models were used to assess sociodemographic predictors of mental health diagnoses. Network and geospatial analyses examined patient mobility and regional disparities in healthcare access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 298,233 outpatient appointments were recorded, with 35% related to depression and 65% to anxiety. Women accounted for 73.9% of consultations, with significantly higher consultation\/care rates per 100,000 inhabitants than men across all age groups. The highest outpatient service-utilization rates were observed among adolescents (15\u201319 years), young adults (20\u201324 years), and older adults (\u226565 years). Geographically, the Amazon region had the highest consultation\/care rates per 100,000 inhabitants for both anxiety and depression. Network analysis revealed that 5.8% of appointment records involved care outside the recorded province of residence, indicating territorial mobility in the use of public mental health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant sex-, age-, and region-specific disparities exist in mental health care utilization in Ecuador. Women, adolescents, and older adults exhibited the highest depression- and anxiety-related consultation\/care rates per 100,000 inhabitants, with anxiety being the most frequent diagnosis. Geographic disparities suggest an urgent need for targeted mental health policies, particularly in underserved regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261473070","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:47:08Z","timestamp":1791478028000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Countrywide Epidemiological and Sociodemographic Analysis of Depression and Anxiety Patterns in Ecuador"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-7498","authenticated-orcid":false,"given":"Esteban","family":"Ortiz-Prado","sequence":"first","affiliation":[{"name":"Universidad de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Paz","sequence":"additional","affiliation":[{"name":"Universidad de Las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-0546","authenticated-orcid":false,"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"Universidad de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda G.","family":"Davila","sequence":"additional","affiliation":[{"name":"Universidad de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Salazar-Santoliva","sequence":"additional","affiliation":[{"name":"Universidad de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Vasconez-Gonzalez","sequence":"additional","affiliation":[{"name":"Universidad de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina B.","family":"Jim\u00e9nes-Vargas","sequence":"additional","affiliation":[{"name":"Universidad de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"Depression and Other Common Mental Disorders. 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Pa\u00eds atrevido: la nueva cara sociodemogr\u00e1fica del Ecuador. Published online September 18 2013. https:\/\/web.archive.org\/web\/20130918214724\/https:\/\/www.inec.gob.ec\/publicaciones_libros\/Nuevacarademograficadeecuador.pdf#. Accessed September 15 2022."},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11625-018-0640-8"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1017\/SJP.2024.19"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.26633\/RPSP.2017.96"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08056-5"},{"key":"e_1_3_5_25_2","volume-title":"Actividades y Recursos de Salud","author":"Instituto Nacional de Estad\u00edstica y Censos","year":"2021","unstructured":"Instituto Nacional de Estad\u00edstica y Censos. Actividades y Recursos de Salud. Instituto Nacional de Estad\u00edstica y Censos; 2021. https:\/\/www.ecuadorencifras.gob.ec\/actividades-y-recursos-de-salud\/. 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