{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:17:21Z","timestamp":1783477041372,"version":"3.55.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Please see manuscript"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychiatry"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pathways: encounter-level treatment helpfulness and persistence in help-seeking after prior unhelpful treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data came from community epidemiologic surveys in 23 countries in the WHO World Mental Health surveys. DSM-5 GAD was assessed with the fully structured WHO Composite International Diagnostic Interview Version 3.0. Respondents with a history of GAD were asked whether they ever received treatment and, if so, whether they ever considered this treatment helpful. Number of professionals seen before obtaining helpful treatment was also assessed. Parallel survival models estimated probability and predictors of a given treatment being perceived as helpful and of persisting in help-seeking after prior unhelpful treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The overall prevalence rate of GAD was 4.5%, with lower prevalence in low\/middle-income countries (2.8%) than high-income countries (5.3%); 34.6% of respondents with lifetime GAD reported ever obtaining treatment for their GAD, with lower proportions in low\/middle-income countries (19.2%) than high-income countries (38.4%); 3) 70% of those who received treatment perceived the treatment to be helpful, with prevalence comparable in low\/middle-income countries and high-income countries. Survival analysis suggested that virtually all patients would have obtained helpful treatment if they had persisted in help-seeking with up to 10 professionals. However, we estimated that only 29.7% of patients would have persisted that long. Obtaining helpful treatment at the person-level was associated with treatment type, comorbid panic\/agoraphobia, and childhood adversities, but most of these predictors were important because they predicted persistence rather than encounter-level treatment helpfulness.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The majority of individuals with GAD do not receive treatment. Most of those who receive treatment regard it as helpful, but receiving helpful treatment typically requires persistence in help-seeking. Future research should focus on ensuring that helpfulness is included as part of the evaluation. Clinicians need to emphasize the importance of persistence to patients beginning treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12888-021-03363-3","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T08:03:24Z","timestamp":1628496204000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Perceived helpfulness of treatment for generalized anxiety disorder: a World Mental Health Surveys report"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7218-7810","authenticated-orcid":false,"given":"Dan J.","family":"Stein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan E.","family":"Kazdin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayelet 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Written or verbal informed consent was obtained in a manner consistent with the regulations of each country. Details of the ethics committees for the WMH surveys can be viewed at this link: . They are:Bioethics Committee, School of Medicine, University of Buenos Aires (Argentina); the authority of Census and Statistics Act, 1905 (Australia); Ethics Committee of the Institute of Public\u00a0Health (Federal Public Service Health, Food Chain Safety, and Environment) (Belgium); Research and Ethics Committee of the School of Medicine, University of Sao Paulo (Brazil);Deputy Minister and head of the Executive Committee of the National Psychiatric Program\u00a0(Bulgaria); Ethical committee of the National Center of Public Health and Analyses\u00a0(Bulgaria); Ethics Committee for the FES Social Foundation (Colombia); Comit\u00e9 Institucional de \u00c9tica Universidad CES (Colombia-Medellin); Committee of the CNIL - Commission Nationale Informatique et Libert\u00e9s (France): Germany Ethics Committee of the University of Leipzig (Germany); Ethics Scientific Committee of the Ministry of Health Iraq (Iraq); Human Subjects Committee for survey and field procedures in Eitanim-Kfar Shaul Hospital (Israel); Italy Italian National Institute of Health (Italy); National Center of Neurology and Psychiatry; Okayama University School of Medicine; Nagasaki University School of Medicine; Keio University School of Medicine; Jichi University School of Medicine; Juntendo University School of Medicine; Yamagata University School of Medicine (Japan); University of Balamand Faculty of Medicine Institutional Review Board (Lebanon); Ethics committee in research of the National Institute of Psychiatry Ramon de la Fuente Mu\u00f1iz (Mexico); Ethics Committee of the Netherlands Institute of Mental Health and Addiction (Netherlands); New Zealand Health Ethics Committees (New Zealand); University of Ulster Ethics Committee (Northern Ireland); Peru National Institute of Health Peru (Peru); Komisja Bioetyczna (Bioethical Committee) of Instytut Psychiatrii i Neurologi (Poland); Ethics Committee, Faculdade de Ciencias M\u00e9dicas, Universidade Nova (Portugal); Office of Research Affairs at King Faisal Specialist Hospital and Research Center (Saudia Arabia); Ethical Committee of Sant Joan de Deu Serveis de Salut Mental and Ethical Committee of IMIMHospital del Mar Medical Research Institute (Spain-Murcia); The Clinical Research Ethics Committee of the University Hospital Virgen de la Arrixaca of Murcia (Spain); Human Subjects Committees of the Institute for Social Research at the University of Michigan and of Harvard Medical School (USA)","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"In the past 3\u2009years, RCK reports being a consultant for Datastat, Inc., RallyPoint Networks, Inc., Sage Pharmaceuticals, and Takeda. FNM reports non-financial support from Otsuka outside and not\u00a0related to the submitted work. In the past 3\u2009years LD has received untied educational grant funding from Indivior and Seqirus, not related to the submitted work. DJS has received research grants and\/or honoraria from Lundbeck, Johnson & Johnson, Servier and Takeda. The remaining authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"392"}}