Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010
Background
The researchers used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs).
Methods
For each of the 20 mental and substance use disorders included in GBD 2010, the study systematically reviewed epidemiological data and used a Bayesian meta-regression tool, DisMod-MR, to model prevalence by age, sex, country, region, and year. The researchers obtained disability weights from representative community surveys and an internet-based survey to calculate YLDs. They calculated premature mortality as YLLs from the cause of death estimates for 1980–2010 for 20 age groups, both sexes, and 187 countries.
The researchers derived DALYs from the sum of YLDs and YLLs.
Findings
In 2010, mental and substance use disorders accounted for 183.9 million DALYs, or 7.4% of all DALYs worldwide.
Such disorders accounted for 8.6 million YLLs and 175.3 million YLDs.
Mental and substance use disorders were the leading cause of YLDs worldwide.
- Depressive disorders accounted for 40·5% of DALYs caused by mental and substance use disorders, with
- Anxiety disorders accounting for 14.6%,
- Illicit drug use disorders for 10.9%,
- Alcohol use disorders for 9.6%,
- Schizophrenia for 7.4%,
- Bipolar disorder for 7·0%,
- Pervasive developmental disorders for 4.2%,
- Childhood behavioral disorders for 3.4% (2·2—4·7), and
- Eating disorders for 1.2%.
DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10 to 29 years. The burden of mental and substance use disorders increased by 37.6% between 1990 and 2010, which for most disorders was driven by population growth and aging.
Interpretation
Despite the apparently small contribution of YLLs – with deaths in people with mental disorders coded to the physical cause of death and suicide coded to the category of injuries under self-harm – the findings show the striking and growing challenge that these disorders pose for health systems in developed and developing regions.
In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority.”
