"...the burden of psychiatric conditions has been heavily underestimated..."
The burden of mental illness on health and productivity in the United States
and throughout the world has long been underestimated. Data developed by the massive Global Burden of
Disease study conducted by the World Health Organization, the World Bank, and Harvard University, reveal that
mental illness, including suicide, accounts for over 15 percent of the burden of disease in established market
economies, such as the United States. This is more than the disease burden caused by all cancers.
This Global Burden of Disease study developed a single measure to allow
comparison of the burden of disease across many different disease conditions
by including both death and disability. This measure was called Disability Adjusted Life Years (DALYs).
DALYs measure lost years of healthy life regardless of whether the years were lost to premature death or disability.
The disability component of this measure is weighted for severity of the disability. For example, disability
caused by major depression was found to be equivalent to blindness or paraplegia
whereas active psychosis seen in schizophrenia produces disability
equal to quadriplegia.
Using the DALYs measure, major depression ranked second only to ischemic heart disease in magnitude of
disease burden in established market economies. Schizophrenia, bipolar disorder,
obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder also contributed significantly
to the total burden of illness attributable to mental disorders.
The projections show that with the aging of the world population and the
conquest of infectious diseases, psychiatric and neurological conditions could
increase their share of the total global disease burden by almost half, from
10.5 percent of the total burden to almost 15 percent in 2020.
Facts
Major depression is the leading cause of disability (measured by the number of years
lived with a disabling condition) worldwide among persons age five and
older.
For women throughout the world as well as those in established market
economies, depression is the leading cause of DALYs. In established market
economies, schizophrenia and bipolar disorder are also among the top ten
causes of DALYs for women.
The Leading Sources of Disease Burden in Established Market
Economies, 1990,
|
|
|
|
Total
(millions) |
Percent
of Total |
|
All Causes |
98.7 |
No Value |
| 1. |
Ischemic heart disease |
8.9 |
9.0 |
| 2. |
Unipolar major depression |
6.7 |
6.8 |
| 3. |
Cardiovascular disease |
5.0 |
5.0 |
| 4. |
Alcohol use |
4.7 |
4.7 |
| 5. |
Road traffic accidents |
4.3 |
4.4 |
| 6. |
Lung & UR cancers |
3.0 |
3.0 |
| 7. |
Dementia & degenerative CNS |
2.9 |
2.9 |
| 8. |
Osteoarthritis |
2.7 |
2.7 |
| 9. |
Diabetes |
2.4 |
2.4 |
| 10. |
COPD |
2.3 |
2.3 |
Disease Burden by Selected Illness Categories in
Established Market Economies, 1990,
|
Percent
of Total |
| All cardiovascular conditions |
18.6 |
| All mental illness including suicide |
15.4 |
| All malignant disease (cancer) |
15.0 |
| All respiratory conditions |
4.8 |
| All alcohol use |
4.7 |
| All infectious and parasitic disease |
2.8 |
| All drug use |
1.5 |
Mental Illness as a Source of Disease Burden in
Established Market Economies, 1990,
|
Total
(millions) |
Percent
of Total |
| All Causes |
98.7 |
No Value |
| Unipolar major depression |
6.7 |
6.8 |
| Schizophrenia |
2.3 |
2.3 |
| Bipolar disorder |
1.7 |
1.7 |
| Obsessive-compulsive disorder |
1.5 |
1.5 |
| Panic disorder |
0.7 |
0.7 |
| Post-traumatic stress disorder |
0.3 |
0.3 |
| Self-inflicted injuries (suicide) |
2.2 |
2.2 |
| All mental disorders |
15.3 |
15.4 |
*DALYs measure lost years of healthy life regardless
of whether the years were lost to premature death or disability.
-----------------------------------
Reference
Murray CJL, Lopez AD, eds. The global burden of disease and injury series, volume 1: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press, 1996.
Global Burden of Disease Web site:
http://www.who.int/msa/mnh/ems/dalys/intro.htm
NIH Publication No. 01-4586
Compliments of National Institute of Mental Health (NIMH)
