Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010

被引:3992
作者
Whiteford, Harvey A. [1 ,3 ]
Degenhardt, Louisa [4 ,5 ]
Rehm, Juergen [6 ,7 ]
Baxter, Amanda J. [1 ,3 ]
Ferrari, Alize J. [1 ,3 ]
Erskine, Holly E. [1 ,3 ]
Charlson, Fiona J. [1 ,3 ]
Norman, Rosana E. [1 ,2 ]
Flaxman, Abraham D. [8 ]
Johns, Nicole [8 ]
Burstein, Roy [8 ]
Murray, Christopher J. L. [8 ]
Vos, Theo [8 ]
机构
[1] Univ Queensland, Sch Populat Hlth, Herston, Qld, Australia
[2] Univ Queensland, Queensland Childrens Med Res Inst, Herston, Qld, Australia
[3] Queensland Ctr Mental Hlth Res, Wacol, Qld, Australia
[4] Univ New S Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW, Australia
[5] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Hlth Policy Programs & Econ, Melbourne, Vic, Australia
[6] Ctr Addict & Mental Hlth, Social & Epidemiol Res Dept, Toronto, ON, Canada
[7] Tech Univ Dresden, Epidemiol Res Unit, D-01062 Dresden, Germany
[8] Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA
基金
英国医学研究理事会; 比尔及梅琳达.盖茨基金会;
关键词
ILLICIT DRUG-USE; SYSTEMATIC ANALYSIS; COST-EFFECTIVENESS; LOW-INCOME; 187; COUNTRIES; RISK-FACTORS; 21; REGIONS; HEALTH; PREVALENCE; DISABILITY;
D O I
10.1016/S0140-6736(13)61611-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background We 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, we systematically reviewed epidemiological data and used a Bayesian meta-regression tool, DisMod-MR, to model prevalence by age, sex, country, region, and year. We obtained disability weights from representative community surveys and an internet-based survey to calculate YLDs. We calculated premature mortality as YLLs from cause of death estimates for 1980-2010 for 20 age groups, both sexes, and 187 countries. We derived DALYs from the sum of YLDs and YLLs. We adjusted burden estimates for comorbidity and present them with 95% uncertainty intervals. Findings In 2010, mental and substance use disorders accounted for 183.9 million DALYs (95% UI 153.5 million216 .7 million), or 7.4% (6.2-8.6) of all DALYs worldwide. Such disorders accounted for 8.6 million YLLs (6.5 million-12.1 million; 0.5% [0.4-0.7] of all YLLs) and 175.3 million YLDs (144.5 million-207.8 million; 22.9% [18.6-27.2] of all YLDs). Mental and substance use disorders were the leading cause of YLDs worldwide. Depressive disorders accounted for 40.5% (31.7-49.2) of DALYs caused by mental and substance use disorders, with anxiety disorders accounting for 14.6% (11.2-18.4), illicit drug use disorders for 10.9% (8.9-13.2), alcohol use disorders for 9.6% (7.7-11.8), schizophrenia for 7.4% (5.0-9.8), bipolar disorder for 7.0% (4.4-10.3), pervasive developmental disorders for 4.2% (3.2-5.3), childhood behavioural disorders for 3.4% (2.2-4.7), and eating disorders for 1.2% (0.9-1.5). DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10-29 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 ageing. 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-our fi ndings 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.
引用
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页码:1575 / 1586
页数:12
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