"...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)
Ecards 
