Mental Disorders Still a Burden on Global Health, According to New Analysis

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The prevalence of mental disorders has been increasing globally and the conditions today remain a leading cause of disease burden worldwide, according to a 30-year systematic analysis published in The Lancet Psychiatry.

“Mental disorders are increasingly recognized as leading causes of disease burden. To meet the mental health needs of individual countries in a way that prioritizes transformation of health systems, in-depth understanding of the scale of the impact of these disorders is essential, including their distribution in the population, the health burden imposed, and their broader health consequences,” wrote corresponding author Alize Ferrari, PhD, of the Queensland Centre for Mental Health Research at the University of Queensland, and colleagues.

Researchers sought to measure the global, regional, and national impact and occurrence of 12 mental disorders between 1990 and 2019, utilizing several metrics related to quality of life: disability-adjusted life-years (DALYs), years lived with disability (YLDs) and years of life lost (YLLs).

Ferrari and colleagues assessed prevalence and burden estimates from the 2019 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) for both men and women within 23 different age groups across 204 countries and territories worldwide.

DALYs were estimated as the sum of YLDs and YLLs to premature mortality. Investigators reviewed several databased to get data on prevalence, incidence, remission, duration, severity, and excess mortality for each mental disorder. The team performed a Bayesian meta-regression analysis to estimate frequency by mental disorder, age, sex, year, and location.

Results showed that mental disorders accounted for 654.8 million estimated cases in 1990 and 970.1 million cases in 2019, an increase of 48.1%. Between 1990 and 2019, the global number of DALYs due to mental disorders increased from 80.8 million to 125.3 million, and the proportion of global DALYs attributed to mental disorders increased from 3.1% in 1990 to 4.9% in 2019.

Age-standardized DALY rates were highest in Australasia, Tropical Latin America, and high-income North America, according to the study. Depressive disorders ranked the highest among all age groups, except for those from birth to age 14 years, where behavioral issues were the leading cause of burden.

The burden of depressive disorders, anxiety disorders, and eating disorders was found higher among women than men, while the burden of autism spectrum disorders and attention-deficit hyperactivity disorder was higher for men than women. In 2019, 80.6% of the mental disorder burden occurred among persons of working age (aged 16 to 65 years), with 9.2% of the remaining burden found in those aged less than 16 years, according to the study results.

“The findings of GBD 2019 emphasize the large proportion of the global disease burden attributable to mental disorders and the global disparities in that burden,” concluded researchers. “Furthermore, there was no evidence of global reduction in the burden since 1990, despite evidence-based interventions that can reduce the burden across age, sex, and geographical locations.”