Mental and substance use disorders cause rise in global disease burden

A team of researchers from Australia and the US, led by Professor Harvey Whiteford from The University of Queensland’s School of Population Health, reported that the leading contributors were depressive disorders (accounting for 40.5% of mental and substance use disorder burden) followed by anxiety disorders (14.6%), illicit drug use disorders (10.9%) and alcohol use disorders (9.6%).

Professor Whiteford said the burden from mental and substance use disorders is rising, especially in developing countries.

“If the impact of mental and substance use disorders is to be reduced, a global effort is required to implement cost-effective prevention and intervention strategies and to develop innovative ways to deliver these to communities,” Professor Whiteford said.

“Treatment rates for people with mental and substance use disorders are low, and even in developed countries, treatment is typically provided many years after the disorder begins.

“In all countries, stigma about mental and substance use disorders constrain the use of available resources, as do inefficiencies in the distribution of funding and interventions.

“We need commitment from policy-makers, governments and other stakeholders to prioritise mental and substance use disorders.”

The Study’s key findings include:
• Mental and substance use disorders were responsible for more of the global burden than conditions such as diabetes or stroke or infectious diseases such as HIV/ AIDS and tuberculosis combined.
• The burden of mental and substance use disorders varied by age and sex, with the largest proportion occurring in those aged between 10 and 29 years.
• The burden of mental and substance use disorders increased by 37.6% between 1990 and 2010. For the majority of mental disorders, this was due to an increase in population growth and aging; for the substance use disorders it was also due to an increase in prevalence.
• In Australia, the burden of mental and substance use disorders increased between 1990 and 2010 but this was mainly due to increases in population growth and ageing (although opioid use increased significantly in Australia).
• In Australia, mental and substance use disorders, as a group, were the 4th leading cause of total burden and the 2nd leading cause of disability, after musculoskeletal disorders.
• Individual mental and substance use disorders were ranked similarly in Australia to other comparable nations such as the UK, USA and New Zealand (e.g. depression was the 2nd leading individual cause of disability in all these countries, including Australia).
• From the 10 – 14 year age group onwards, girls and women had a greater burden of death and disease from mental disorders than did boys and men, whereas men had a greater burden from drug and alcohol dependence in all age groups.
• The overall findings mask striking differences between world regions for some of the disorders analysed, with eating disorders showing the greatest overall variation; the proportion of total burden attributed to eating disorders was nearly 40 times higher in Australasia, where it was highest, than in western sub-Saharan Africa, where it was lowest.
• The burden of mental and substance use disorders was lower in China, North Korea, Japan and Nigeria when compared to the global average.

Other Australian authors involved with the Study were Dr Rosana Norman, Amanda Baxter, Alize Ferrari, Fiona Charlson and Holly Erskine from the UQ School of Population Health and Professor Louisa Degenhardt from the University of New South Wales.

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Biographical summary for Professor Whiteford

Professor Whiteford holds the Kratzmann Chair in Psychiatry and Population Health at The University of Queensland (UQ). He trained in medicine, psychiatry and health policy in Queensland and at Stanford University. He has held senior clinical and administrative positions, including those of Director of Mental Health in the Queensland and Federal governments in Australia and at the World Bank in Washington DC. His research interests are in psychiatric epidemiology, burden of disease estimates, mental health policy analysis and the structural reform of mental health services.

Professor Whiteford leads the Policy and Epidemiology Group at the Queensland Centre for Mental Health Research and the research group developing the mental disorder estimates for the Global Burden of Disease Study. He is the Chief Investigator for a National Health and Medical Research Council (NHMRC) Centre for Research Excellence in mental health policy and planning. He has worked as a consultant to national governments, the World Bank, the World Health Organisation and the Organisation for Economic Co-operation and Development (OECD). He has clinical responsibilities in general adult psychiatry at Toowong Private Hospital, a teaching hospital of UQ, and teaches undergraduate and postgraduate students at UQ.

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Media: Kirsten O’Leary, Media and Communications, The University of Queensland Faculty of Health Sciences, 07 3346 4713, 0412307594 or [email protected]