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The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys*

Published online by Cambridge University Press:  11 April 2011


Ronald C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston
Sergio Aguilar-Gaxiola
Affiliation:
University of California, Davis, School of Medicine, CTSC Building
Jordi Alonso
Affiliation:
Health Services Research Unit, Institut Municipal d'Investigaciò Mèdica (IMIM-Hospital del Mar); CIBER en Epidemiologìa y Salud Pùblica (CIBERESP), Barcelona
Somnath Chatterji
Affiliation:
World Health Organization, Geneva
Sing Lee
Affiliation:
Chinese University of Hong Kong,
Johan Ormel
Affiliation:
University Medical Center, Groningen, The Netherlands
T. Bedirhan Üstün
Affiliation:
World Health Organization EIP/HFS
Philip S. Wang
Affiliation:
National Institute of Mental Health
Corresponding

Abstract

Aims - The paper reviews recent findings from the WHO World Mental Health (WMH) surveys on the global burden of mental disorders. Methods - The WMH surveys are representative community surveys in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, distribution, burden, and unmet need for treatment of common mental disorders. Results - The first 17 WMH surveys show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, externalizing, and substance use disorders) is 18.1–36.1%. The IQR of 12-month prevalence estimates is 9.8–19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4–6.8% in half the countries, 2.3–3.6% in one-fourth, and 0.8–1.9% in one-fourth. Many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions in the WMH data. Adult mental disorders are found to be associated with such high role impairment in the WMH data that available clinical interventions could have positive cost-effectiveness ratios. Conclusions - Mental disorders are commonly occurring and often seriously impairing in many countries throughout the world. Expansion of treatment could be cost-effective from both employer and societal perspectives


Type
Special Articles
Copyright
Copyright © Cambridge University Press 2009

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Footnotes

*

Preparation of this paper was supported, in part, by the following grants from the US Public Health Service: U01MH060220, R01DA012058, R01MH070884 and R01DA016558. An earlier version of this paper was presented as a keynote address at the 8th National Congress of the Italian Society of Psychiatric Epidemiology in Florence, Italy on October 25, 2007. Portions of this paper appeared previously in Kessler, R.C., Ruscio, A.M., Shear, K., Wittchen, H.-U. (in press). The epidemiology of anxiety disorders. In M.M. Antony & M.B. Stein (Eds.), Handbook of Anxiety and the Anxiety Disorders. New York: Oxford University Press © Oxford University Press; Wang, P.S., Kessler, R.C. (2005). Global burden of mood disorders. In D. Stein, D. Kupfer & A. Schatzberg (Eds.), Textbook of Mood Disorders (pp. 55-67). Washington DC: American Psychiatric Publishing, Inc. © American Psychiatric Publishing, Inc. 2005; Kessler, R.C. (2007). The global burden of anxiety and mood disorders: Putting the European Study of the Epidemiology of Mental Disorders (ESEMeD) findings into perspective. Journal of Clinical Psychiatry 68 (suppl. 2), 10-19, © Physicians Postgraduate Press, Inc. 2007. All used with permission. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government.


References

Berto, P., D'Ilario, D., Ruffo, P., Di, Virgilio R. & Rizzo, F. (2000). Depression: cost-of-illness studies in the international literature, a review. Journal of Mental Health Policy and Economics 3, 310.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Brown, T.A.Barlow, D.H. (2005). Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and beyond: comment on the special section. Journal of Abnormal Psychology 114, 551556.CrossRefGoogle ScholarPubMed
Chang, S.M., Hahm, B.J., Lee, J.Y., Shin, M.S., Jeon, H.J., Hong, J.P., Lee, H.B., Lee, D.W. & Cho, M.J. (2008). Cross-national difference in the prevalence of depression caused by the diagnostic threshold. Journal of Affective Disorders 106, 159167.CrossRefGoogle ScholarPubMed
Connor, K.M. & Davidson, J.R. (2001). SPRINT: a brief global assessment of post-traumatic stress disorder. International Clinical Psychopharmacology 16, 279284.CrossRefGoogle ScholarPubMed
de Graaf, R., Kessler, R.C., Fayyad, J., ten Have, M., Alonso, J., Angermeyer, M., Borges, G., Demyttenaere, K., Gasquet, I., de Girolamo, G., Haro, J.M., Jin, R., Karam, E.G., Ormel, J. & Posada-Villa, J. (in press). Adult Attention-Deficit/hyperactivity Disorder (ADHD) and the effects on performance in workers: Results from the WHO World Mental Health Survey Initiative. Occupational and Environmental Medicine.Google Scholar
Druss, B.G., Hwang, I., Petukhova, M., Sampson, N.A., Wang, P.S. & Kessler, R.C. (2008). Impairment in role functioning in mental and chronic medical disorders in the United States: results from the National Comorbidity Survey Replication. Molecular Psychiatry, Feb 19. [Epub ahead of print]Google ScholarPubMed
Endicott, J., Spitzer, R.L., Fleiss, J.L. & Cohen, J. (1976). The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766771.CrossRefGoogle ScholarPubMed
Furmark, T. (2002). Social phobia: overview of community surveys. Acta Psychiatrica Scandinavica 105 (2), 8493.CrossRefGoogle ScholarPubMed
Greenberg, P.E. & Birnbaum, H.G. (2005). The economic burden of depression in the US: societal and patient perspectives. Expert Opinion on Pharmacotherapy 6, 369376.CrossRefGoogle ScholarPubMed
Greenberg, P.E., Sisitsky, T., Kessler, R.C., Finkelstein, S.N., Berndt, E.R., Davidson, J.R., Ballenger, J.C. & Fyer, A.J. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry 60, 427435.CrossRefGoogle ScholarPubMed
Gureje, O., Lasebikan, V.O., Kola, L. & Makanjuola, V.A. (2006). Lifetime and 12-month prevalence of mental disorders in the Nigerian Survey of Mental Health and Well-Being. British Journal of Psychiatry 188, 465471.CrossRefGoogle ScholarPubMed
Hambrick, J.P., Turk, C.L., Heimberg, R.G., Schneier, F.R. & Liebowitz, M.R. (2004). Psychometric properties of disability measures among patients with social anxiety disorder. Journal of Anxiety Disorders 18, 825839.CrossRefGoogle ScholarPubMed
Haro, J.M., Arbabzadeh-Bouchez, S., Brugha, T.S., de Girolamo, G., Guyer, M.E., Jin, R., Lepine, J.P., Mazzi, F., Reneses, B., Vilagut, G., Sampson, N.A. & Kessler, R.C. (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. International Journal of Methods in Psychiatric Research 15, 167180.CrossRefGoogle ScholarPubMed
Hasin, D.S. & Grant, B.F. (2004). The co-occurrence of DSM-IV alcohol abuse in DSM-IV alcohol dependence: results of the National Epidemiologic Survey on Alcohol and Related Conditions on heterogeneity that differ by population subgroup. Archives of General Psychiatry 61, 891896.CrossRefGoogle ScholarPubMed
He, Y., Zhang, M., Lin, E.H., Bruffaerts, R., Posada-Villa, J., Angermeyer, M.C., Levinson, D., de Girolamo, G., Uda, H., Mneimneh, Z., Benjet, C., Graaf, R.D., Scott, K.M., Gureje, O., Seedat, S., Haro, J.M., Bromet, E.J., Alonso, J., von Korff, M. & Kessler, R. (2008). Mental disorders among persons with arthritis: results from the World Mental Health Surveys. Psychological Medicine 38, 16391650.CrossRefGoogle ScholarPubMed
Judd, L.L. & Akiskal, H.S. (2000). Delineating the longitudinal structure of depressive illness: beyond clinical subtypes and duration thresholds. Pharmacopsychiatry 33, 37.CrossRefGoogle ScholarPubMed
Katschnig, H., Freeman, H. & Sartorius, N. (Eds.) (1997). Quality of Life in Mental Disorders. John Wiley & Sons: Chichester, England.Google Scholar
Kessler, R.C., Foster, C.L., Saunders, W.B. & Stang, P.E. (1995). Social consequences of psychiatric disorders, I: Educational attainment. American Journal of Psychiatry 152, 10261032.Google ScholarPubMed
Kessler, R.C., Berglund, P.A., Foster, C.L., Saunders, W.B., Stang, P.E. & Walters, E.E. (1997). Social consequences of psychiatric disorders, II: Teenage parenthood. American Journal of Psychiatry 154, 14051411.Google ScholarPubMed
Kessler, R.C., Walters, E.E. & Forthofer, M.S. (1998). The social consequences of psychiatric disorders, III: probability of marital stability. American Journal of Psychiatry 155, 10921096.CrossRefGoogle ScholarPubMed
Kessler, R.C. & Üstün, T.B. (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.CrossRefGoogle Scholar
Kessler, R.C., Akiskal, H.S., Ames, M., Birnbaum, H., Greenberg, P., Hirschfeld, R.M., Jin, R., Merikangas, K.R., Simon, G.E. & Wang, P.S. (2006). Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. American Journal of Psychiatry 163, 15611568.CrossRefGoogle Scholar
Kessler, R.C., Amminger, G.P., Aguilar-Gaxiola, S., Alonso, J., Lee, S. & Üstün, T.B. (2007). Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry 20, 359364.CrossRefGoogle ScholarPubMed
Kessler, R.C., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M.C., Anthony, J.C., Berglund, P., Chatterji, S., de Girolamo, G., de Graaf, R., Demyttenaere, K., Gasquet, I., Gluzman, S., Gruber, M.J., Gureje, O., Haro, J.M., Heeringa, S., Karam, A., Kawakami, N., Lee, S., Levinson, D., Medina-Mora, M.E., Oakley-Browne, M.A., Pennell, B., Petukhova, M., Posada-Villa, J., Ruscio, R., Stein, D.J., Tsang, C.H.A. & Üstün, T.B. (in press). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Mental Health Survey Initiative. In Volume 1: Patterns of Mental Illness in the World Mental Health Surveys (ed. Kessler, R. C.and Üstün, T. B.). Cambridge University Press: Cambridge, UK.Google Scholar
Leon, A.C., Olfson, M., Portera, L., Farber, L. & Sheehan, D.V. (1997). Assessing psychiatric impairment in primary care with the Sheehan Disability Scale. International Journal of Psychiatry in Medicine 27, 93105.CrossRefGoogle ScholarPubMed
Maetzel, A. & Li, L. (2002). The economic burden of low back pain: a review of studies published between 1996 and 2001. Best Practice and Research Clinical Rheumatology 16, 2330.CrossRefGoogle ScholarPubMed
Matsunaga, H. & Seedat, S. (2007). Obsessive-compulsive spectrum disorders: cross-national and ethnic issues. CNS Spectrums 12, 392400.CrossRefGoogle ScholarPubMed
Merikangas, K.R., Ames, M., Cui, L., Stang, P.E., Ustun, T.B., Von Korff, M. & Kessler, R.C. (2007). The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Archives of General Psychiatry 64, 11801188.CrossRefGoogle ScholarPubMed
Murray, C.J.L. & Lopez, A.D. (1996). The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Harvard University Press: Cambridge, MA.Google Scholar
Mylle, J. & Maes, M. (2004). Partial posttraumatic stress disorder revisited. Journal of Affective Disorders 78, 3748.CrossRefGoogle ScholarPubMed
Ormel, J., Von Korff, M., Burger, H., Scott, K., Demyttenaere, K., Huang, Y.Q., Posada-Villa, J., Pierre, Lepine J., Angermeyer, M.C., Levinson, D., de Girolamo, G., Kawakami, N., Karam, E., Medina-Mora, M.E., Gureje, O., Williams, D., Haro, J.M., Bromet, E.J., Alonso, J. & Kessler, R. (2007). Mental disorders among persons with heart disease - results from World Mental Health surveys. General Hospital Psychiatry 29, 325334.CrossRefGoogle ScholarPubMed
Ormel, J., Petukhova, M., Chatterji, S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M.C., Bromet, E.J., Burger, H., Demyttenaere, K., de Girolamo, G., Haro, J.M., Hwang, I., Karam, E., Kawakami, N., Lepine, J.P., Medina-Mora, M.E., Posada-Villa, J., Sampson, N., Scott, K., Üstun, T.B., Von Korff, M., Williams, D., Zhang, M. & Kessler, R.C. (in press). Disability and treatment of specific mental and physical disorders across the world: Results from the WHO World Mental Health Surveys. British Journal of Psychiatry.Google Scholar
Pallanti, S., Bernardi, S. & Quercioli, L. (2006). The Shorter PROMIS Questionnaire and the Internet Addiction Scale in the assessment of multiple addictions in a high-school population: prevalence and related disability. CNS Spectrums 11, 966974.CrossRefGoogle Scholar
Reed, S.D., Lee, T.A. & McCrory, D.C. (2004). The economic burden of allergic rhinitis: a critical evaluation of the literature. Pharmacoeconomics 22, 345361.CrossRefGoogle ScholarPubMed
Ruscio, A.M., Chiu, W.T., Roy-Byrne, P., Stang, P.E., Stein, D.J., Wittchen, H.U. & Kessler, R.C. (2007). Broadening the definition of generalized anxiety disorder: effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication. Journal of Anxiety Disorders 21, 662676.CrossRefGoogle ScholarPubMed
Shen, Y.C., Zhang, M.Y., Huang, Y.Q., He, Y.L., Liu, Z.R., Cheng, H., Tsang, A., Lee, S. & Kessler, R.C. (2006). Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychological Medicine 36, 257267.CrossRefGoogle ScholarPubMed
Silverman, W.K. & Moreno, J. (2005). Specific phobia. Child and Adolescent Psychiatric Clinics of North America 14, 819843, ix-x.CrossRefGoogle Scholar
Simon, G.E., Goldberg, D.P., Von Korff, M. & Üstün, T.B. (2002). Understanding cross-national differences in depression prevalence. Psychological Medicine 32, 585594.CrossRefGoogle ScholarPubMed
Skeppar, P. & Adolfsson, R. (2006). Bipolar II and the bipolar spectrum. Nordic Journal of Psychiatry 60, 726.CrossRefGoogle ScholarPubMed
Somers, J.M., Goldner, E.M., Waraich, P. & Hsu, L. (2006). Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Canadian Journal of Psychiatry 51, 100113.CrossRefGoogle ScholarPubMed
Üstün, T.B. & Sartorius, N. (1995). Mental Illness in General Health Care: An International Study. John Wiley & Sons: New York, NY.Google Scholar
Wang, P.S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M.C., Borges, G., Bromet, E.J., Bruffaerts, R., de Girolamo, G., de Graaf, R., Gureje, O., Haro, J.M., Karam, E.G., Kessler, R.C., Kovess, V., Lane, M.C., Lee, S., Levinson, D., Ono, Y., Petukhova, M., Posada-Villa, J., Seedat, S. & Wells, J.E. (2007a). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 370, 841850.CrossRefGoogle ScholarPubMed
Wang, P.S., Simon, G.E., Avorn, J., Azocar, F., Ludman, E.J., McCulloch, J., Petukhova, M.Z. & Kessler, R.C. (2007b). Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Journal of the American Medical Association 298, 14011411.CrossRefGoogle ScholarPubMed
Waraich, P., Goldner, E.M., Somers, J.M. & Hsu, L. (2004). Prevalence and incidence studies of mood disorders: a systematic review of the literature. Canadian Journal of Psychiatry 49, 124138.CrossRefGoogle ScholarPubMed
Wittchen, H.U. & Jacobi, F. (2005). Size and burden of mental disorders in Europe-a critical review and appraisal of 27 studies. European Neuropsychopharmacology 15, 357376.CrossRefGoogle ScholarPubMed
World Health Organization (2006). World Health Statistics 2006. WHO: Geneva, Switzerland.Google Scholar

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