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The World Health Organization (WHO) has stated that the three leading
causes of burden of disease in 2030 are projected to include HIV/AIDS,
unipolar depression and ischaemic heart disease.
To estimate health-related quality of life (HRQoL) and quality-adjusted
life-year (QALY) losses associated with mental disorders and chronic
physical conditions in primary healthcare using data from the diagnosis
and treatment of mental disorders in primary care (DASMAP) study, an
epidemiological survey carried out with primary care patients in
A cross-sectional survey of a representative sample of 3815 primary care
patients. A preference-based measure of health was derived from the
12-item Short Form Health Survey (SF–12): the Short Form–6D (SF–6D)
multi-attribute health-status classification. Each profile generated by
this questionnaire has a utility (or weight) assigned. We used
non-parametric quantile regressions to model the association between both
mental disorders and chronic physical condition and SF–6D scores.
Conditions associated with SF–6D were: mood disorders, β =−0.20 (95% CI
−0.18 to −0.21); pain, β = −0.08 (95%CI −0.06 to −0.09) and anxiety, β
=−0.04 (95% CI −0.03 to −0.06). The top three causes of QALY losses
annually per 100 000 participants were pain (5064), mood disorders (2634)
and anxiety (805).
Estimation of QALY losses showed that mood disorders ranked second behind
pain-related chronic medical conditions.
There is evidence that the prevalence of common mental disorders varies
To compare prevalence of common mental disorders in general practice
attendees in six European countries.
Unselected attendees to general practices in the UK, Spain, Portugal,
Slovenia, Estonia and The Netherlands were assessed for major depression,
panic syndrome and other anxiety syndrome. Prevalence of DSM–IV major
depression, other anxiety syndrome and panic syndrome was compared
between the UK and other countries after taking account of differences in
demographic factors and practice consultation rates.
Prevalence was estimated in 2344 men and 4865 women. The highest
prevalence for all disorders occurred in the UK and Spain, and lowest in
Slovenia and The Netherlands. Men aged 30–50 and women aged 18–30 had the
highest prevalence of major depression; men aged 40–60 had the highest
prevalence of anxiety, and men and women aged 40–50 had the highest
prevalence of panic syndrome. Demographic factors accounted for the
variance between the UK and Spain but otherwise had little impact on the
significance of observed country differences.
These results add to the evidence for real differences between European
countries in prevalence of psychological disorders and show that the
burden of care on general practitioners varies markedly between
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