Nanna Weye1, Damian F Santomauro2, Esben Agerbo3, Maria Klitgaard Christensen1, Kim Moesgaard Iburg4, Natalie C Momen1, Preben Bo Mortensen3, Carsten Bøcker Pedersen5, Harvey A Whiteford6, John J McGrath7, Oleguer Plana-Ripoll1. 1. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark. 2. School of Public Health, Aarhus University, Aarhus, Denmark; School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. 3. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark. 4. School of Public Health, Aarhus University, Aarhus, Denmark. 5. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark. 6. School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. 7. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia; Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia. Electronic address: j.mcgrath@uq.edu.au.
Abstract
BACKGROUND: Mental disorders account for a substantial proportion of the years lived with disability (YLDs) globally. These estimates have generally been calculated top down based on summary statistics. The aim for this study was to calculate YLDs and a novel related measure, Health Loss Proportion (HeLP), for 18 mental and substance use disorders, based on person-level register data (bottom up). METHODS: A cohort of 6 989 627 Danish residents (5·9% had a diagnosis of a mental or substance use disorder registered in the Danish Psychiatric Central Research Register) was investigated. YLDs (the duration of disease multiplied by a disability weight) were calculated for the disorder of interest and for comorbid mental and substance use disorders. HeLPs were estimated as YLDs associated with an index disorder and comorbid mental and substance use disorders divided by person-years at risk in persons with the index disorder. All analyses were adjusted for mental and substance use comorbidity using a multiplicative model of disability weights. FINDINGS: Major depressive disorder was the most prevalent disorder, although schizophrenia was the leading cause of YLDs in both sexes combined (YLDs 273·3 [95 % CI 232·3-313·6] per 100 000 person-years). People diagnosed with schizophrenia lost the equivalent of 73% (63-83%) of healthy life per year due to mental and substance use disorders, the largest HeLP of all mental and substance use disorders. Comorbidity of mental and substance use disorders accounted for 69-83% of HeLPs in people with either cannabis use disorders, other drug use disorder and ADHD. By contrast, comorbidity explained 11-23% of the HeLPs in people with autism spectrum disorders, conduct disorder, and schizophrenia. INTERPRETATION: Substantial variation in disability was observed across age, sex, and disorders. The new HeLP metric provides novel details of the contribution of comorbidity to the disability associated with mental and substance use disorders. FUNDING: The Danish National Research Foundation, Queensland Government Department of Health, European Union's Horizon 2020, Lundbeck Foundation, Stanley Medical Research Institute. TRANSLATION: For the Danish translation of the abstract see Supplementary Materials section.
BACKGROUND:Mental disorders account for a substantial proportion of the years lived with disability (YLDs) globally. These estimates have generally been calculated top down based on summary statistics. The aim for this study was to calculate YLDs and a novel related measure, Health Loss Proportion (HeLP), for 18 mental and substance use disorders, based on person-level register data (bottom up). METHODS: A cohort of 6 989 627 Danish residents (5·9% had a diagnosis of a mental or substance use disorder registered in the Danish Psychiatric Central Research Register) was investigated. YLDs (the duration of disease multiplied by a disability weight) were calculated for the disorder of interest and for comorbid mental and substance use disorders. HeLPs were estimated as YLDs associated with an index disorder and comorbid mental and substance use disorders divided by person-years at risk in persons with the index disorder. All analyses were adjusted for mental and substance use comorbidity using a multiplicative model of disability weights. FINDINGS: Major depressive disorder was the most prevalent disorder, although schizophrenia was the leading cause of YLDs in both sexes combined (YLDs 273·3 [95 % CI 232·3-313·6] per 100 000 person-years). People diagnosed with schizophrenia lost the equivalent of 73% (63-83%) of healthy life per year due to mental and substance use disorders, the largest HeLP of all mental and substance use disorders. Comorbidity of mental and substance use disorders accounted for 69-83% of HeLPs in people with either cannabis use disorders, other drug use disorder and ADHD. By contrast, comorbidity explained 11-23% of the HeLPs in people with autism spectrum disorders, conduct disorder, and schizophrenia. INTERPRETATION: Substantial variation in disability was observed across age, sex, and disorders. The new HeLP metric provides novel details of the contribution of comorbidity to the disability associated with mental and substance use disorders. FUNDING: The Danish National Research Foundation, Queensland Government Department of Health, European Union's Horizon 2020, Lundbeck Foundation, Stanley Medical Research Institute. TRANSLATION: For the Danish translation of the abstract see Supplementary Materials section.
Authors: Marco Solmi; Minjin Song; Dong Keon Yon; Seung Won Lee; Eric Fombonne; Min Seo Kim; Seoyeon Park; Min Ho Lee; Jimin Hwang; Roberto Keller; Ai Koyanagi; Louis Jacob; Elena Dragioti; Lee Smith; Christoph U Correll; Paolo Fusar-Poli; Giovanni Croatto; Andre F Carvalho; Jae Won Oh; San Lee; Corentin J Gosling; Keun-Ah Cheon; Dimitris Mavridis; Che-Sheng Chu; Chih-Sung Liang; Joaquim Radua; Laurent Boyer; Guillaume Fond; Jae Il Shin; Samuele Cortese Journal: Mol Psychiatry Date: 2022-06-29 Impact factor: 15.992
Authors: Paolo Fusar-Poli; Andrés Estradé; Giovanni Stanghellini; Jemma Venables; Juliana Onwumere; Guilherme Messas; Lorenzo Gilardi; Barnaby Nelson; Vikram Patel; Ilaria Bonoldi; Massimiliano Aragona; Ana Cabrera; Joseba Rico; Arif Hoque; Jummy Otaiku; Nicholas Hunter; Melissa G Tamelini; Luca F Maschião; Mariana Cardoso Puchivailo; Valter L Piedade; Péter Kéri; Lily Kpodo; Charlene Sunkel; Jianan Bao; David Shiers; Elizabeth Kuipers; Celso Arango; Mario Maj Journal: World Psychiatry Date: 2022-06 Impact factor: 79.683