Skip to main content

Global Burden of Disease and the Impact of Mental and Addictive Disorders

Abstract

Purpose of Review

This contribution reviews the newest empirical evidence regarding the burden of mental and addictive disorders and weighs their importance for global health in the first decades of the twenty-first century.

Recent Findings

Mental and addictive disorders affected more than 1 billion people globally in 2016. They caused 7% of all global burden of disease as measured in DALYs and 19% of all years lived with disability. Depression was associated with most DALYs for both sexes, with higher rates in women as all other internalizing disorders, whereas other disorders such as substance use disorders had higher rates in men.

Summary

Mental and addictive disorders affect a significant portion of the global population with high burden, in particular in high- and upper-middle-income countries. The relative share of these disorders has increased in the past decades, in part due to stigma and lack of treatment. Future research needs to better analyze the role of mental and addictive disorders in shifts of life expectancy.

This is a preview of subscription content, access via your institution.

Fig. 1

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    World Health Organization. NCD Global Monitoring Framework: ensuring progress on noncommunicable diseases in countries 2017 Accessed: 10/30/2018. Available from: http://www.who.int/nmh/global_monitoring_framework/en/.

  2. 2.

    United Nations. Sustainable Development Goals: 17 goals to transform our world. 2017 Accessed: 10/30/2018. Available from: http://www.un.org/sustainabledevelopment/sustainable-development-goals/.

  3. 3.

    •• Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49:509–38 The classic paper on epidemiologic transition, which summarized all major changes related to increasing health.

    CAS  Article  Google Scholar 

  4. 4.

    GBD 2016 Mortality Collaborators. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1084–150.

    Article  Google Scholar 

  5. 5.

    GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151–210.

    Article  Google Scholar 

  6. 6.

    Miranda JJ, Kinra S, Casas JP, Davey Smith G, Ebrahim S. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Tropical Med Int Health. 2008;13(10):1225–34.

    CAS  Article  Google Scholar 

  7. 7.

    • Ezzati M, Pearson-Stuttard J, Bennett JE, Mathers CD. Acting on non-communicable diseases in low- and middle-income tropical countries. Nature. 2018;559(7715):507–16 Important overview on development of NCD in low- and middle-income countries.

    CAS  Article  Google Scholar 

  8. 8.

    McKeown RE. The epidemiologic transition: changing patterns of mortality and population dynamics. Am J Lifestyle Med. 2009;3(Suppl 1):19S–26S.

    Article  Google Scholar 

  9. 9.

    Riley JC. Rising life expectancy: a global history. Cambridge: Cambridge University Press; 2001.

    Book  Google Scholar 

  10. 10.

    • Deaton A. The Great Escape – health, wealth and the origins of inequality. Princeton: Princeton University Press; 2013. Analyses of historical developments and the links between economic wealth and health.

    Google Scholar 

  11. 11.

    World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. 2013 Accessed: 10/30/2018. Available from: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf.

  12. 12.

    Bennett JE, Stevens GA, Mathers CD, Bonita R, Rehm J, Kruk ME, et al. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet. 2018;392(10152):1072–88.

    Article  Google Scholar 

  13. 13.

    Lopez AD, Williams TN, Levin A, Tonelli M, Singh JA, Burney PG, et al. Remembering the forgotten non-communicable diseases. BMC Med. 2014;12(1):200.

    Article  Google Scholar 

  14. 14.

    Rehm J, Probst C. Decreases of life expectancy despite decreases in non-communicable disease mortality: the role of substance use and socioeconomic status. Eur Addict Res. 2018;24(2):53–9.

    Article  Google Scholar 

  15. 15.

    Lloyd-Sherlock P, Ebrahim S, McKee M, Prince M. A premature mortality target for the SDG for health is ageist. Lancet. 2015;385(9983):2147–8.

    Article  Google Scholar 

  16. 16.

    Shield KD, Rehm J. Substance use and the objectives of current global health frameworks: measurement matters. Addiction. 2018. https://doi.org/10.1111/add.14485.

  17. 17.

    Murray CJL. Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ. 1994;72(3):429–45.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Beltrán-Sánchez H, Soneji S, Crimmins EM. Past, present, and future of healthy life expectancy. Cold Spring Harb Perspect Med. 2015;5(11). https://doi.org/10.1101/cshperspect.a025957

  19. 19.

    • United Nations University, United Nations, World Bank Group, The University of Tokyo. Mental health, well-being and disability: a new global priority key United Nations resolutions and documents 2015 Accessed: 10/30/2018. Available from: http://pubdocs.worldbank.org/en/619761454942779225/Mental-Health-Well-being-Disability-A-New-Global-Priority.pdf. Important document on the role of mental health in the Substainable Development Framework.

  20. 20.

    •• United Nations. Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages. 2016 Accessed: 10/30/2018. Available from: https://sustainabledevelopment.un.org/sdg3. Most important basis of current health policy.

  21. 21.

    Ferrari AJ, Norman RE, Freedman G, Baxter AJ, Pirkis JE, Harris MG, et al. The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study 2010. PLoS One. 2014;9(4):e91936.

    Article  Google Scholar 

  22. 22.

    Charlson FJ, Baxter AJ, Dua T, Degenhardt L, Whiteford HA, Vos T. Excess mortality from mental, neurological, and substance use disorders in the Global Burden of Disease Study 2010. In: Patel V, Dua T, Laxminarayan R, Medina-Mora ME, editors. Mental, neurological, and substance use disorders, disease control priorities 4. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; 2016. p. 41–65.

    Google Scholar 

  23. 23.

    Tannenbaum C, Lexchin J, Tamblyn R, Romans S. Indicators for measuring mental health: towards better surveillance. Healthc Policy = Politiques de sante. 2009;5(2):e177–86.

    Article  Google Scholar 

  24. 24.

    Murray CJL, Salomon J, Mathers C, Lopez A. Summary measures of population health: concepts, ethics, measurement and applications. Geneva: WHO; 2002.

    Google Scholar 

  25. 25.

    GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–59.

    Article  Google Scholar 

  26. 26.

    GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1260–344.

    Article  Google Scholar 

  27. 27.

    • Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–86 Last epidemiological overview of global burden of mental and addictive disorders.

    Article  Google Scholar 

  28. 28.

    Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2016 (GBD 2016) results. 2017 Accessed: 10/30/2018. Available from: http://ghdx.healthdata.org/gbd-results-tool.

  29. 29.

    Global Burden of Disease Study 2015. Global Burden of Disease Study 2015 (GBD 2015) causes of death and nonfatal causes mapped to ICD codes. 2016 Accessed: 10/30/2018. Available from: http://ghdx.healthdata.org/record/global-burden-disease-study-2015-gbd-2015-causes-death-and-nonfatal-causes-mapped-icd-codes.

  30. 30.

    Krueger RF. The structure of common mental disorders. Arch Gen Psychiatry. 1999;56(10):921–6.

    CAS  Article  Google Scholar 

  31. 31.

    Baxter AJ, Scott KM, Ferrari AJ, Norman RE, Vos T, Whiteford HA. Challenging the myth of an “epidemic” of common mental disorders: trends in the global prevalence of anxiety and depression between 1990 and 2010. Depress Anxiety. 2014;31(6):506–16.

    Article  Google Scholar 

  32. 32.

    Rehm J, Dawson D, Frick U, Gmel G, Roerecke M, Shield KD, et al. Burden of disease associated with alcohol use disorders in the United States. Alcohol Clin Exp Res. 2014;38(4):1068–77.

    Article  Google Scholar 

  33. 33.

    World Health Organization. Disease burden and mortality estimates: cause-specific mortality, 2000-2016. 2018 Accesssed: 10/30/2018. Available from: https://stats.oecd.org/glossary/detail.asp?ID=6325. Accessed 20 Jan 2019.

  34. 34.

    Organization for Economic Co-operation and Development OECD. Glossary of statistical terms: underlying cause of death. 2018.

  35. 35.

    Harris EC, Barraclough B. Excess mortality of mental disorder. Br J Psychiatry. 1998;173:11–53.

    CAS  Article  Google Scholar 

  36. 36.

    Roerecke M, Rehm J. Cause-specific mortality risk in alcohol use disorder treatment patients: a systematic review and meta-analysis. Int J Epidemiol. 2014;43(3):906–19.

    Article  Google Scholar 

  37. 37.

    World Health Organization. International statistical classification of diseases and related health problems 10th Revision 2016 Accessed: 10/30/2018. Available from: http://apps.who.int/classifications/icd10/browse/2016/en.

  38. 38.

    Lajoie J. Understanding the measurement of Global Burden of Disease 2015 Accessed: 10/30/2018. Available from: https://nccid.ca/publications/understanding-the-measurement-of-global-burden-of-disease/.

  39. 39.

    The World Bank. GDP per capita, PPP (current international $) 2018 [Accessed: 10/30/2018]. Available from: https://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD?end=2017&start=2017&view=bar&year_high_desc=true

  40. 40.

    Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol. 2014;43(2):476–93.

    Article  Google Scholar 

  41. 41.

    The World Bank. GINI Index (World Bank estimate) 2018 [Accessed: 10/30/2018]. Available from: https://data.worldbank.org/indicator/SI.POV.GINI.

  42. 42.

    Carter KN, Blakely T, Collings S, Imlach Gunasekara F, Richardson K. What is the association between wealth and mental health? J Epidemiol Community Health. 2009;63(3):221–6.

    CAS  Article  Google Scholar 

  43. 43.

    Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, et al. Poverty and common mental disorders in low and middle income countries: a systematic review. Soc Sci Med. 2010;71(3):517–28.

    Article  Google Scholar 

  44. 44.

    • Saxena S, Thornicroft G, Knapp M, Whiteford H. Resources for mental health: scarcity, inequity, and inefficiency. Lancet. 2007;370(9590):878–89 Important call for action on increasing resources for mental health.

    Article  Google Scholar 

  45. 45.

    World Health Organization. WHO Mental Health Gap Action Programme (mhGAP) 2018 Accessed: 10/30/2018. Available from: https://www.who.int/mental_health/mhgap/en/.

  46. 46.

    • Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet Commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–1598. https://doi.org/10.1016/S0140-6736(18)31612-X. First results of the Lancet Commission pointing to the need to increase resources for mental health in order to achieve sustainable development.

  47. 47.

    Patel V, Saxena S, Frankish H, Boyce N. Sustainable development and global mental health--a Lancet Commission. Lancet. 2016;387(10024):1143–5.

    Article  Google Scholar 

  48. 48.

    Milanovic B. Global inequality: a new approach for the age of globalization. Boston: The Belknap Press of Harvard University Press; 2016.

    Book  Google Scholar 

  49. 49.

    • Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015;112(49):15078–83 Influential paper on the importance of deaths of despair for lift expectancy in large parts of the US general population.

    CAS  Article  Google Scholar 

  50. 50.

    Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, et al. The association between income and life expectancy in the United States, 2001-2014. JAMA. 2016;315(16):1750–66.

    CAS  Article  Google Scholar 

  51. 51.

    Singh GK, Siahpush M. Widening rural–urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969–2009. J Urban Health. 2014;91(2):272–92.

    Article  Google Scholar 

  52. 52.

    Case A, Deaton A. Mortality and morbidity in the 21(st) century. Brook Pap Econ Act. 2017;2017:397–476.

    Article  Google Scholar 

  53. 53.

    Yoon YH, Chen CM, Yi HY. Unintentional alcohol and drug poisoning in association with substance use disorders and mood and anxiety disorders: results from the 2010 Nationwide Inpatient Sample. Inj Prev. 2014;20(1):21–8.

    Article  Google Scholar 

  54. 54.

    Rehm J, Taylor B, Mohapatra S, Irving H, Baliunas D, Patra J, et al. Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev. 2010;29(4):437–45.

    Article  Google Scholar 

  55. 55.

    Schwarzinger M, Baillot S, Yazdanpanah Y, Rehm J, Mallet V. Alcohol use disorders and the burden of chronic hepatitis C in France, 2008-2013: a nationwide retrospective cohort study. J Hepatol. 2017;67(3):454–61.

    Article  Google Scholar 

  56. 56.

    Imtiaz S, Probst C, Rehm J. Substance use and population life expectancy in the USA: interactions with health inequalities and implications for policy. Drug Alcohol Rev. 2018;37:S263–S7.

    Article  Google Scholar 

  57. 57.

    Probst C, Rehm J. Alcohol use, opioid overdose and socioeconomic status in Canada: a threat to life expectancy? Can Med Assoc J. 2018;190(44):E1294–5.

    Article  Google Scholar 

  58. 58.

    • Rehm J, Anderson P, Fischer B, Gual A, Room R. Policy implications of marked reversals of population life expectancy caused by substance use. BMC Med. 2016;14:42 One of the first papers to point to the role of addictive disorders in changing the course of life expectancy.

    Article  Google Scholar 

  59. 59.

    Robine J-M. Summarizing health status. In: Pencheon D, Guest C, Melzer D, Gray JAM, editors. Oxford handbook of public health practice. 2nd ed. Oxford: Oxford University Press; 2006. p. 160–8.

    Google Scholar 

  60. 60.

    Pathare S, Brazinova A, Levav I. Care gap: a comprehensive measure to quantify unmet needs in mental health. Epidemiol Psychiatr Sci. 2018;27(5):463–7.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Jürgen Rehm.

Ethics declarations

Conflict of Interest

Jürgen Rehm and Kevin D. Shield declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Public Policy and Public Health

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rehm, J., Shield, K.D. Global Burden of Disease and the Impact of Mental and Addictive Disorders. Curr Psychiatry Rep 21, 10 (2019). https://doi.org/10.1007/s11920-019-0997-0

Download citation

Keywords

  • Mental disorders
  • Substance-use disorders
  • Global burden of disease
  • Excess mortality
  • Deaths of despair
  • Life expectancy