Developed countries have been related to a higher prevalence of mental disorders. This led us to hypothesize that cultural values typical of developed countries could be associated with mental disorders. Here, we sought to determine the association of indulgence (seeking momentary pleasure and freely expressing oneself) and individualism (being able to deviate from in-group norms) with the burden of four mental disorders: depressive, bipolar, anxiety, and eating disorders. We controlled for socio-economic factors (socio-demographic development, income inequality, and unemployment rate), negative life experiences, quality of health care systems, and quality of measurements. We also included world regions fixed effects to account for unobserved geo-spatial factors clustered at the regional level. Our sample included ninety-seven countries. Fully adjusted models revealed that indulgence was associated with an increase in the burden of all four disorders (p < 0.05). A 30 points increase in the indulgence dimension (from Italy = 47 to the UK = 77) was associated with an increase in DALYs by 8.4% (depressive disorders) to 21.0% (eating disorders). Other factors did not demonstrate any such systematic association. Developed nations may be exposed to mental disorders due to socio-cultural factors: seeking pleasure and freedom might be deleterious to population-level mental health.
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We wish to acknowledge the contribution of the GBD collaborator network in providing the disease burden estimates, which we downloaded from their publicly available data source (http://ghdx.healthdata.org/gbd-results-tool). The GBD network was not consulted nor involved in this paper.
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Barbalat, G., Liu, S. Country-level association of socio-cultural factors with the burden of four common mental disorders. An ecological analysis using the Global Burden of Disease database. Curr Psychol (2022). https://doi.org/10.1007/s12144-022-04065-z