The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

Pallab Maulik, Raghid Charara, Mohammad Forouzanfar, Mohsen Naghavi, Maziar Moradi-Lakeh, Ashkan Afshin, Theo Vos, Farah Daoud, Haidong Wang, Charbel El Bcheraoui, Ibrahim Khalil, Randah Hamadeh, Ardeshir Khosravi, Vafa Rahimi-Movaghar, Yousef Khader, Nawal Al-Hamad, Carla Makhlouf Obermeyer, Anwar Rafay, Rana Asghar, Saleem RanaAmira Shaheen, Niveen Abu-Rmeileh, Abdullatif Husseini, Laith Abu-Raddad, Tawfik Khoja, Zulfa Al Rayess, Fadia AlBuhairan, Mohamed Hsairi, Mahmoud Alomari, Raghib Ali, Gholamreza Roshandel, Abdullah Sulieman Terkawi, Samer Hamidi, Amany Refaat, Ronny Westerman, Aliasghar Ahmad Kiadaliri, Ali Akanda, Syed Danish Ali, Umar Bacha, Alaa Badawi, Shahrzad Bazargan-Hejazi, Imad Faghmous, Seyed-Mohammad Fereshtehnejad, Florian Fischer, Jost Jonas, Barthelemy Kuate Defo, Alem Mehari, Saad Omer, Farshad Pourmalek, Olalekan Uthman, Ali Mokdad, Fadi Maalouf, Foad Abd-Allah, Nadia Akseer, Dinesh Arya, Rohan Borschmann, Alexandra Brazinova, Traolach Brugha, Ferrán Catalá-López, Louisa Degenhardt, Alize Ferrari, Josep Maria Haro, Masako Horino, John Hornberger, Hsiang Huang, Christian Kieling, Daniel Kim, Yunjin Kim, Ann Kristin Knudsen, Philip Mitchell, George Patton, Rajesh Sagar, Maheswar Satpathy, Kim Savuon, Soraya Seedat, Ivy Shiue, Jens Christoffer Skogen, Dan Stein, Karen Tabb, Harvey Whiteford, Paul Yip, Naohiro Yonemoto, Christopher Murray

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Abstract

The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25–49 age group, with a peak in the 35–39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.
Original languageEnglish
Article numbere0169575
Pages (from-to)1-17
Number of pages17
JournalPLoS One
Volume12
Issue number1
DOIs
Publication statusPublished - 17 Jan 2017

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