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 Rana; Amira 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

doi:10.1371/journal.pone.0169575

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 language	English
Article number	e0169575
Pages (from-to)	1-17
Number of pages	17
Journal	PLoS One
Volume	12
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0169575
Publication status	Published - 17 Jan 2017

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JournalFinal published version, 1.71 MBLicence: CC BY

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Maulik, P., Charara, R., Forouzanfar, M., Naghavi, M., Moradi-Lakeh, M., Afshin, A., Vos, T., Daoud, F., Wang, H., El Bcheraoui, C., Khalil, I., Hamadeh, R., Khosravi, A., Rahimi-Movaghar, V., Khader, Y., Al-Hamad, N., Makhlouf Obermeyer, C., Rafay, A., Asghar, R., ... Murray, C. (2017). The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013. PLoS One, 12(1), 1-17. Article e0169575. https://doi.org/10.1371/journal.pone.0169575

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

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.",

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

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doi = "10.1371/journal.pone.0169575",

language = "English",

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Maulik, P, Charara, R, Forouzanfar, M, Naghavi, M, Moradi-Lakeh, M, Afshin, A, Vos, T, Daoud, F, Wang, H, El Bcheraoui, C, Khalil, I, Hamadeh, R, Khosravi, A, Rahimi-Movaghar, V, Khader, Y, Al-Hamad, N, Makhlouf Obermeyer, C, Rafay, A, Asghar, R, Rana, S, Shaheen, A, Abu-Rmeileh, N, Husseini, A, Abu-Raddad, L, Khoja, T, Al Rayess, Z, AlBuhairan, F, Hsairi, M, Alomari, M, Ali, R, Roshandel, G, Terkawi, AS, Hamidi, S, Refaat, A, Westerman, R, Kiadaliri, AA, Akanda, A, Ali, SD, Bacha, U, Badawi, A, Bazargan-Hejazi, S, Faghmous, I, Fereshtehnejad, S-M, Fischer, F, Jonas, J, Kuate Defo, B, Mehari, A, Omer, S, Pourmalek, F, Uthman, O, Mokdad, A, Maalouf, F, Abd-Allah, F, Akseer, N, Arya, D, Borschmann, R, Brazinova, A, Brugha, T, Catalá-López, F, Degenhardt, L, Ferrari, A, Haro, JM, Horino, M, Hornberger, J, Huang, H, Kieling, C, Kim, D, Kim, Y, Knudsen, AK, Mitchell, P, Patton, G, Sagar, R, Satpathy, M, Savuon, K, Seedat, S, Shiue, I, Skogen, JC, Stein, D, Tabb, K, Whiteford, H, Yip, P, Yonemoto, N & Murray, C 2017, 'The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013', PLoS One, vol. 12, no. 1, e0169575, pp. 1-17. https://doi.org/10.1371/journal.pone.0169575

TY - JOUR

T1 - The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

AU - Maulik, Pallab

AU - Charara, Raghid

AU - Forouzanfar, Mohammad

AU - Naghavi, Mohsen

AU - Moradi-Lakeh, Maziar

AU - Afshin, Ashkan

AU - Vos, Theo

AU - Daoud, Farah

AU - Wang, Haidong

AU - El Bcheraoui, Charbel

AU - Khalil, Ibrahim

AU - Hamadeh, Randah

AU - Khosravi, Ardeshir

AU - Rahimi-Movaghar, Vafa

AU - Khader, Yousef

AU - Al-Hamad, Nawal

AU - Makhlouf Obermeyer, Carla

AU - Rafay, Anwar

AU - Asghar, Rana

AU - Rana, Saleem

AU - Shaheen, Amira

AU - Abu-Rmeileh, Niveen

AU - Husseini, Abdullatif

AU - Abu-Raddad, Laith

AU - Khoja, Tawfik

AU - Al Rayess, Zulfa

AU - AlBuhairan, Fadia

AU - Hsairi, Mohamed

AU - Alomari, Mahmoud

AU - Ali, Raghib

AU - Roshandel, Gholamreza

AU - Terkawi, Abdullah Sulieman

AU - Hamidi, Samer

AU - Refaat, Amany

AU - Westerman, Ronny

AU - Kiadaliri, Aliasghar Ahmad

AU - Akanda, Ali

AU - Ali, Syed Danish

AU - Bacha, Umar

AU - Badawi, Alaa

AU - Bazargan-Hejazi, Shahrzad

AU - Faghmous, Imad

AU - Fereshtehnejad, Seyed-Mohammad

AU - Fischer, Florian

AU - Jonas, Jost

AU - Kuate Defo, Barthelemy

AU - Mehari, Alem

AU - Omer, Saad

AU - Pourmalek, Farshad

AU - Uthman, Olalekan

AU - Mokdad, Ali

AU - Maalouf, Fadi

AU - Abd-Allah, Foad

AU - Akseer, Nadia

AU - Arya, Dinesh

AU - Borschmann, Rohan

AU - Brazinova, Alexandra

AU - Brugha, Traolach

AU - Catalá-López, Ferrán

AU - Degenhardt, Louisa

AU - Ferrari, Alize

AU - Haro, Josep Maria

AU - Horino, Masako

AU - Hornberger, John

AU - Huang, Hsiang

AU - Kieling, Christian

AU - Kim, Daniel

AU - Kim, Yunjin

AU - Knudsen, Ann Kristin

AU - Mitchell, Philip

AU - Patton, George

AU - Sagar, Rajesh

AU - Satpathy, Maheswar

AU - Savuon, Kim

AU - Seedat, Soraya

AU - Shiue, Ivy

AU - Skogen, Jens Christoffer

AU - Stein, Dan

AU - Tabb, Karen

AU - Whiteford, Harvey

AU - Yip, Paul

AU - Yonemoto, Naohiro

AU - Murray, Christopher

PY - 2017/1/17

Y1 - 2017/1/17

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85009892168

U2 - 10.1371/journal.pone.0169575

DO - 10.1371/journal.pone.0169575

M3 - Article

SN - 1932-6203

VL - 12

SP - 1

EP - 17

JO - PLoS One

JF - PLoS One

IS - 1

M1 - e0169575

ER -

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

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