Global Burden of Mental Illness in 2010 nby Whiteford

1.
The Global Burden of
Mental & Substance Use Disorders
Findings from the Global Burden of Disease Study
2010
Professor Harvey Whiteford
Queensland Centre for Mental Health Research
School of Population Health, The University of Queensland
Brisbane, Australia

2. Outline
1. The Global Burden of Disease Study (GBD)
2. Calculation of disability-adjusted life years (DALYs)
a) Years of life lost due to premature mortality (YLLs)
b) Years lived with disability (YLDs)
3. Results:
a) DALYs
b) YLDs
c) YLLs
4. Implications for global health

3. The Global Burden of Disease Study
Institute for Health Metrics and Evaluation. DALY - GBD 2010 Poster. Washington, USA: Institute for Health Metrics
and Evaluation; 2012.
The Global Burden of Disease Study (GBD) aims to quantifying the global
burden attributable to different diseases, injuries, and risks.
DALY = YLD + YLL

4. GBD 1990
The first GBD study, GBD 1990, quantified burden for 107 causes across 8
world regions.
GBD 1990 included these disorders which grouped under neuropsychiatric
disorders:
• Unipolar major depression
• Anxiety disorders (GAD, PTSD and panic disorder separately)
• Bipolar disorder
• Schizophrenia
• Drug use
• Alcohol use
GBD 1990 found depression to be the leading cause of disability (YLDs) .
Murray CJL, Lopez AD, eds. The Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases,
injuries, and
risk factors in 1990 and projected to 2020. USA: World Health Organization, Harvard School of Public Health, World Bank.; 1996.

5. GBD 2010
GBD 2010 quantified burden for 291 diseases, injuries and risks for 187
countries, 21 world regions, 6 super-regions and the world.
This included 13 mental disorders categorised into 9 groups:
• Depressive disorders – MDD and dysthymia
• Anxiety disorders
• Schizophrenia
• Bipolar disorder
• Eating disorders – anorexia and bulimia
• Disruptive behavioural disorders – conduct disorder and ADHD
• Pervasive developmental disorders – autism and Asperger’s disorder
• Idiopathic intellectual disability
• Other mental disorders
Murray CJL, Ezzati M, Flaxman AD, Lim S, Lozano R, Michaud C, et al. GBD 2010: design, definitions, and metrics. The
Lancet 2012;380:2063-2066.

6. GBD 2010 continued
GBD 2010 quantified burden for 291 diseases, injuries and risks for 187
countries, 21 world regions, 6 super-regions and the world.
This also included five drug disorders along with alcohol use disorders:
• Cannabis
• Cocaine
• Amphetamines
• Opioids
• Alcohol use disorders
Murray CJL, Ezzati M, Flaxman AD, Lim S, Lozano R, Michaud C, et al. GBD 2010: design, definitions, and metrics. The
Lancet 2012;380:2063-2066.

7. Calculation of YLLs and YLDs
YLLs = Attributable Deaths x Life Expectancy
YLDs = Prevalent Cases x Disability Weight
Prevalent cases:
• Systematic review and extraction of epidemiological data.
• Modelling the epidemiological data in DisMod-MR.
• Use of prevalence output and population data to ascertain prevalent cases.
Disability weights:
• Disability was defined as ‘any short or long term health loss due to a
particular cause’.
• Population and online surveys with lay descriptions presented as pairwise
comparisons.
• Fixed on a 0 to 1 scale.
Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries
1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012; 380(9859):
2163-2196.

8. Total DALYs (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

9. Mental & Substance Use Disorder DALYs (2010)
Whiteford HA, Degenhardt L, Rehm JT, et al. The Global Burden of Mental and Substance Use Disorders, 2010. The Lancet. 2013; In
press.

10. Total DALYs (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.
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11. DALY Rates and Proportions
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

12. This map shows the age-standardised DALY rates per 100,000 people for
mental and substance use disorders.
DALY Rates By Country (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

13. Total DALYs (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

14. Total YLDs (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

15. Total YLDs (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

16. Total YLLs (2010)
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

17. Global Rankings (2010)
DALYS
YLDs
YLLs
Institute for Health Metrics and Evaluation. GBD Compare. 2013; http://viz.healthmetricsandevaluation.org/gbd-compare/.

18. Implications
• Global disease burden has shifted:
• From communicable to non-communicable diseases
• From YLLs to YLDs
• Mental and substance use disorders make up a significant component of
the changing global picture.
• While comprehensive, the mental and substance use disorders presented
here do not represent the full picture of mental and substance use burden.
• Current estimates need to be regularly updated.
Whiteford HA, Degenhardt L, Rehm JT, et al. The Global Burden of Mental and Substance Use Disorders, 2010. The Lancet. 2013; In
press.