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

Charara R 1 , Forouzanfar M 1 , Naghavi M 1 , Moradi-Lakeh M 1 , Afshin A 1 , Vos T 1 Show all authors , Daoud F 1 , Wang H 1 , El Bcheraoui C 1 , Khalil I 1 , Hamadeh RR 2 , Khosravi A 3 , Rahimi-Movaghar V 4 , Khader Y 5 , Al-Hamad N 6 , Makhlouf Obermeyer C 7 , Rafay A 8 , Asghar R 9 , Rana SM 8 , Shaheen A 10 , Abu-Rmeileh NM 11 , Husseini A 11 , Abu-Raddad LJ 12 , Khoja T 13 , Al Rayess ZA 14 , AlBuhairan FS 15 , Hsairi M 16 , Alomari MA 17 , Ali R 18 , Roshandel G 19 , Terkawi AS 20 , Hamidi S 21 , Refaat AH 22 , Westerman R 23 , Kiadaliri AA 24 , Akanda AS 25 , Ali SD 26 , Bacha U 27 , Badawi A 28 , Bazargan-Hejazi S 29 , Faghmous IA 30 , Fereshtehnejad SM 31 , Fischer F 32 , Jonas JB 33 , Kuate Defo B 34 , Mehari A 35 , Omer SB 36 , Pourmalek F 37 , Uthman OA 38 , Mokdad AA 39 , Maalouf FT 40 , Abd-Allah F 41 , Akseer N 42 , Arya D 43 , Borschmann R 44 , Brazinova A 45 , Brugha TS 46 , Catalá-López F 47 , Degenhardt L 48 , Ferrari A 1 , Haro JM 49 , Horino M 50 , Hornberger JC 51 , Huang H 52 , Kieling C 53 , Kim D 54 , Kim Y 55 , Knudsen AK 56 , Mitchell PB 57 , Patton G 58 , Sagar R 59 , Satpathy M 60 , Savuon K 61 , Seedat S 62 , Shiue I 63 , Skogen JC 64 , Stein DJ 65 , Tabb KM 66 , Whiteford HA 67 , Yip P 68 , Yonemoto N 69 , Murray CJ 1 , Mokdad AH 1

Affiliations 

  • 1 Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
  • 2 Arabian Gulf University, Manama, Bahrain
  • 3 Iranian Ministry of Health and Medical Education, Tehran, Iran
  • 4 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • 5 Jordan University of Science and Technology, Irbid, Jordan
  • 6 Public Authority for Food and Nutrition, Kuwait, Kuwait
  • 7 Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  • 8 Contech International Health Consultants, Lahore, Pakistan
  • 9 South Asian Public Health Forum, Islamabad, Pakistan
  • 10 Department of Public Health, An-Najah University, Nablus, Palestine
  • 11 Institute of Community and Public Health, Birzeit University, Ramallah, Palestine
  • 12 Harvard University, Boston, MA, United States of America
  • 13 Health Ministers' Council for Cooperation Council States, Riyadh, Saudi Arabia
  • 14 The Saudi Center for Evidence Based Healthcare, Riyadh, Saudi Arabia
  • 15 King Abdullah Specialized Children's Hospital, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  • 16 Ministry of Health-Tunisia (Faculty of Medicine Tunis), Tunis, Tunisia
  • 17 Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
  • 18 University of Oxford, Oxford, United Kingdom
  • 19 Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  • 20 Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States of America
  • 21 Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  • 22 Suez Canal University, Ismailia, Egypt
  • 23 Federal Institute for Population Research, Wiesbaden, Germany
  • 24 Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
  • 25 University of Rhode Island, Kingston, RI, United States of America
  • 26 SIR Consultants, Sindh, Pakistan
  • 27 School of Health Sciences, University of Management and Technology, Lahore, Pakistan
  • 28 Public Health Agency of Canada, Toronto, ON, Canada
  • 29 Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
  • 30 Tehran University of Medical Sciences, Tehran, Iran
  • 31 Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
  • 32 Bielefeld University, Bielefeld, Germany
  • 33 Department of Ophthalmology, Medical Faculty Mannheim, University Heidelberg, Heidelberg, Germany
  • 34 Department of Social and Preventive Medicine, School of Public Health of the University of Montreal, Montreal, Quebec, Canada
  • 35 Howard University College of Medicine, Howard University, Washington DC, United States of America
  • 36 Emory University, Atlanta, GA, United States of America
  • 37 University of British Columbia, Vancouver, BC, Canada
  • 38 Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
  • 39 Department of Surgery, University of Texas Southwestern, Dallas, Texas, United States of America
  • 40 Department of Psychiatry, American University of Beirut, Beirut, Lebanon
  • 41 Department of Neurology, Cairo University, Cairo, Egypt
  • 42 The Hospital for Sick Children, Toronto, Canada; University of Toronto, Toronto, Ontario, Canada
  • 43 Northern Territory Department of Health, Darwin, Northern Territory, Australia
  • 44 Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  • 45 Trnava University, Trnava, Slovakia
  • 46 University of Leicester, Leicester, United Kingdom
  • 47 Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
  • 48 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
  • 49 Parc Sanitari Sant Joan de Déu-CIBERSAM, Sant Boi de Llobregat, Spain
  • 50 Nevada Division of Behavior and Public Health, Carson City, NV, United States of America
  • 51 National Institutes of Health, Bethesda, MD, United States of America
  • 52 Cambridge Health Alliance, Cambridge, MA, United States of America
  • 53 Federal University of Rio Grande do Sul, Porto Alegre, Brazil
  • 54 Department of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America
  • 55 Southern University College, Johor, Malaysia
  • 56 Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
  • 57 School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
  • 58 Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
  • 59 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
  • 60 UGC Centre for Advanced Studies in Psychology, Utkal University, Vani Vihar, Bhubaneswar, Odisha, INDIA
  • 61 Department of Hospital Services, Ministry of Health, Phnom Penh, Cambodia
  • 62 Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
  • 63 Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
  • 64 Domain for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
  • 65 Department of Psychiatry, University of Cape Town, Cape Town, South Africa
  • 66 School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
  • 67 University of Queensland, Brisbane, QLD, Australia
  • 68 Centre for Suicide Research and Prevention, The University of Hong Kong, Pok Fu Lam, Hong Kong
  • 69 Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
PLoS One, 2017;12(1):e0169575.
PMID: 28095477 DOI: 10.1371/journal.pone.0169575

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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