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

Raghid Charara(Institute for Health Metrics and Evaluation), Mohammad H. Forouzanfar(Institute for Health Metrics and Evaluation), Mohsen Naghavi(Institute for Health Metrics and Evaluation), Maziar Moradi‐Lakeh(Iran University of Medical Sciences), Ashkan Afshin(Institute for Health Metrics and Evaluation), Theo Vos(Institute for Health Metrics and Evaluation), Farah Daoud(Institute for Health Metrics and Evaluation), Haidong Wang(Institute for Health Metrics and Evaluation), Charbel El Bcheraoui(Institute for Health Metrics and Evaluation), Ibrahim Khalil(Institute for Health Metrics and Evaluation), Randah R Hamadeh(Arabian Gulf University), Ardeshir Khosravi(Ministry of Health and Medical Education), Vafa Rahimi‐Movaghar(Tehran University of Medical Sciences), Yousef Khader(Jordan University of Science and Technology), Nawal Al‐Hamad(Public Authority for Applied Education and Training), Carla Makhlouf Obermeyer(American University of Beirut), Anwar Rafay, Rana J Asghar, Saleem M. Rana, Amira Shaheen(An-Najah National University), Niveen M. E. Abu-Rmeileh(Birzeit University), Abdullatif Husseini(Birzeit University), Laith J. Abu‐Raddad(Harvard University), Tawfik Khoja, Zulfa A. Al Rayess(Saudi Center for Disease Prevention and Control), Fadia AlBuhairan(King Saud bin Abdulaziz University for Health Sciences), Mohamed Hsaïri(Ministry of Agriculture), Mahmoud A. Alomari(Jordan University of Science and Technology), Raghib Ali(University of Oxford), Gholamreza Roshandel(Golestan University), Abdullah Sulieman Terkawi(Outcomes Research Consortium), Samer Hamidi(Hamdan Bin Mohammed Smart University), Amany Refaat(Suez Canal University), Ronny Westerman(Federal Institute for Population Research), Ali Kiadaliri(Lund University), A. S. Akanda(University of Rhode Island), Syed Danish Ali, Umar Bacha(University of Management and Technology), Alaa Badawi(Public Health Agency of Canada), Shahrzad Bazargan‐Hejazi(University of California, Los Angeles), Imad A. D. Faghmous(London School of Hygiene & Tropical Medicine), Seyed‐Mohammad Fereshtehnejad(Karolinska Institutet), Florian Fischer(Bielefeld University), Jost B. Jonas(Heidelberg University), Barthélémy Kuate Defo(Université de Montréal), Alem Mehari(Howard University), Saad B Omer(Emory University), Farshad Pourmalek(University of British Columbia), Olalekan A. Uthman(University of Warwick), Ali A. Mokdad(Institute for Health Metrics and Evaluation), Ali A. Mokdad(Institute for Health Metrics and Evaluation), Fadi T. Maalouf(Cairo University), Foad Abd-Allah(Cairo University), Nadia Akseer(University of Toronto), Dinesh Arya(Northern Territory Health Services), Rohan Borschmann(University of Trnava), Alexandra Bražinová(University of Trnava), Traolach Brugha(University of Leicester), Ferrán Catalá-López(Universitat de València), Louisa Degenhardt(The University of Queensland), Alize J Ferrari(The University of Queensland), Josep María Haro(Parc Sanitari Sant Joan de Déu), Masako Horino(National Institutes of Health), John Hornberger(Cambridge Health Alliance), Hsiang Huang(Cambridge Health Alliance), Christian Kieling(Northeastern University), Daniel Kim(Northeastern University), Yun Jin Kim(Norwegian Institute of Public Health), Ann Kristin Knudsen(Norwegian Institute of Public Health), Philip B. Mitchell(The University of Melbourne), George Patton(The University of Melbourne), Rajesh Sagar(All India Institute of Medical Sciences), Maheswar Satpathy(Ministry of Health), Savuon Kim(Ministry of Health), Soraya Seedat(Stellenbosch University), Ivy Shiue(Norwegian Institute of Public Health), Jens Christoffer Skogen(Norwegian Institute of Public Health), Dan J. Stein(University of Cape Town), Karen M. Tabb(University of Illinois Urbana-Champaign), Harvey Whiteford(The University of Queensland), Paul Yip(Kyoto University), Naohiro Yonemoto(Kyoto University), Christopher J L Murray(Institute for Health Metrics and Evaluation), Ali H. Mokdad(Institute for Health Metrics and Evaluation), Ali H. Mokdad(Institute for Health Metrics and Evaluation)
PLoS ONE
January 17, 2017
10.1371/journal.pone.0169575
Cited by 186Open Access
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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.

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