The Burden Attributable to Mental and Substance Use Disorders as Risk Factors for Suicide: Findings from the Global Burden of Disease Study 2010

Abstract

BackgroundThe Global Burden of Disease Study 2010 (GBD 2010) identified mental and substance use disorders as the 5th leading contributor of burden in 2010, measured by disability adjusted life years (DALYs). This estimate was incomplete as it excluded burden resulting from the increased risk of suicide captured elsewhere in GBD 2010's mutually exclusive list of diseases and injuries. Here, we estimate suicide DALYs attributable to mental and substance use disorders.MethodsRelative-risk estimates of suicide due to mental and substance use disorders and the global prevalence of each disorder were used to estimate population attributable fractions. These were adjusted for global differences in the proportion of suicide due to mental and substance use disorders compared to other causes then multiplied by suicide DALYs reported in GBD 2010 to estimate attributable DALYs (with 95% uncertainty).ResultsMental and substance use disorders were responsible for 22.5 million (14.8–29.8 million) of the 36.2 million (26.5–44.3 million) DALYs allocated to suicide in 2010. Depression was responsible for the largest proportion of suicide DALYs (46.1% (28.0%–60.8%)) and anorexia nervosa the lowest (0.2% (0.02%–0.5%)). DALYs occurred throughout the lifespan, with the largest proportion found in Eastern Europe and Asia, and males aged 20–30 years. The inclusion of attributable suicide DALYs would have increased the overall burden of mental and substance use disorders (assigned to them in GBD 2010 as a direct cause) from 7.4% (6.2%–8.6%) to 8.3% (7.1%–9.6%) of global DALYs, and would have changed the global ranking from 5th to 3rd leading cause of burden.ConclusionsCapturing the suicide burden attributable to mental and substance use disorders allows for more accurate estimates of burden. More consideration needs to be given to interventions targeted to populations with, or at risk for, mental and substance use disorders as an effective strategy for suicide prevention.

Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use

“…4,5 Consequently, mental health disorders are often associated with disruptions in relationships, education, and employment, as well as lost productivity, poor health outcomes, increased risk of suicide, and premature mortality. [6][7][8][9][10][11][12] Primary care is often the first place for treatment of mental disorders, 13 and this is expected to increase with promulgation of the integrated care approach established by the Affordable Care Act (ACA). 14 Primary care providers (PCPs) are increasingly charged with screening, diagnosing, treating, and referring patients for treatment of mental health disorders.…”

Why is depression more prevalent in women?

“…3 Major depression is growing in overall disease burden in Canada and around the world; it is predicted to be the leading cause of disease burden by 2030, and it is already the leading cause in women worldwide. 4 Between 1990 and 2010 in Canada, major depressive disorder showed a 75% increase in disability-adjusted life years, 1 the second greatest increase in prevalence after Alzheimer disease; in comparison, the increase in the United States was 43%.…”

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

“…About 90% of suicides are due to underlying mental illness [5] with the World Health Organization (WHO) estimating an incidence of 800,000 suicides per year in 2005, with 86% being in low and middleincome countries [6]. Mental and substance use disorders were responsible for 22Á5 million of the 36Á2 million DALYs allocated to suicide in 2010 with depression contributing the most (46Á1%) to suicide DALYS [7].…”