The Burden of Mental Illness and Addiction in Ontario

Abstract

Objective: Public Health Ontario and the Institute for Clinical Evaluative Sciences have collaborated to estimate the burden of illness attributable to mental disorder and addictions in Ontario. Methods: Health-adjusted life years were used to estimate burden. It is conceptually similar to disability-adjusted life years that were used in the global burden of disease studies. Data sources for the mental illnesses and addictions used in our study included health administrative data for the province of Ontario, survey data from Statistics Canada and the Centre for Addiction and Mental Health, vital statistics data from the Ontario Office of the Registrar General, and US epidemiologic survey data. Results: The 5 conditions with the highest burden are: major depression, bipolar affective disorder, alcohol use disorders (AUDs), social phobia, and schizophrenia. The burden of depression is double the next highest mental health condition (that is, bipolar affective disorder) and is more than the combined burden of the 4 most common cancers in Ontario. AUDs were the only disease group that had a substantial proportion of burden attributable to early death. The burden estimates for the other conditions were primarily due to disability. Conclusions: The burden of these conditions in Ontario is as large or larger than other conditions, such as cancer and infectious diseases, owing in large part to the high prevalence, chronicity, and age of onset for most mental disorders and addiction problems. The findings serve as an important baseline for future evaluation of interventions intended to address the burden of mental health and addictions.

Risk of suicide after a concussion

“…57,58 Prior psychiatric conditions (schizophrenia, depression, bipolar disorder, suicide attempt, anxiety, substance abuse) were determined from physician diagnostic data for the full year before injury. 59 The available databases contained no information on social stress, life events, employment status, race or ethnicity, sexual orientation, immigration status, borderline personality disorder, childhood abuse, eating disorders, suicidal ideation, novel biomarkers or other suicide risks.…”

Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada

“…11 There are likely reciprocal effects between depression and disease, with depression being a risk factor for, and a sequela of, disease. 11 Summary measures of population health using the Global Burden of Disease methodology 1,[12][13][14][15] have ranked depression very high on the list of health conditions contributing to the global and national burden of disease, particularly in terms of losses due to disability. Major depressive episode is the second leading cause of years lived with disability globally 1 as well as in the United States, 12 the United Kingdom, 13 China 14 and Canada.…”

“…Major depressive episode is the second leading cause of years lived with disability globally 1 as well as in the United States, 12 the United Kingdom, 13 China 14 and Canada. 15 Less well documented is the association of depression with life expectancy and healthy (or disease-free) life expectancy. Understanding both life expectancy and healthy life expectancy among people who have depression will help to better characterize its disease burden.…”

Description du fardeau de la dépression sur la santé de la population au Canada : utilisation de l’espérance de vie ajustée en fonction de la santé

“…Des effets réciproques existent probablement entre la dépression et la maladie, la dépression constituant à la fois un facteur de risque et une conséquence de la maladie 11 . Des mesures globales de l'état de santé de la population effectuées à l'aide de la méthodologie de mesure du fardeau mondial de la maladie (Global Burden of Disease) 1,[12][13][14][15] ont accordé à la dépression une place très élevée sur la liste des problèmes de santé contribuant au fardeau de la maladie à l'échelle nationale et mondiale, particulièrement en matière de pertes résultant d'une incapacité. Vivre un épisode de dépression majeure arrive au deuxième rang des causes à des années vécues avec une incapacité, que ce soit à l'échelle mondiale 1 17 ont rapporté que, aux États-Unis, à l'âge de 18 ans, les adultes souffrant de dépression subissent une perte d'espérance de vie pondérée par la qualité de l'existence (EVPQE) de 28,9 ans par rapport aux personnes ne souffrant pas de dépression.…”