The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013.
The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013.
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DOI：
10.1371/journal.pone.0169575
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Mokdad AH
中科院分区：
文献类型：
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作者：
Charara R;Forouzanfar M;Naghavi M;Moradi-Lakeh M;Afshin A;Vos T;Daoud F;Wang H;El Bcheraoui C;Khalil I;Hamadeh RR;Khosravi A;Rahimi-Movaghar V;Khader Y;Al-Hamad N;Makhlouf Obermeyer C;Rafay A;Asghar R;Rana SM;Shaheen A;Abu-Rmeileh NM;Husseini A;Abu-Raddad LJ;Khoja T;Al Rayess ZA;AlBuhairan FS;Hsairi M;Alomari MA;Ali R;Roshandel G;Terkawi AS;Hamidi S;Refaat AH;Westerman R;Kiadaliri AA;Akanda AS;Ali SD;Bacha U;Badawi A;Bazargan-Hejazi S;Faghmous IA;Fereshtehnejad SM;Fischer F;Jonas JB;Kuate Defo B;Mehari A;Omer SB;Pourmalek F;Uthman OA;Mokdad AA;Maalouf FT;Abd-Allah F;Akseer N;Arya D;Borschmann R;Brazinova A;Brugha TS;Catalá-López F;Degenhardt L;Ferrari A;Haro JM;Horino M;Hornberger JC;Huang H;Kieling C;Kim D;Kim Y;Knudsen AK;Mitchell PB;Patton G;Sagar R;Satpathy M;Savuon K;Seedat S;Shiue I;Skogen JC;Stein DJ;Tabb KM;Whiteford HA;Yip P;Yonemoto N;Murray CJ;Mokdad AH
东地中海区域正在目睹包括精神疾病在内的慢性疾病的增加。随着持续的动荡，预计这一数字将上升。这是第一项量化EMR中精神障碍负担的研究。我们使用了2013年全球疾病负担研究（GBD）的数据。DALYs（残疾调整生命年）可以评估过早死亡率（生命损失年数-YLL）和非致命结局（残疾生存年数-YLD）。通过将每个年龄-性别-国家组的YLL和YLD相加来计算残疾人。2013年，精神障碍占EMR总疾病负担的5.6%（1894年丹麦/100，000人口）：2519丹麦克朗/100 000（男性2590/100 000，女性2426/100 000），高收入国家，1884丹麦克朗/100 000在中等收入国家为1618/100 000（男性1618/100 000，女性2157/100 000），在低收入国家为1607/100 000（男性1500/100 000，女性1717/100 000）。除15岁以下的人外，女性因精神障碍而承受的负担比例高于同龄男性。25-49岁年龄组的残疾人比例最高，35-39岁年龄组的残疾人比例最高（5 344残疾人/100 000）。EMR中精神障碍的负担从1990年的1726 DALLS/100，000增加到2013年的1912 DALLS/100，000（增长10.8%）。在EMR中的精神障碍组中，抑郁症占大多数，其次是焦虑症。在EMR国家中，巴勒斯坦的精神障碍负担最大。与全球水平相比，几乎所有EMR国家的精神障碍负担都更高。我们的研究结果呼吁EMR卫生部增加精神卫生服务的提供，并解决精神疾病的耻辱感。此外，我们的结果显示，随着该地区的不稳定程度增加，心理健康的负担正在加速，这是令人震惊的。事实上，心理健康问题如果得不到妥善解决，将导致本区域疾病负担的增加。
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.