Whiteford Harvey A, Ferrari Alize J, Degenhardt Louisa, Feigin Valery, Vos Theo
University of Queensland, School of Public Health, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America.
University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America; UNSW Australia, National Drug and Alcohol Research Centre, New South Wales, Australia; University of Melbourne, Melbourne School of Population and Global Health, Victoria, Australia.
PLoS One. 2015 Feb 6;10(2):e0116820. doi: 10.1371/journal.pone.0116820. eCollection 2015.
The Global Burden of Disease Study 2010 (GBD 2010), estimated that a substantial proportion of the world's disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders.
For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs). Years lost to premature mortality (YLLs) were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs) were computed as the sum of YLDs and YLLs.
In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson's disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific.
Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the research necessary to develop better prevention and treatment options.
《2010年全球疾病负担研究》(GBD 2010)估计,全球相当一部分疾病负担来自精神、神经和物质使用障碍。在本文中,我们使用GBD 2010数据来研究精神、神经和物质使用障碍所致负担在时间、年份、地区和年龄方面的特定趋势。
对于每种障碍,通过系统文献综述收集患病率数据。使用贝叶斯元回归工具DisMod-MR对国家、地区、年龄、性别和年份的患病率进行建模。患病率数据与从调查数据得出的残疾权重相结合,以估计失能调整生命年(YLDs)。因过早死亡而损失的年数(YLLs)通过将特定障碍导致的死亡人数乘以死亡发生年龄的参考标准预期寿命来估计。伤残调整生命年(DALYs)计算为YLDs与YLLs之和。
2010年,精神、神经和物质使用障碍占全球DALYs的10.4%,占全球YLLs的2.3%,占全球YLDs的28.5%,使其成为YLDs的主要原因。精神障碍占DALYs的比例最大(56.7%),其次是神经障碍(28.6%)和物质使用障碍(14.7%)。精神和物质使用障碍的DALYs在成年早期达到峰值,但神经障碍在各年龄段更为一致。在所有精神和神经障碍中,女性占DALYs的比例更高,但儿童期精神障碍、精神分裂症、物质使用障碍、帕金森病和癫痫除外,这些疾病中男性占DALYs的比例更高。总体DALYs在东欧/中亚最高,在东亚/太平洋最低。
精神、神经和物质使用障碍导致了相当大比例的疾病负担。卫生系统可以通过实施既定的、具有成本效益的干预措施,或通过支持开展更好的预防和治疗方案所需的研究来做出应对。