1990 - 2019年欧洲年轻人的精神障碍、物质使用障碍和自我伤害负担：全球疾病负担研究2019的结果
The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019.
作者信息
Castelpietra Giulio, Knudsen Ann Kristin Skrindo, Agardh Emilie E, Armocida Benedetta, Beghi Massimiliano, Iburg Kim Moesgaard, Logroscino Giancarlo, Ma Rui, Starace Fabrizio, Steel Nicholas, Addolorato Giovanni, Andrei Catalina Liliana, Andrei Tudorel, Ayuso-Mateos Jose L, Banach Maciej, Bärnighausen Till Winfried, Barone-Adesi Francesco, Bhagavathula Akshaya Srikanth, Carvalho Felix, Carvalho Márcia, Chandan Joht Singh, Chattu Vijay Kumar, Couto Rosa A S, Cruz-Martins Natália, Dargan Paul I, Deuba Keshab, da Silva Diana Dias, Fagbamigbe Adeniyi Francis, Fernandes Eduarda, Ferrara Pietro, Fischer Florian, Gaal Peter Andras, Gialluisi Alessandro, Haagsma Juanita A, Haro Josep Maria, Hasan M Tasdik, Hasan Syed Shahzad, Hostiuc Sorin, Iacoviello Licia, Iavicoli Ivo, Jamshidi Elham, Jonas Jost B, Joo Tamas, Jozwiak Jacek Jerzy, Katikireddi Srinivasa Vittal, Kauppila Joonas H, Khan Moien A B, Kisa Adnan, Kisa Sezer, Kivimäki Mika, Koly Kamrun Nahar, Koyanagi Ai, Kumar Manasi, Lallukka Tea, Langguth Berthold, Ledda Caterina, Lee Paul H, Lega Ilaria, Linehan Christine, Loureiro Joana A, Madureira-Carvalho Áurea M, Martinez-Raga Jose, Mathur Manu Raj, McGrath John J, Mechili Enkeleint A, Mentis Alexios-Fotios A, Mestrovic Tomislav, Miazgowski Bartosz, Mirica Andreea, Mirijello Antonio, Moazen Babak, Mohammed Shafiu, Mulita Francesk, Nagel Gabriele, Negoi Ionut, Negoi Ruxandra Irina, Nwatah Vincent Ebuka, Padron-Monedero Alicia, Panda-Jonas Songhomitra, Pardhan Shahina, Pasovic Maja, Patel Jay, Petcu Ionela-Roxana, Pinheiro Marina, Pollok Richard Charles G, Postma Maarten J, Rawaf David Laith, Rawaf Salman, Romero-Rodríguez Esperanza, Ronfani Luca, Sagoe Dominic, Sanmarchi Francesco, Schaub Michael P, Sharew Nigussie Tadesse, Shiri Rahman, Shokraneh Farhad, Sigfusdottir Inga Dora, Silva João Pedro, Silva Renata, Socea Bogdan, Szócska Miklós, Tabarés-Seisdedos Rafael, Torrado Marco, Tovani-Palone Marcos Roberto, Vasankari Tommi Juhani, Veroux Massimiliano, Viner Russell M, Werdecker Andrea, Winkler Andrea Sylvia, Hay Simon I, Ferrari Alize J, Naghavi Mohsen, Allebeck Peter, Monasta Lorenzo
机构信息
Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy.
Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
出版信息
Lancet Reg Health Eur. 2022 Apr 1;16:100341. doi: 10.1016/j.lanepe.2022.100341. eCollection 2022 May.
BACKGROUND
Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time.
METHODS
Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated.
FINDINGS
In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs.
INTERPRETATION
Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people.
FUNDING
The Bill and Melinda Gates Foundation.
背景
心理健康是欧洲年轻人面临的一个公共卫生问题，在资源分配上存在很大差异。需要开展基于代表性人群的研究。《2019年全球疾病负担研究》提供了关于人群健康状况趋势以及疾病负担主要原因随时间变化的国际可比信息。
方法
对31个欧洲国家10至24岁年轻人的精神障碍（MD）、物质使用障碍（SUD）和自我伤害的患病率、发病率、伤残损失生命年（YLD）和生命损失年数（YLL）进行了估计。计算了每10万人口的发病率、1990 - 2019年的百分比变化、95%不确定区间（UI）以及与社会人口指数（SDI）的相关性。
研究结果
2019年，每10万人口中精神障碍的发病率为16,983（95% UI 12,823 - 21,630），物质使用障碍为3,891（3,020 - 4,905），自我伤害为89.1（63.8 - 123.1）。就残疾而言，焦虑导致每10万人口中有647.3（432 - 912.3）个伤残损失生命年，而就过早死亡而言，自我伤害导致每10万人口中有319.6（248.9 - 412.8）个生命损失年数。在研究的30年中，饮食失调（14.9%；9.4 - 20.1）和药物使用障碍（16.9%；8.9 - 26.3）的伤残损失生命年有所增加，特发性发育性智力残疾则有所下降（-29.1%；23.8 - 38.5）。自我伤害的生命损失年数有所下降（-27.9%；38.3 - 18.7）。在性别、年龄组和国家方面发现了差异。社会人口指数较低的国家中物质使用障碍和自我伤害的负担较高，精神障碍与物质使用障碍相关。
解读
心理健康状况是欧洲年轻人的一项重要负担。国家政策应加强心理健康，尤其关注年轻人。
资金来源
比尔及梅琳达·盖茨基金会。
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