The burden of mental disorders in the eastern mediterranean region, 1990-2013

Raghid Charara; Mohammad Forouzanfar; Mohsen Naghavi; Maziar Moradi-Lakeh; Ashkan Afshin; Theo Vos; Farah Daoud; Haidong Wang; Charbel El Bcheraoui; Ibrahim Khalil; Randah R. Hamadeh; Ardeshir Khosravi; Vafa Rahimi-Movaghar; Yousef Khader; Nawal Al-Hamad; Carla Makhlouf Obermeyer; Anwar Rafay; Rana Asghar; Saleem M. Rana; Amira Shaheen; Niveen M.E. Abu-Rmeileh; Abdullatif Husseini; Laith J. Abu-Raddad; Tawfik Khoja; Zulfa A.Al Rayess; Fadia S. AlBuhairan; Mohamed Hsairi; Mahmoud A. Alomari; Raghib Ali; Gholamreza Roshandel; Abdullah Sulieman Terkawi; Samer Hamidi; Amany H. Refaat; Ronny Westerman; Aliasghar Ahmad Kiadaliri; Ali S. Akanda; Syed Danish Ali; Umar Bacha; Alaa Badawi; Shahrzad Bazargan-Hejazi; Imad A.D. Faghmous; Seyed Mohammad Fereshtehnejad; Florian Fischer; Jost B. Jonas; Barthelemy Kuate Defo; Alem Mehari; Saad B. Omer; Farshad Pourmalek; Olalekan A. Uthman; Ali A. Mokdad; Fadi T. Maalouf; Foad Abd-Allah; Nadia Akseer; Dinesh Arya; Rohan Borschmann; Alexandra Brazinova; Traolach S. Brugha; Ferran Catala-Lopez; Louisa Degenhardt; Alize Ferrari; Josep Maria Haro; Masako Horino; John C. Hornberger; Hsiang Huang; Christian Kieling; Daniel Kim; Yunjin Kim; Ann Kristin Knudsen; Philip B. Mitchell; George Patton; Rajesh Sagar; Maheswar Satpathy; Kim Savuon; Soraya Seedat; Ivy Shiue; Jens Christoffer Skogen; Dan J. Stein; Karen M. Tabb; Harvey A. Whiteford; Paul Yip; Naohiro Yonemoto; Christopher J.L. Murray; Ali H. Mokdad

doi:10.1371/journal.pone.0169575

The burden of mental disorders in the eastern mediterranean region, 1990-2013

Raghid Charara, Mohammad Forouzanfar, Mohsen Naghavi, Maziar Moradi-Lakeh, Ashkan Afshin, Theo Vos, Farah Daoud, Haidong Wang, Charbel El Bcheraoui, Ibrahim Khalil, Randah R. Hamadeh, Ardeshir Khosravi, Vafa Rahimi-Movaghar, Yousef Khader, Nawal Al-Hamad, Carla Makhlouf Obermeyer, Anwar Rafay, Rana Asghar, Saleem M. Rana, Amira ShaheenNiveen M.E. Abu-Rmeileh, Abdullatif Husseini, Laith J. Abu-Raddad, Tawfik Khoja, Zulfa A.Al Rayess, Fadia S. AlBuhairan, Mohamed Hsairi, Mahmoud A. Alomari, Raghib Ali, Gholamreza Roshandel, Abdullah Sulieman Terkawi, Samer Hamidi, Amany H. Refaat, Ronny Westerman, Aliasghar Ahmad Kiadaliri, Ali S. Akanda, Syed Danish Ali, Umar Bacha, Alaa Badawi, Shahrzad Bazargan-Hejazi, Imad A.D. Faghmous, Seyed Mohammad Fereshtehnejad, Florian Fischer, Jost B. Jonas, Barthelemy Kuate Defo, Alem Mehari, Saad B. Omer, Farshad Pourmalek, Olalekan A. Uthman, Ali A. Mokdad, Fadi T. Maalouf, Foad Abd-Allah, Nadia Akseer, Dinesh Arya, Rohan Borschmann, Alexandra Brazinova, Traolach S. Brugha, Ferran Catala-Lopez, Louisa Degenhardt, Alize Ferrari, Josep Maria Haro, Masako Horino, John C. Hornberger, Hsiang Huang, Christian Kieling, Daniel Kim, Yunjin Kim, Ann Kristin Knudsen, Philip B. Mitchell, George Patton, Rajesh Sagar, Maheswar Satpathy, Kim Savuon, Soraya Seedat, Ivy Shiue, Jens Christoffer Skogen, Dan J. Stein, Karen M. Tabb, Harvey A. Whiteford, Paul Yip, Naohiro Yonemoto, Christopher J.L. Murray, Ali H. Mokdad

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Abstract

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 Burden of Mental Disorders in EMR PLOS ONE 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.

Original language	English (US)
Article number	0169575
Journal	PloS one
Volume	12
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0169575
State	Published - Jan 2017

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Charara, R., Forouzanfar, M., Naghavi, M., Moradi-Lakeh, M., Afshin, A., Vos, T., Daoud, F., Wang, H., Bcheraoui, C. E., Khalil, I., Hamadeh, R. R., Khosravi, A., Rahimi-Movaghar, V., Khader, Y., Al-Hamad, N., Obermeyer, C. M., Rafay, A., Asghar, R., Rana, S. M., ... Mokdad, A. H. (2017). The burden of mental disorders in the eastern mediterranean region, 1990-2013. PloS one, 12(1), Article 0169575. https://doi.org/10.1371/journal.pone.0169575

Charara, R, Forouzanfar, M, Naghavi, M, Moradi-Lakeh, M, Afshin, A, Vos, T, Daoud, F, Wang, H, Bcheraoui, CE, Khalil, I, Hamadeh, RR, Khosravi, A, Rahimi-Movaghar, V, Khader, Y, Al-Hamad, N, Obermeyer, CM, Rafay, A, Asghar, R, Rana, SM, Shaheen, A, Abu-Rmeileh, NME, Husseini, A, Abu-Raddad, LJ, Khoja, T, Rayess, ZAA, 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, IAD, Fereshtehnejad, SM, Fischer, F, Jonas, JB, Defo, BK, 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, Catala-Lopez, 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, CJL & Mokdad, AH 2017, 'The burden of mental disorders in the eastern mediterranean region, 1990-2013', PloS one, vol. 12, no. 1, 0169575. https://doi.org/10.1371/journal.pone.0169575

@article{20e2efae258d43108b7333360f122c37,

title = "The burden of mental disorders in the eastern mediterranean region, 1990-2013",

abstract = "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 Burden of Mental Disorders in EMR PLOS ONE 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.",

author = "Raghid Charara and Mohammad Forouzanfar and Mohsen Naghavi and Maziar Moradi-Lakeh and Ashkan Afshin and Theo Vos and Farah Daoud and Haidong Wang and Bcheraoui, {Charbel El} and Ibrahim Khalil and Hamadeh, {Randah R.} and Ardeshir Khosravi and Vafa Rahimi-Movaghar and Yousef Khader and Nawal Al-Hamad and Obermeyer, {Carla Makhlouf} and Anwar Rafay and Rana Asghar and Rana, {Saleem M.} and Amira Shaheen and Abu-Rmeileh, {Niveen M.E.} and Abdullatif Husseini and Abu-Raddad, {Laith J.} and Tawfik Khoja and Rayess, {Zulfa A.Al} and AlBuhairan, {Fadia S.} and Mohamed Hsairi and Alomari, {Mahmoud A.} and Raghib Ali and Gholamreza Roshandel and Terkawi, {Abdullah Sulieman} and Samer Hamidi and Refaat, {Amany H.} and Ronny Westerman and Kiadaliri, {Aliasghar Ahmad} and Akanda, {Ali S.} and Ali, {Syed Danish} and Umar Bacha and Alaa Badawi and Shahrzad Bazargan-Hejazi and Faghmous, {Imad A.D.} and Fereshtehnejad, {Seyed Mohammad} and Florian Fischer and Jonas, {Jost B.} and Defo, {Barthelemy Kuate} and Alem Mehari and Omer, {Saad B.} and Farshad Pourmalek and Uthman, {Olalekan A.} and Mokdad, {Ali A.} and Maalouf, {Fadi T.} and Foad Abd-Allah and Nadia Akseer and Dinesh Arya and Rohan Borschmann and Alexandra Brazinova and Brugha, {Traolach S.} and Ferran Catala-Lopez and Louisa Degenhardt and Alize Ferrari and Haro, {Josep Maria} and Masako Horino and Hornberger, {John C.} and Hsiang Huang and Christian Kieling and Daniel Kim and Yunjin Kim and Knudsen, {Ann Kristin} and Mitchell, {Philip B.} and George Patton and Rajesh Sagar and Maheswar Satpathy and Kim Savuon and Soraya Seedat and Ivy Shiue and Skogen, {Jens Christoffer} and Stein, {Dan J.} and Tabb, {Karen M.} and Whiteford, {Harvey A.} and Paul Yip and Naohiro Yonemoto and Murray, {Christopher J.L.} and Mokdad, {Ali H.}",

note = "Publisher Copyright: {\textcopyright} 2017 Charara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2017",

month = jan,

doi = "10.1371/journal.pone.0169575",

language = "English (US)",

volume = "12",

journal = "PloS one",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "1",

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TY - JOUR

T1 - The burden of mental disorders in the eastern mediterranean region, 1990-2013

AU - Charara, Raghid

AU - Forouzanfar, Mohammad

AU - Naghavi, Mohsen

AU - Moradi-Lakeh, Maziar

AU - Afshin, Ashkan

AU - Vos, Theo

AU - Daoud, Farah

AU - Wang, Haidong

AU - Bcheraoui, Charbel El

AU - Khalil, Ibrahim

AU - Hamadeh, Randah R.

AU - Khosravi, Ardeshir

AU - Rahimi-Movaghar, Vafa

AU - Khader, Yousef

AU - Al-Hamad, Nawal

AU - Obermeyer, Carla Makhlouf

AU - Rafay, Anwar

AU - Asghar, Rana

AU - Rana, Saleem M.

AU - Shaheen, Amira

AU - Abu-Rmeileh, Niveen M.E.

AU - Husseini, Abdullatif

AU - Abu-Raddad, Laith J.

AU - Khoja, Tawfik

AU - Rayess, Zulfa A.Al

AU - AlBuhairan, Fadia S.

AU - Hsairi, Mohamed

AU - Alomari, Mahmoud A.

AU - Ali, Raghib

AU - Roshandel, Gholamreza

AU - Terkawi, Abdullah Sulieman

AU - Hamidi, Samer

AU - Refaat, Amany H.

AU - Westerman, Ronny

AU - Kiadaliri, Aliasghar Ahmad

AU - Akanda, Ali S.

AU - Ali, Syed Danish

AU - Bacha, Umar

AU - Badawi, Alaa

AU - Bazargan-Hejazi, Shahrzad

AU - Faghmous, Imad A.D.

AU - Fereshtehnejad, Seyed Mohammad

AU - Fischer, Florian

AU - Jonas, Jost B.

AU - Defo, Barthelemy Kuate

AU - Mehari, Alem

AU - Omer, Saad B.

AU - Pourmalek, Farshad

AU - Uthman, Olalekan A.

AU - Mokdad, Ali A.

AU - Maalouf, Fadi T.

AU - Abd-Allah, Foad

AU - Akseer, Nadia

AU - Arya, Dinesh

AU - Borschmann, Rohan

AU - Brazinova, Alexandra

AU - Brugha, Traolach S.

AU - Catala-Lopez, Ferran

AU - Degenhardt, Louisa

AU - Ferrari, Alize

AU - Haro, Josep Maria

AU - Horino, Masako

AU - Hornberger, John C.

AU - Huang, Hsiang

AU - Kieling, Christian

AU - Kim, Daniel

AU - Kim, Yunjin

AU - Knudsen, Ann Kristin

AU - Mitchell, Philip B.

AU - Patton, George

AU - Sagar, Rajesh

AU - Satpathy, Maheswar

AU - Savuon, Kim

AU - Seedat, Soraya

AU - Shiue, Ivy

AU - Skogen, Jens Christoffer

AU - Stein, Dan J.

AU - Tabb, Karen M.

AU - Whiteford, Harvey A.

AU - Yip, Paul

AU - Yonemoto, Naohiro

AU - Murray, Christopher J.L.

AU - Mokdad, Ali H.

N1 - Publisher Copyright: © 2017 Charara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2017/1

Y1 - 2017/1

N2 - 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 Burden of Mental Disorders in EMR PLOS ONE 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.

AB - 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 Burden of Mental Disorders in EMR PLOS ONE 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.

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U2 - 10.1371/journal.pone.0169575

DO - 10.1371/journal.pone.0169575

M3 - Article

C2 - 28095477

AN - SCOPUS:85009892168

SN - 1932-6203

VL - 12

JO - PloS one

JF - PloS one

IS - 1

M1 - 0169575

ER -

The burden of mental disorders in the eastern mediterranean region, 1990-2013

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