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Non-fatal burden of disease due to mental disorders in the Netherlands
Joran Lokkerbol1, Dirk Adema, Ron de Graaf
1Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 724, 3500 AS, Utrecht, The Netherlands, jlokkerbol@trimbos.nl.
Purpose:
To estimate the disease burden due to 15 mental disorders at both individual and population level.
Methods:
Using a population-based survey (NEMESIS, N = 7,056) the number of years lived with disability per one million population were assessed. This was done with and without adjustment for comorbidity.
Results:
At individual level, major depression, dysthymia, bipolar disorder, panic disorder, social phobia, eating disorder and schizophrenia are the disorders most markedly associated with health-related quality of life decrement. However, at population level, the number of affected people and the amount of time spent in an adverse health state become strong drivers of population ill-health. Simple phobia, social phobia, depression, dysthymia and alcohol dependence emerged as public health priorities.
Conclusions:
From a clinical perspective, we tend to give priority to the disorders that exact a heavy toll on individuals. This puts the spotlight on disorders such as bipolar disorder and schizophrenia. However, from a public health perspective, disorders such as simple phobia, social phobia and dysthymia--which are highly prevalent and tend to run a chronic course--are identified as leading causes of population ill-health, and thus, emerge as public health priorities.
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