Abstract
Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease. Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8%) of global YLDs and dysthymia for 1.4% (0.9%-2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2%) of global DALYs and dysthymia for 0.5% (0.3%-0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8%) to 3.8% (3.0%-4.7%) of global DALYs. GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. Please see later in the article for the Editors' Summary.
Highlights
Depressive disorders are common mental disorders, occurring as early as 3 years of age and across all world regions [1,2,3]
major depressive disorder (MDD) was a contributor of burden allocated to suicide and ischemic heart disease
One disability adjusted life years (DALY) represents the loss of a healthy year of life and aggregates the years of life lived with disability (YLD) with the years of life lost due to premature mortality (YLL) [4,5,6]
Summary
Depressive disorders are common mental disorders, occurring as early as 3 years of age and across all world regions [1,2,3]. GBD 1990 ranked depressive disorders as the fourth leading cause of burden worldwide (equivalent to 3.7% of all DALYs) after lower respiratory infections, diarrhoeal diseases, and conditions arising during the perinatal period [4]. In GBD 2000, depressive disorders were the third leading cause of burden (equivalent to 4.3% of all DALYs) after lower respiratory infections and diarrhoeal diseases. It was the leading cause of disability, responsible for 13.4% of YLDs in women and 8.3% in men [8]. Both these subtypes of depression (and others such as that experienced in bipolar disorder) can be treated with antidepressant drugs and with talking therapies
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