Abstract
The current study aims to evaluate the burden of disease in Singapore by estimating the quality-adjusted life years (QALYs) lost due to mental disorders and chronic physical conditions. The second Singapore Mental Health Study (SMHS-2016) was conducted in 2016 among 6126 respondents aged 18 years and above. The World Health Organization Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0) and a modified version of the CIDI chronic medical disorders checklist were used to assess the 12-month diagnoses of mental and chronic physical disorders while the SF-6D scores derived from the 12-item Short Form Health Survey instrument was used to estimate the QALYs lost. The mean SF-6D score in this population was 0.87. The largest reduction in SF-6D scores among people with mental disorders was observed in Generalized Anxiety Disorder (GAD), followed by Major Depressive Disorder (MDD), alcohol abuse, bipolar disorder and Obsessive Compulsive Disorder (OCD) while the largest reduction in SF-6D score among people with chronic physical conditions was observed in ulcer, followed by lung disease, chronic pain and cardiovascular disease. At the population level, chronic pain was associated with the greatest QALY loss followed by MDD (14,204 and 6,889 respectively). Lung disease was associated with the smallest QALY loss (376). These findings highlight chronic pain, MDD, OCD, cardiovascular disease and GAD as the five leading contributors of QALYs lost in the general population which deserve prioritisation in public health prevention programmes.
Highlights
Between 1990 and 2017, the decline in mortality rates has been associated globally with increasing life span, and an ageing population which has translated into an increase in the magnitude of the non-fatal disease burden[1]
It was found that the impact of the two mood disorders - major depressive disorders (MDD) and bipolar disorder, as well as one of the anxiety disorders - obsessive compulsive disorder (OCD), examined in the study were associated with significantly larger qualityadjusted life years (QALYs) losses than the impact of any chronic physical condition at an individual level[9]
This study has revealed that a number of mental and chronic physical conditions in Singapore were significantly associated with substantial QALY loss at the societal level and a significant decrease in health utility scores at an individual level
Summary
Between 1990 and 2017, the decline in mortality rates has been associated globally with increasing life span, and an ageing population which has translated into an increase in the magnitude of the non-fatal disease burden[1]. The value is interpreted as the annual loss in QALYs resulting from the disorder, without considering mortality[9,14,15] This method is commonly used to www.nature.com/scientificreports measure the burden of disease in the general population so that health services and initiatives can be planned to target the relevant chronic disorder that has a higher impact on the individual and the society. Previous studies have investigated the impact of mental and physical disorders on QALY in the general population[9], little is known about the change in the prevalence of these conditions over the years and its impact on QALYs. the current study aims to estimate QALYs lost due to mental disorders and chronic physical conditions in Singapore using the recent data from the second SMHS-2016
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