Abstract
BackgroundGlobally, depressive disorders are one of the most common forms of mental illness. Using data from the most recent Global Burden of Disease, Injury, and Risk Factor Study 2016 (GBD 2016), we aimed to describe the burden of disease attributable to depressive disorders in terms of prevalence and disability-adjusted life years (DALYs) in South Asia countries (namely India, Pakistan, Bangladesh, Nepal and Bhutan).MethodsGBD 2016 used epidemiological data on depressive disorders (major depression and dysthymia) from South Asia and a Bayesian meta-regression tool (DisMod-MR 2.1) to model prevalence and DALYs of depressive disorders by age, sex, country and year. DALYs were calculated from the years lived with disability (YLDs), derived from the prevalence of depressive disorders and disability weights, obtained from a community and internet-based surveys. The analyses adjusted for comorbidity, data sources and multiple modelling, and estimates were presented with 95% uncertainty intervals (UI).ResultsIn 2016, the age-standardised prevalence of depressive disorders in South Asia was 3.9% (95% UI: 3.6–4.2%), 4.4% (95% UI: 4.4–4.8%) in Bangladesh, 3.9% (95% UI: 3.6–4.2%) in India, 3.0% (95% UI: 2.8–3.3%) in Pakistan, 4.0% (95% UI: 3.7–4.3%) in Nepal and 3.7% (95% UI: 3.4–4.1%) in Bhutan. In South Asia, depressive disorders accounted for 9.8 million DALYs (95% UI: 6.8–13.2 million) or 577.8 (95% UI: 399.9–778.9) per 100,000 population in 2016. Of these, major depressive disorders (MDD) accounted for 7.8 million DALYs (95% UI: 5.3–10.5 million). India generated the largest numbers of DALYs due to depressive disorders and MDD, followed by Bangladesh and Pakistan. DALYs due to depressive disorders were highest in females and older adults (75–79 years) across all countries.ConclusionOur findings show the substantial public health burden of depressive disorders in South Asian populations and healthcare systems. Given the scale of depressive disorders, improvement in overall population health is possible if South Asian countries prioritise the prevention and treatment of depressive disorders.
Highlights
Depressive disorders are one of the most common forms of mental illness
years lived with disability (YLDs) and disability-adjusted life years (DALYs) due to depressive disorders In 2016, depressive disorders contributed 577.8 (95% uncertainty intervals (UI): 399.9–778.9) per 100,000 population in South Asian countries, an increase of 9% (Table 1) or a total of 9.8 million DALYs (95% UI: 6.8–13.2 million) in 2016 (Table 2)
In South Asia, major depressive disorder (MDD) accounted for 2% (95% UI: 1–3%) of the total cause of DALYs in 2016 for both sexes and all age groups and was ranked the 19th leading cause of disease burden – an increase from a ranking of 30th leading cause of disease burden in 1990, data not shown
Summary
Using data from the most recent Global Burden of Disease, Injury, and Risk Factor Study 2016 (GBD 2016), we aimed to describe the burden of disease attributable to depressive disorders in terms of prevalence and disability-adjusted life years (DALYs) in South Asia countries (namely India, Pakistan, Bangladesh, Nepal and Bhutan). Depressive disorders are one of the most common mental health illnesses worldwide, affecting approximately 121 million people and accounting for 5% of disability-adjusted life years (DALYs) globally [1, 2]. In many developing countries (including South Asia), there is an increasing societal awareness and better acknowledgement of mental illness [10, 17, 18] This increasing recognition of mental disorders in many communities has led to global, regional and national efforts to address the burden of mental illness, including depressive disorders [19, 20]
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