Economic Burden Of Mental Disorders Research Articles

Effects of ambient air pollution on the hospitalization risk and economic burden of mental disorders in Qingdao, China.

The aim of this study was to examine the impacts of short-term exposure to air pollutants on hospitalizations for mental disorders (MDs) in Qingdao, a Chinese coastal city, and to assess the corresponding hospitalization risk and economic cost. Daily data on MD hospitalizations and environmental variables were collected from January 1, 2015, to December 31, 2019. An overdispersed generalized additive model was used to estimate the association between air pollution and MD hospitalizations. The cost of illness method was applied to calculate the corresponding economic burden. With each 10μg/m3 increase in the concentration of fine particulate matter (PM2.5) at lag05, inhalable particulate matter (PM10) at lag0, sulfur dioxide (SO2) at lag06 and ozone (O3) at lag0, the corresponding relative risks (RRs) and 95% confidence intervals (CIs) were 1.0182 (1.0035-1.0332), 1.0063 (1.0001-1.0126), 1.0997 (1.0200-1.1885) and 1.0099 (1.0005-1.0194), respectively. However, no significant effects of nitrogen dioxide (NO2) or carbon monoxide (CO) were found. Stratified analysis showed that males were susceptible to SO2 and O3, while females were susceptible to PM2.5. Older individuals (≥ 45years) were more vulnerable to air pollutants (PM2.5, PM10, SO2 and O3) than younger individuals (< 45years). Taking the Global Air Quality Guidelines 2021 as a reference, 8.71% (2,168 cases) of MD hospitalizations were attributable to air pollutant exposure, with a total economic burden of 154.36 million RMB. Short-term exposure to air pollution was associated with an increased risk of hospitalization for MDs. The economic advantages of further reducing air pollution are enormous.

The economic burden of mental disorders: results from the Netherlands mental health survey and incidence study-2.

Currently, there is a paucity of up-to-date estimates of the economic burden caused by mental disorders. Such information could provide vital insight into one of the most serious and costly-yet to some extent preventable-health challenges facing the world today. Data from a national psychiatric-epidemiological cohort study (NEMESIS-2, N = 6506) were used to provide reliable, relevant, and up-to-date cost estimates (in 2019 Euro) regarding healthcare costs, productivity losses, and patient and family costs associated with DSM-IV mental disorders both at individual level, but also in the general population and in the workforce of the Netherlands (per 1 million population). In the general population, the costs of mood disorders, specifically depression, are substantial and rank above those from the anxiety disorders, whilst costs of anxiety disorders are more substantial than those stemming from substance use disorders, even when the per-person costs of drug abuse appear highest of all. In the workforce, specific and social phobias are leading causes of excess costs. The workforce has lower healthcare costs but higher productivity costs than general population. The findings suggest that (preventive) healthcare interventions targeting the workforce are likely to become cost-effective and underscore the importance for employers to create healthy work environments. Overall, the results highlight the need to strengthen the role of mental health promotion and prevention of mental disorders in the social domain before people require treatment to reduce the staggering and costly burden caused by mental disorders to individuals and society.

Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems

In view of the staggering disease and economic burden of mental disorders, internet and mobile-based interventions (IMIs) targeting mental disorders have often been touted to be cost-effective; however, available evidence is inconclusive and outdated. This review aimed to provide an overview of the cost-effectiveness of IMIs for mental disorders and symptoms. A systematic search was conducted for trial-based economic evaluations published before 10th May 2021. Electronic databases (including MEDLINE, PsycINFO, CENTRAL, PSYNDEX, and NHS Economic Evaluations Database) were searched for randomized controlled trials examining IMIs targeting mental disorders and symptoms and conducting a full health economic evaluation. Methodological quality and risk of bias were assessed. Cost-effectiveness was assumed at or below £30,000 per quality-adjusted life year gained. Of the 4044 studies, 36 economic evaluations were reviewed. Guided IMIs were likely to be cost-effective in depression and anxiety. The quality of most evaluations was good, albeit with some risks of bias. Heterogeneity across studies was high because of factors such as different costing methods, design, comparison groups, and outcomes used. IMIs for anxiety and depression have potential to be cost-effective. However, more research is needed into unguided (preventive) IMIs with active control conditions (e.g., treatment as usual) and longer time horizon across a wider range of disorders.Trial registration: PROSPERO Registration No. CRD42018093808.

The economic burden of mental disorders among adults in Singapore: evidence from the 2016 Singapore Mental Health Study

Background Little is known about the economic burden of mental disorders in multiethnic Asian populations. Aims The study aimed to estimate the economic cost of mental disorders in Singapore using data from the second Singapore Mental Health Study (SMHS 2016). Method The SMHS 2016 is a nationally representative survey of the Singapore Resident population aged 18 years and above. Data on mental disorders and healthcare resource utilization were obtained from the World Mental Health Composite International Diagnostic Interview and the adapted version of the Client Service Receipt Inventory. Results The costs of visits to a restructured hospital doctor, other private health workers, accident and emergency, and intermediate and long-term care services and productivity losses tend to be much higher in those with mental disorders than those without mental disorders. The average annual excess cost associated with mental disorders per person was estimated to be S$3938.9 (95% CI, S$-100.8–S$7978.7). Extrapolation of these excess costs to the population suggests that the incremental costs of mental disorders in Singapore is about S$1.7 billion per year. Conclusion This study provides evidence of the substantial burden of mental disorders on Singaporean society – both in terms of direct medical costs and loss of productivity costs.

'Precision' or 'personalized' psychiatry: different terms - same content?

Due to the increased lifetime prevalence and personal, social, and economic burden of mental disorders, psychiatry is in need of a significant change in several aspects of its clinical and research approaches. Over the last few decades, the development of personalized / precision medicine in psychiatry focusing on tailored therapies that fit each patient's unique individual, physiological, and genetic profile has not achieved the same results as those obtained in other branches, such as oncology. The long-awaited revolution has not yet surfaced. There are various explanations for this including imprecise diagnostic criteria, incomplete understanding of the molecular pathology involved, absence of available clinical tools and, finally, the characteristics of the patient. Since then, the co-existence of the two terms has sparked a great deal of discussion around the definition and differentiation between the two types of psychiatry, as they often seem similar or even superimposable. Generally, the two terminologies are used indiscriminately, alternatively, and / or separately, within the same scientific works. In this paper, an overview is provided on the overlap between the application and meaning of the terms 'precision psychiatry' and 'personalized psychiatry'.

The excess economic burden of mental disorders: findings from a cross-sectional prevalence survey in Austria

Information about the scope of mental disorders (MDs), resource use patterns in health and social care sectors and economic cost is crucial for adequate mental healthcare planning. This study provides the first representative estimates about the overall utilisation of resources by people with MDs and the excess healthcare and productivity loss costs associated with MDs in Austria. Data were collected in a cross-sectional survey conducted on a representative sample (n = 1008) between June 2015 and June 2016. Information on mental health diagnoses, 12-month health and social care use, medication use, comorbidities, informal care, early retirement, sick leave and unemployment was collected via face-to-face interviews. Generalised linear model was used to assess the excess cost of MDs. The healthcare cost was 37% higher (p = 0.06) and the total cost was twice as high (p < 0.001) for the respondents with MDs compared to those without MDs. Lost productivity cost was over 2.5-times higher (p < 0.001) for those with MDs. Participants with severe MDs had over 2.5-times higher health and social care cost (p < 0.001) and 9-times higher mental health services cost (p < 0.001), compared to those with non-severe MDs. The presence of two or more physical comorbidities was a statistically significant determinant of the total cost. Findings suggest that the overall excess economic burden on health and social care depends on the severity of MDs and the number of comorbidities. Both non-severe and severe MDs contribute to substantially higher loss productivity costs compared to no MDs. Future resource allocation and service planning should take this into consideration.

T153. THE ECONOMIC BURDEN OF MENTAL DISORDERS: A SYSTEMATIC REVIEW

BackgroundAbout a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders.MethodsSystematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses; (2) diagnosis of at least one mental disorder (3) samples based on the general population; (4) outcome in monetary units.13,640 publications were screened by their title/abstract and 439 articles were full-text screened by two independent reviewers. 113 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 144 included articles. Of these, 41 studies had estimates of the economic burden among people with schizophrenia.ResultsInformation about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies.An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality.DiscussionTo the best of our knowledge, this is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policy-making.

Exercise and Schizophrenia.

Schizophrenia is a psychiatric disorder characterized by distortions of thinking and perception, with no strictly pathognomonic symptoms that can be divided into positive, negative, and cognitive symptom domains. People with schizophrenia have, between others, a reduced life expectancy and cardiorespiratory and muscular fitness and increased risk of cardiovascular disease, metabolic syndrome, obesity, hypertension, and hyperlipidemia compared to the general population. Furthermore, the economic burden of mental disorders including schizophrenia is evident and it is expected to increase to more than double by 2030. Therefore, reducing the growing burden of mental disorders such as schizophrenia should be a health priority. Improved prevention and treatment are two key factors that may reduce the burden of schizophrenia. Pharmacological- and psychotherapy-based interventions have been traditionally considered for treating schizophrenia disorders; however, there is an increasing amount of scientific evidence confirming that physical activity and physical exercise should be highly considered in prevention and treatment of schizophrenia disorders. In this chapter, we aim to summarize and discuss the research progress of physical activity and exercise in prevention and treatment of schizophrenia disorder. Specifically, we summarized and discussed the research progress of the prognostic use of physical activity for incident schizophrenia; the importance of other outcomes typically improved by physical activity/exercise such as obesity and fitness (cardiorespiratory and muscular fitness) for future schizophrenia; the research progress of the evidence of the benefits of exercise in people with schizophrenia disorders differentiating between effects of exercise on varied health outcomes, cognitive functioning, and cardiorespiratory fitness; and finally the clinical practice recommendations.

The Impact of Air Pollution on Attributable Risks and Economic Costs of Hospitalization for Mental Disorders

This study aims to fill the gap in our understanding about exposure to particulate matters with diameter less than 2.5 μm (PM2.5) and attributable risks and economic costs of mental disorders (MDs). We identify the relationship between PM2.5 and risk of hospital admissions (HAs) for MDs in Beijing and measure the attributable risk and economic cost. We apply a generalized additive model (GAM) with controls for time trend, meteorological conditions, holidays and day of the week. Stratified analyses are performed by age, gender and season. We further estimate health and economic burden of HAs for MDs attributable to PM2.5. A total of 17,252 HAs for MDs are collected. We show that PM2.5 accounts for substantial morbidity and economic burden of MDs. Specifically, a 10 μg/m3 daily increase in PM2.5 is associated with a 3.55% increase in the risk of HAs for MDs, and the effect is more pronounced for older males in colder weather. According to the WHO's air quality guidelines, 15.12 percent of HAs and 16.19 percent of related medical expenses for MDs are respectively attributable to PM2.5.

Exercise and Depressive Disorder.

Depression is a psychiatric disorder characterized by low mood, loss of interest/enjoyment, and reduced energy and one of the five leading causes of disability and a major contributor to all-cause mortality worldwide. People with depression have, between others, a reduced life expectancy, worse quality of life and cardiorespiratory fitness, and increased risk of type 2 diabetes, compared to the general population. Furthermore, the economic burden of mental disorders including depression is evident, and it is expected to increase to more than double by 2030. Therefore, reducing the growing burden of mental disorders such as depression should be a health priority. Improved prevention and treatment are two key factors that may reduce the burden of depression. Pharmacological- and psychotherapy-based interventions have been traditionally considered for treating depression disorders; however, there is an increasing amount of scientific evidence confirming that physical activity and physical exercise should be highly considered in prevention and treatment of depressive disorders. In this chapter, we aim to summarize and discuss the research progress of physical activity and exercise in prevention and treatment of depressive disorder. Specifically, we summarized and discussed the research progress of the prognostic use of physical activity for incident depression, the importance of sedentary behavior and other outcomes typically improved by physical activity/exercise such as cardiorespiratory fitness for future depression, the research progress of the evidence of the benefits of exercise in people with depression disorders, the resistance training effects in adults and older adults with depression, and the recommendations for the prescription of exercise for people with depression.

The economic burden of mental disorders in children and adolescents in China: a cross-sectional study

BackgroundMental disorders of children and adolescents, as a major contributor to disease burden in both developed and developing countries, have gained much attention from researchers and policy makers. This study aimed to estimate the economic burden of mental disorders in children and adolescents in China. MethodsWe obtained data from electronic medical records of 107 hospitals in 2017, which we selected from Shandong province using multi-stage stratified random sampling methods. We included 3378 inpatient and 47859 outpatient records of patients aged 18 years or younger who were diagnosed with mental disorders (classified under the tenth revision of the International Classification of Diseases, codes F00–F99). Prevalence, population, and gross domestic product per capita were derived from Health Statistical Yearbook of China while disability weight and productivity weight were derived from previous research. We used a prevalence-based bottom-up approach and an estimation model to estimate the total economic burden. The total burden contains the direct burden, indicating direct medical costs to patients and their families, and indirect burden, including the economic loss to patients' families represented by the wage loss of patients' caregivers, and economic burden to society due to the loss of quality of life and productivity for the patients, also termed social costs. FindingsThe total economic burden of mental disorders in children and adolescents in 2017 was US$1·191 billion. The direct burden was $565 million (comprising $351 million from inpatients and $213 million from outpatients), and would have increased to $49 billion if all patients had sought professional therapy. The indirect costs were $1653 for each family and $47 billion in the whole country because of the working time loss of caregivers. We estimated 1287 disability-adjusted life-years per 1000 people, and the indirect cost to society was $1181 billion. Additionally, the direct medical costs of female patients, $342 million, was higher than those of male patients ($226 million. By contrast, the estimate of indirect burden on society of male patients ($627 billion) was larger than that of female patients ($554 billion). InterpretationMental disorders in children and adolescents have led to a considerable economic burden for both individuals and society. More effective prevention measures and more preferential policies should be adopted to cut down economic burdens caused by mental disorders in children and adolescents. FundingNational Natural Science Foundation of China (71373146).

Mental health challenges raised by rapid economic and social transformations in China: a systematic review

BackgroundWith the largest proportion of world's total population, the mental health pandemic in China and related challenges of treating mental disorders could influence the accomplishment of UN Sustainable Development Goals, which include mental health. Therefore, understanding China's current mental health status after rapid economic and social transformations, including urbanisation, industrialisation, globalisation and informatisation, could strengthen awareness of mental health, and aid the proposal of solutions to prevent and control mental disorders. MethodsWe did a systematic search of the literature using PubMed, Embase, PsycINFO, CNKI, and Wanfang databases to find relevant studies published between Jan 1, 1990, and Dec 31, 2018. Articles in English and Chinese were included. The search terms included “urbanisation”, “industrialisation”, “globalisation”, “informatisation”, “mental disorders[MeSH Term]” and “China”. FindingsDuring the past three decades, both the disease and economic burden of mental disorders have increased in China. Rapid urbanisation and industrialisation have resulted in increasing internal migration and left-behind families, who have poorer mental health status than their peers. The ageing population will lead to higher prevalence of mental and neurological disorders, such as depression and dementia. Adoption of unhealthy diets can directly affect mental health, as well as indirectly by facilitating intermediate risk factors such as obesity. Increased alcohol intake and smoking can induce increased alcohol and nicotine dependence, and even illicit drug abuse. Additionally, internet and social media use can not only increase internet or gaming addiction, but also facilitate exposure and delivery channels via the internet. The growth of urbanisation and manufactories has also increased air, light, and noise pollution that can further induce mental problems. InterpretationSocial and economic transformations have triggered increasing disease and economic burden of mental disorders. We propose three priorities to deal with these challenges: identify social and economic effects on mental health on the basis of high-quality qualitative and quantitative analysis, improve mental health awareness and literacy, and enhance the mental health-care system and promote implementation research. Lessons from China can be a great reference for low-and-middle-income countries (LMICs) and upper-middle-income countries in prevention and control mental disorders. FundingNational Natural Science Foundation of China.

Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study

ObjectivesTo provide cost burden estimates and long-term trend forecast of mental disorders that need hospitalisations in Shanghai, China.DesignDaily hospital admissions and medical expenditures for mental disorder hospitalisations between 1 January...

Clinical and Economic Burden of Mental Disorders Among Children With Chronic Physical Conditions, United States, 2008-2013.

IntroductionThe prevalence of chronic physical and mental disorders is increasing among children and adolescents in the United States. In this study, we investigated the association between mental health disorders and chronic physical conditions among children, and we assessed whether having mental disorders is associated with increased health care costs for children with chronic physical conditions, using Medical Expenditure Panel Survey data from 2008 through 2013.MethodsChildren aged 5 to 17 with at least 1 chronic physical condition were included in the study. Chronic physical conditions and mental disorders were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes. We used logistic regression to assess the relationship between mental disorders and chronic physical conditions, and we used generalized linear models with gamma distribution and log link to estimate direct medical costs.ResultsOf 42,130 children, 4,640 had at least 1 chronic physical condition. After controlling for sociodemographic and health care access characteristics, we found that children with at least 1 chronic physical condition were 62% more likely to have a mental health disorder than were children without chronic physical conditions (odds ratio = 1.62; 95% confidence interval [CI], 1.37–1.92). Having a mental disorder was a significant predictor of total health care cost (β = 0.64; 95% CI, 0.43–0.85; P < .001). The adjusted annual incremental cost due to mental disorders among children with chronic physical conditions was $2,631 (P < .001).ConclusionHaving chronic physical conditions in childhood is a significant predictor of mental health disorders and total health care expenditures.

The economic burden of mental disorders in China, 2005-2013: implications for health policy.

BackgroundMental disorders represent a major contributor to disease burden worldwide. We sought to quantify the national economic burden of mental disorders in China.MethodsWe used a prevalence-based, bottom-up approach to estimate the economic costs of mental disorders in 2005–2013 in China. Prevalence data were derived from a national survey. Cost data were derived from the electronic health records of two psychiatric hospitals that consisted of 25,289 outpatients (10 %) and inpatients (90 %) who were diagnosed with a mental disorder. Cost items included direct medical costs, direct non-medical costs, and indirect costs.ResultsThe total annual costs of mental disorders in China increased from $1,094.8 in 2005 to $3,665.4 in 2013 for individual patients, and from $21.0 billion to $88.8 billion for the whole society. The total costs of mental disorders in 2013 accounted for more than 15 % of the total health expenditure in China, and 1.1 % of China’s gross domestic product. If the needs of the professional care for all patients with mental illnesses were fully met, the potential economic costs would have been almost five times higher than the actual estimated costs.ConclusionsMental disorders imposed a huge economic burden on individuals and the society in China. A nation-wide strategic action plan for preventing mental disorders and promoting mental health and well-being is in urgent need to reduce the individual and societal costs of mental illnesses.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0839-0) contains supplementary material, which is available to authorized users.

PHS105 - Clinical and Economic Burden of Mental Disorders in Children with Chronic Physical Conditions in the United States

PHS105 - Clinical and Economic Burden of Mental Disorders in Children with Chronic Physical Conditions in the United States

The Economic Burden of Mental Disorders in Korea

The Economic Burden of Mental Disorders in Korea

Assessing the Economic Costs of Serious Mental Illness

Assessing the Economic Costs of Serious Mental Illness