The Burden Of Mental Health Disorders

The Burden Of Mental Health Disorders 

A blog by Lens of Curiosum

Whether an illness affects your heart, your arm or your brain, it’s still an illness, and there shouldn’t be any distinction…we should make it clear that getting help isn’t a sign of weakness ,it’s a sign of strength.- Michelle Obama

                          

 Team Credits

Ideation - Akshit Parekh

Drafting and Data Extraction- Devanshi Dagli, Khushi Mehta , Vinay Mhatre , Madhurima Vuddemarry                       

Writing- Srushti Gurav ,Madhurima Vuddemarry, Akshit Parekh

Visualizations - Madhurima Vuddemarry

Understanding the burden of mental health disorders in a global range

An overlooked centerpiece to the conversation around mental health disorders is the wide   margin of victims who succumb. 

Disability adjusted life years(DALYs) or the years of life lost due to the disability is used statistically to estimate the burden of mental health disorders.

WHO estimates that the burden of mental health problems in India is 2,443 disability-adjusted life years (DALYs) per 10000 population ,which translates to a prodigious loss of 2,443 years per 10000 population.

Major depressive disorder(MDD) ,generalized anxiety disorder(GAD) and post traumatic stress disorder (PTSD) have been estimated as the common mental health disorders(CMDs) globally. 

This blog attempts to understand the burden and risk factors associated with Major Depressive disorder and generalized anxiety. 

Understanding the burden of MDD in the context of age groups. 

The prevalence of depression in the age group 15 to 49 is significantly higher in  comparison to the rest of the age groups. The comparison was made across every 5 years from 1990 to 2019. In 1990, DALYs for age group 15-49 years is 685.17 and that for the rest of the age groups is 467.31, which translates to a loss of 685.17 years per 10000 population and a loss of 467.31 years per 10000 population for all age groups. Throughout three decades the DALYs for the age group 15-49 remained significantly higher than that of the general population. 

This places the age group of 15-49 at a high risk of developing MDD. 

https://datawrapper.dwcdn.net/62kSW/1/  

Understanding the burden of MDD in context of gender

The DALYs for females were in the range of 750-1500(per 10,000 population) while those for males were in the range of 400-700. Therefore, across 30 years, the DALYs for females were notably higher than males, suggesting that females were at a higher risk of developing MDD.

Understanding the burden of Generalized anxiety disorders

WHO estimates 301 million people living with anxiety disorders(AD) across the world. Some factors that may increase the risk of anxiety disorders are trauma  due to previous experiences, stress due to illness, drug or alcohol abuse, and patients in palliative care.

The DALYs due to Anxiety disorders across the globe are depicted as an annual rate of change. This is expressed for all groups and genders. The scale ranges from blue (indicating an annual decrease in the DALYs) to red (indicating an annual increase in the DALYs). Significant increases in the DALYs are observed in Brazil(1.27%), Mexico(1.1%), Nepal(0.94%) and Bangladesh(0.88%)  with Brazil leading the world in prevalence of ADs. This increase in prevalence across the South American and South Asian regions can be attributed to the socio-politico-environmental changes in the region over the course of 30 years. Financial recessions, unstable government ,epidemic of yellow fever and zika virus have significant impact on the mental well being of citizens. India shows an annual increase in the prevalence by 0.47%. 

Countries such as Japan(-0.59%) ,Italy(-0.31%) and the Scandinavian region manage to record an annual decrease in the prevalence of AD. 

Understanding the burden of anxiety disorders from India’s NMHS 2016.

The National mental health survey(NMHS) was conducted across 12 states in 2016. The current weighted prevalence of total ADs was 2.57% among the adult general population in the present survey. Among ADs, agoraphobia(an intense fear of being in open places or in situations where it may be hard to escape)was found to be the most common (1.6%), followed by GAD (0.57%).The highest distribution of ADs was among the age group 18-29.

Lack of literacy played a very important role in developing AD as highest prevalence was recorded in illiterate individuals with a maximum education of primary schooling.

Overall weighted prevalence of ADs among females was 1.67 times higher than males. The factors for female preponderance in ADs can be attributed to poor social support and differential access to care. In addition, women were susceptible to relapse more frequently compared to men.

Urbanization also played a significant role with people living in urban metros being 2.23 times more likely to be diagnosed with ADs compared to rural areas. A meta-analysis of studies on urban–rural differences in mental disorders showed a 21% increase in ADs in urban areas. Postulated reasons are overcrowding, poor social support, social isolation, migration, and poor quality of life. 

Economic burden due to MDD and AD.

Interestingly, the prevalence of AD (2.57%) is comparable with MDD(2.68%) in India.

Since AD and MDD most commonly affect those in the working-age group and their functionality, their  impact on individual and national economic burden is substantive. Impact on the quality of life(DALYs) is apparent through increasingly consistent  reports of work absenteeism among people with anxiety and depressive disorders.Apart from disability at work, people with AD and MDD report a significant disability in family and social life which sets up a vicious cycle of cause-effect-cause relationship among these disorders.

On ground reality of Dharavi.

A systematic observational study was carried out in Dharavi, a large slum in Asia where a prevalence of psychiatric conditions was found to be  12.5%. Affective disorders were the most common accounting for 42.7% of the total morbidity, followed by anxiety disorders (30.7%) and psychoses (21.3%). The adjusted odds ratios for psychiatric disorder were significantly higher for illiterates and those with primary education only (2.4), unemployed (2.1) and those with family history of a psychiatric disorder (1.9).