Hu Teh-wei
University of California, Berkeley, CA 94720, USA.
J Ment Health Policy Econ. 2006 Mar;9(1):3-13.
Mental illness is a major group of disorder that can lead to both physical and emotional disability. Policymakers need to learn not only the epidemiological indicators of mental illness, such as prevalence rate and incidence rate, but also the size of its negative impact on the economy.
This study is to review international publications on cost of major mental illness literature, from 1990 to 2003, focusing on the concepts, methods, and future perspective of cost illness studies. Reviewing the status quo on costs of mental illness can provide further information about gaps, limitations, and future needs on this topic.
This review searched all major international journals in psychiatry, clinical psychology, health economics, and mental health policy published since 1990. All national or aggregate cost of mental illness studies were included in the review. All were individually reviewed using a conceptual framework of cost of illness methodology.
A large majority of published cost of mental illness studies were conducted in the US and UK. Cost of illness studies were lacking from Africa, Asia, Eastern Europe, and Latin America. Empirical results from the reviewed studies indicate that the negative economic consequences of mental illness far exceed the direct costs of treatment, thus making it important to treat mental illness. Direct treatment costs for each mental disorder (i.e. depression, schizophrenia, dementia, etc.) is between 1% and 2% of total national health care costs.
The studies reviewed indicate great variation in cost estimates even for the same mental disorder during the same time period within a country. These wide variations may be due to differences in disorder classification, definition of cost categories, sample populations, data sources, and discounting rate. Given the limitations of the cost of illness studies reviewed, one should be careful in interpreting and using these estimated results. IMPLICATIONS FOR HEALTH SERVICES: These cost studies can be useful for understanding the magnitude of treating an illness of economic consequences or economic consequences of an illness for purposes of planning or budgeting. Such studies are one way to inform policymakers about economic consequences of mental illness.
精神疾病是一大类疾病，可导致身体和情感残疾。政策制定者不仅需要了解精神疾病的流行病学指标，如患病率和发病率，还需要了解其对经济的负面影响程度。
本研究旨在回顾1990年至2003年期间关于主要精神疾病文献成本的国际出版物，重点关注疾病成本研究的概念、方法和未来展望。回顾精神疾病成本的现状可以提供有关该主题的差距、局限性和未来需求的更多信息。
本综述检索了自1990年以来在精神病学、临床心理学、卫生经济学和精神卫生政策领域发表的所有主要国际期刊。所有关于精神疾病研究的国家或总体成本均纳入综述。所有研究均使用疾病成本方法的概念框架进行单独审查。
绝大多数已发表的精神疾病成本研究是在美国和英国进行的。非洲、亚洲、东欧和拉丁美洲缺乏疾病成本研究。综述研究的实证结果表明，精神疾病的负面经济后果远远超过直接治疗成本，因此治疗精神疾病非常重要。每种精神障碍（即抑郁症、精神分裂症、痴呆症等）的直接治疗成本占国家医疗保健总成本的1%至2%。
综述研究表明，即使在同一国家的同一时期，即使对于同一种精神障碍，成本估计也存在很大差异。这些巨大差异可能是由于疾病分类、成本类别定义、样本人群、数据来源和贴现率的不同。鉴于所综述的疾病成本研究的局限性，在解释和使用这些估计结果时应谨慎。对卫生服务的启示：这些成本研究对于理解治疗疾病所产生的经济后果或疾病的经济后果的规模，以便进行规划或预算编制可能是有用的。此类研究是向政策制定者通报精神疾病经济后果的一种方式。
