Kessler Ronald C, Aguilar-Gaxiola Sergio, Alonso Jordi, Chatterji Somnath, Lee Sing, Ormel Johan, Ustün T Bedirhan, Wang Philip S
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA.
Epidemiol Psichiatr Soc. 2009 Jan-Mar;18(1):23-33. doi: 10.1017/s1121189x00001421.
The paper reviews recent findings from the WHO World Mental Health (WMH) surveys on the global burden of mental disorders.
The WMH surveys are representative community surveys in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, distribution, burden, and unmet need for treatment of common mental disorders.
The first 17 WMH surveys show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, externalizing, and substance use disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4-6.8% in half the countries, 2.3-3.6% in one-fourth, and 0.8-1.9% in one-fourth. Many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions in the WMH data. Adult mental disorders are found to be associated with such high role impairment in the WMH data that available clinical interventions could have positive cost-effectiveness ratios.
Mental disorders are commonly occurring and often seriously impairing in many countries throughout the world. Expansion of treatment could be cost-effective from both employer and societal perspectives.
本文回顾了世界卫生组织世界心理健康（WMH）调查关于精神障碍全球负担的近期研究结果。
WMH调查是对全球28个国家具有代表性的社区调查，旨在为心理健康政策制定者提供有关常见精神障碍的患病率、分布、负担以及未满足的治疗需求的信息。
前17次WMH调查显示，精神障碍在所有参与国家普遍存在。终生DSM-IV障碍患病率估计值（合并焦虑、情绪、外化和物质使用障碍）的四分位间距（IQR：第25至75百分位数）为18.1%至36.1%。12个月患病率估计值的IQR为9.8%至19.1%。在一半的国家中，12个月严重精神疾病（SMI）的患病率估计为4%至6.8%，四分之一的国家为2.3%至3.6%，四分之一的国家为0.8%至1.9%。在WMH数据中，许多精神障碍始于儿童期至青少年期，并对随后的角色转变产生重大不利影响。在WMH数据中发现，成人精神障碍与如此高的角色损害相关，以至于现有的临床干预措施可能具有积极的成本效益比。
精神障碍在世界许多国家普遍存在，且常常严重损害功能。从雇主和社会的角度来看，扩大治疗可能具有成本效益。
