Epidemiologist, Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Can J Psychiatry. 2013 Sep;58(9):529-37. doi: 10.1177/070674371305800908.
Public Health Ontario and the Institute for Clinical Evaluative Sciences have collaborated to estimate the burden of illness attributable to mental disorder and addictions in Ontario.
Health-adjusted life years were used to estimate burden. It is conceptually similar to disability-adjusted life years that were used in the global burden of disease studies. Data sources for the mental illnesses and addictions used in our study included health administrative data for the province of Ontario, survey data from Statistics Canada and the Centre for Addiction and Mental Health, vital statistics data from the Ontario Office of the Registrar General, and US epidemiologic survey data.
The 5 conditions with the highest burden are: major depression, bipolar affective disorder, alcohol use disorders (AUDs), social phobia, and schizophrenia. The burden of depression is double the next highest mental health condition (that is, bipolar affective disorder) and is more than the combined burden of the 4 most common cancers in Ontario. AUDs were the only disease group that had a substantial proportion of burden attributable to early death. The burden estimates for the other conditions were primarily due to disability.
The burden of these conditions in Ontario is as large or larger than other conditions, such as cancer and infectious diseases, owing in large part to the high prevalence, chronicity, and age of onset for most mental disorders and addiction problems. The findings serve as an important baseline for future evaluation of interventions intended to address the burden of mental health and addictions.
安大略省公共卫生局和临床评估研究所合作，估计安大略省精神障碍和成瘾所致疾病负担。
使用健康调整生命年来估计负担。它在概念上类似于全球疾病负担研究中使用的残疾调整生命年。我们研究中使用的精神疾病和成瘾数据来源包括安大略省的健康管理数据、加拿大统计局和成瘾与心理健康中心的调查数据、安大略省注册总署的生命统计数据以及美国流行病学调查数据。
负担最高的 5 种疾病是：重度抑郁症、双相情感障碍、酒精使用障碍、社交恐惧症和精神分裂症。抑郁症的负担是下一个最高的心理健康状况（即双相情感障碍）的两倍，超过安大略省 4 种最常见癌症的总和。酒精使用障碍是唯一一个有相当一部分负担归因于早逝的疾病组。其他疾病的负担估计主要是由于残疾。
这些疾病在安大略省的负担与其他疾病一样大或更大，例如癌症和传染病，这在很大程度上是由于大多数精神障碍和成瘾问题的高患病率、慢性和发病年龄。这些发现为未来评估旨在解决精神健康和成瘾负担的干预措施提供了重要的基线。
