1990 - 2013年东地中海区域精神障碍负担
The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013.
作者信息
Charara Raghid, Forouzanfar Mohammad, Naghavi Mohsen, Moradi-Lakeh Maziar, Afshin Ashkan, Vos Theo, Daoud Farah, Wang Haidong, El Bcheraoui Charbel, Khalil Ibrahim, Hamadeh Randah R, Khosravi Ardeshir, Rahimi-Movaghar Vafa, Khader Yousef, Al-Hamad Nawal, Makhlouf Obermeyer Carla, Rafay Anwar, Asghar Rana, Rana Saleem M, Shaheen Amira, Abu-Rmeileh Niveen M E, Husseini Abdullatif, Abu-Raddad Laith J, Khoja Tawfik, Al Rayess Zulfa A, AlBuhairan Fadia S, Hsairi Mohamed, Alomari Mahmoud A, Ali Raghib, Roshandel Gholamreza, Terkawi Abdullah Sulieman, Hamidi Samer, Refaat Amany H, Westerman Ronny, Kiadaliri Aliasghar Ahmad, Akanda Ali S, Ali Syed Danish, Bacha Umar, Badawi Alaa, Bazargan-Hejazi Shahrzad, Faghmous Imad A D, Fereshtehnejad Seyed-Mohammad, Fischer Florian, Jonas Jost B, Kuate Defo Barthelemy, Mehari Alem, Omer Saad B, Pourmalek Farshad, Uthman Olalekan A, Mokdad Ali A, Maalouf Fadi T, Abd-Allah Foad, Akseer Nadia, Arya Dinesh, Borschmann Rohan, Brazinova Alexandra, Brugha Traolach S, Catalá-López Ferrán, Degenhardt Louisa, Ferrari Alize, Haro Josep Maria, Horino Masako, Hornberger John C, Huang Hsiang, Kieling Christian, Kim Daniel, Kim Yunjin, Knudsen Ann Kristin, Mitchell Philip B, Patton George, Sagar Rajesh, Satpathy Maheswar, Savuon Kim, Seedat Soraya, Shiue Ivy, Skogen Jens Christoffer, Stein Dan J, Tabb Karen M, Whiteford Harvey A, Yip Paul, Yonemoto Naohiro, Murray Christopher J L, Mokdad Ali H
机构信息
Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America.
Preventive Medicine and Public Health Research Center, Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran.
出版信息
PLoS One. 2017 Jan 17;12(1):e0169575. doi: 10.1371/journal.pone.0169575. eCollection 2017.
The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.
东地中海区域（EMR）的慢性疾病，包括精神疾病，正在呈上升趋势。随着动荡局势持续，预计这一趋势还会加剧。这是第一项对东地中海区域精神障碍负担进行量化的研究。我们使用了《2013年全球疾病负担研究》（GBD）的数据。伤残调整生命年（DALYs）可用于评估过早死亡（生命损失年数 - YLLs）和非致命后果（带病生存年数 - YLDs）。DALYs通过将每个年龄 - 性别 - 国家组的YLLs和YLDs相加来计算。2013年，精神障碍占东地中海区域总疾病负担的5.6%（每10万人口中有1894个DALYs）：高收入国家为每10万人口2519个DALYs（男性每10万人口中有2590个，女性每10万人口中有2426个），中等收入国家为每10万人口1884个DALYs（男性每10万人口中有1618个，女性每10万人口中有2157个），低收入国家为每10万人口1607个DALYs（男性每10万人口中有1500个，女性每10万人口中有1717个）。除15岁以下人群外，同年龄段女性因精神障碍导致的负担比例高于男性。DALYs比例最高的年龄段为25 - 49岁，在35 - 39岁年龄组达到峰值（每10万人口中有5344个DALYs）。东地中海区域精神障碍负担从1990年的每10万人口1726个DALYs增加到2013年的每10万人口1912个DALYs（增长了10.8%）。在东地中海区域的精神障碍类别中，抑郁症导致的DALYs最多，其次是焦虑症。在东地中海区域各国中，巴勒斯坦的精神障碍负担最重。几乎所有东地中海区域国家的精神障碍负担都高于全球水平。我们的研究结果呼吁东地中海区域各国卫生部增加心理健康服务的提供，并消除对精神疾病的污名化。此外，鉴于该地区不稳定程度不断加剧，我们的研究结果显示心理健康负担加速加重，令人担忧。事实上，如果心理健康问题得不到妥善解决，将导致该地区疾病负担增加。
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