1 Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, SA, Australia.
2 School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
Aust N Z J Psychiatry. 2018 May;52(5):483-490. doi: 10.1177/0004867417751641. Epub 2018 Jan 11.
Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia.
For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates.
Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015.
Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.
及时、准确地评估疾病负担对于制定有效的国家卫生政策至关重要。本研究使用 2015 年全球疾病负担研究来评估澳大利亚的精神和物质使用障碍疾病负担。
对 2015 年全球疾病负担研究中包含的 20 种精神和物质使用障碍进行了系统的文献回顾,利用贝叶斯荟萃回归工具对数据进行建模,以产生按年龄、性别、地理位置和年份的患病率估计值。然后,将每种疾病的患病率与特定疾病的残疾权重相结合,以给出失能生命年,作为非致死性负担的衡量标准。通过将因疾病而导致的死亡人数与死亡时剩余的预期寿命相结合,计算因过早死亡而导致的生命损失年,作为死亡负担的衡量标准。将失能生命年和生命损失年相加,计算残疾调整生命年,以衡量总负担。对所有负担估计值都进行了不确定性计算。
2015 年,精神和物质使用障碍是澳大利亚非致死性负担的主要原因,占失能生命年的 24.3%,也是总负担的第二大原因,占残疾调整生命年的 14.6%。1990 年至 2015 年,精神和物质使用障碍的年龄标准化残疾调整生命年率没有显著变化。
2015 年全球疾病负担研究发现,精神和物质使用障碍是澳大利亚疾病负担的主要原因。尽管国家进行了几十年的改革,但 1990 年至 2015 年期间,精神和物质使用障碍的负担基本没有变化。为了降低这种负担,除了需要有效的、持续时间和覆盖面足够的干预措施外,还需要有效的人群预防策略。