Rice D P, Miller L S
Institute for Health & Aging, University of California, San Francisco 94118, USA.
Br J Psychiatry Suppl. 1998(34):4-9.
Mental disorders impose a multi-billion dollar burden on the economy each year; translating the burden into economic terms is important to facilitate formulating policies about the use of resources.
For direct costs, data were obtained from national household interview and provider surveys; for morbidity costs, a timing model was used that measures the lifetime effect on current income of individuals with mental disorders, taking into account the timing of onset and the duration of these disorders, based on regression analysis of Epidemiologic Catchment Area study data.
The total economic costs of mental disorders amounted to US$147.8 billion in 1990. Anxiety disorders are the most costly, amounting to $46.6 billion, or 31.5% of the total; schizophrenic disorders accounted for $32.5 billion, affective disorders for $30.4 billion, and other mental disorders for $38.4 billion.
Mental illnesses, especially anxiety disorders, are costly to society. Although anxiety disorders have a higher prevalence than affective disorders and schizophrenia, use of medical care services is lowest for anxiety disorders. Anxiety disorders appear to be under-recognised and untreated even though treatment interventions have been shown to be effective and can be delivered in a cost-efficient manner.
精神障碍每年给经济带来数十亿美元的负担;将负担转化为经济术语对于促进制定资源使用政策很重要。
对于直接成本,数据来自全国家庭访谈和提供者调查;对于发病成本,使用了一种时间模型,该模型基于流行病学集水区研究数据的回归分析,衡量精神障碍患者对当前收入的终生影响,同时考虑到发病时间和这些障碍的持续时间。
1990年精神障碍的总经济成本达1478亿美元。焦虑症成本最高,达466亿美元,占总数的31.5%;精神分裂症占325亿美元,情感障碍占304亿美元,其他精神障碍占384亿美元。
精神疾病,尤其是焦虑症,对社会造成高昂成本。尽管焦虑症的患病率高于情感障碍和精神分裂症,但焦虑症的医疗服务使用率最低。尽管治疗干预已被证明有效且可以高效实施,但焦虑症似乎未得到充分认识和治疗。