Epidemiologia e Psichiatria Sociale

Special Articles

The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys*

Ronald C. Kesslera1 c1, Sergio Aguilar-Gaxiolaa2, Jordi Alonsoa3, Somnath Chatterjia4, Sing Leea5, Johan Ormela6, T. Bedirhan Üstüna7 and Philip S. Wanga8

a1 Department of Health Care Policy, Harvard Medical School, Boston

a2 University of California, Davis, School of Medicine, CTSC Building

a3 Health Services Research Unit, Institut Municipal d'Investigaciò Mèdica (IMIM-Hospital del Mar); CIBER en Epidemiologìa y Salud Pùblica (CIBERESP), Barcelona

a4 World Health Organization, Geneva

a5 Chinese University of Hong Kong,

a6 University Medical Center, Groningen, The Netherlands

a7 World Health Organization EIP/HFS

a8 National Institute of Mental Health

Abstract

Aims - The paper reviews recent findings from the WHO World Mental Health (WMH) surveys on the global burden of mental disorders. Methods - 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. Results - 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. Conclusions - 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

(Received April 23 2008)

(Revised April 23 2008)

(Accepted May 02 2008)

Correspondence

c1 Address for correspondence: Professor R.C. Kessler, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston MA 02115 (USA) Fax: 1-617-432-3588 E-mail: Kessler@hcp.med.harvard.edu

Footnotes

* Preparation of this paper was supported, in part, by the following grants from the US Public Health Service: U01MH060220, R01DA012058, R01MH070884 and R01DA016558. An earlier version of this paper was presented as a keynote address at the 8th National Congress of the Italian Society of Psychiatric Epidemiology in Florence, Italy on October 25, 2007. Portions of this paper appeared previously in Kessler, R.C., Ruscio, A.M., Shear, K., Wittchen, H.-U. (in press). The epidemiology of anxiety disorders. In M.M. Antony & M.B. Stein (Eds.), Handbook of Anxiety and the Anxiety Disorders. New York: Oxford University Press © Oxford University Press; Wang, P.S., Kessler, R.C. (2005). Global burden of mood disorders. In D. Stein, D. Kupfer & A. Schatzberg (Eds.), Textbook of Mood Disorders (pp. 55-67). Washington DC: American Psychiatric Publishing, Inc. © American Psychiatric Publishing, Inc. 2005; Kessler, R.C. (2007). The global burden of anxiety and mood disorders: Putting the European Study of the Epidemiology of Mental Disorders (ESEMeD) findings into perspective. Journal of Clinical Psychiatry 68 (suppl. 2), 10-19, © Physicians Postgraduate Press, Inc. 2007. All used with permission. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government.