Is the global prevalence rate of adult mental illness increasing? Systematic review and meta‐analysis

Abstract

Is the global prevalence rate of adult mental illness increasing? Systematic review and meta-analysis Richter D, Wall A, Bruen A, Whittington R. Is the global prevalence rate of adult mental illness increasing? Systematic review and metaanalysis Objectives: The question whether mental illness prevalence rates are increasing is a controversially debated topic. Epidemiological articles and review publications that look into this research issue are often compromised by methodological problems. The present study aimed at using a meta-analysis technique that is usually applied for the analysis of intervention studies to achieve more transparency and statistical precision. Methods: We searched PubMed, PsycINFO, CINAHL, Google Scholar and reference lists for repeated cross-sectional population studies on prevalence rates of adult mental illness based on ICD-or DSM-based diagnoses, symptom scales and distress scales that used the same methodological approach at least twice in the same geographical region. The study is registered with PROSPERO (CRD42018090959). Results: We included 44 samples from 42 publications, representing 1 035 697 primary observations for the first time point and 783 897 primary observations for the second and last time point. Studies were conducted between 1978 and 2015. Controlling for a hierarchical data structure, we found an overall global prevalence increase in odds ratio of 1.179 (95%-CI: 1.065-1.305). A multivariate meta-regression suggested relevant associations with methodological characteristics of included studies. Conclusions: We conclude that the prevalence increase in adult mental illness is small, and we assume that this increase is mainly related to demographic changes. Summations• The issue of potentially increasing prevalence rates of mental illness is controversial. • Using a meta-analysis, we found a small increase in prevalence rates over time.• The increase may be due to demographic changes in current societies. Limitations• There is a scarcity of data from non-Western regions.• The coverage of mental illness is unevenly distributed.• No data on prevalence changes of psychosis/schizophrenia were available.

An epidemic or a plague of common mental disorders?

“…Given Richter et al's new study and other corroborating evidence, we can probably summarize: The prevalence of common mental disorders may be increasing modestly in the recent decades, but this increase is mainly driven by population aging and growth. The question remains however: Why has increasing provision of mental health services including antidepressant prescriptions not apparently had an impact on the annual prevalence of common mental disorders in these decades?…”

“…Richter and his colleagues in this issue set out to answer this challenging yet extremely important question by systematically reviewing epidemiological surveys that used the same methodology in the same geographical region repeatedly. They found 42 such studies, which compared prevalences of various conditions including depression, distress, alcohol dependence, and general mental illness, between two time points of, on average, 9.9 years apart.…”

Use of sequence analysis for classifying individual antidepressant trajectories to monitor population mental health

“…In recent years there has been a global increase in mental health morbidity [1], an increase in treatment by antidepressant medicines in high income counties [2]and a growing awareness of gaps in service delivery and resources in low and middle income countries [3] . For example, between 2000 and 2015 antidepressant use more than doubled in some countries including the UK, Germany, Sweden, Australia [4].…”

Psychiatrische Versorgung während der COVID-19-Pandemie

“…Die gesamte psychiatrische Versorgung muss sich sehr wahrscheinlich auf eine nochmals wachsende Inanspruchnahme einstellen. Bereits in den Jahren vor der Coronavirus-Krise ist die Nachfrage nach psychiatrischen oder psychologischen Dienstleistungen trotz unveränderter Prävalenzen erheblich gestiegen [9]. Soziale Schockereignisse wie Epidemien oder die schon jetzt absehbare massive Wirtschaftsrezession führen oftmals zu einer deutlich höheren psychischen Belastung sowie zu einer steigenden Suizidmortalität (z.…”