The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

Abstract

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.

Knowledge and Awareness Regarding Mental Health and Barriers to Seeking Psychiatric Consultation in Saudi Arabia

“…Among the high-income countries in the EMR, mental disorders contributed to 2519 DALYS/100,000. Mental disorders rank as the ninth leading cause of disease burden in the EMR and the burden increased 11% from 1990 to 2013 12,13 . Depression and anxiety disorders are the most frequent mental disorders, and rates in women are up to double those in men 14 .…”

What are the barriers to accessing psychological therapy in Qatar: A concept mapping study

“…Despite this growth, Sharkey () reported that spending on mental health care represented only 0.34% of all healthcare expenditure, a rate that is seven times lower than spending in developed Western countries. This suboptimal level of spending on mental compared with physical health has been consistently observed across low‐, middle‐, and high‐income countries within the region (Charara et al, ; Okasha, Karam, & Okasha, ) and thus seems to reflect a bias against mental health rather than, say, the persistence of severe health problems affecting mortality, such as infectious diseases and malnourishment. Sharkey also noted that most of this spending within Qatar went on in‐patient services within the one mental health hospital situated in Doha, Qatar’s capital city.…”

“…Recent analysis from the global burden of disease data set has found that in Middle Eastern countries such as Qatar the burden from mental health disorders is higher than it is in other parts of the Western world (Charara et al, ). Furthermore, this burden has increased over the past 20 years.…”

Burden of diarrhea in the Eastern Mediterranean Region, 1990–2015: Findings from the Global Burden of Disease 2015 study

“…The EMR is facing numerous health challenges as a result of previous wars, and recent revolutions and the wars that followed (Mokdad et al 2016; Charara et al 2017) resulted in a huge refugee problem with millions of refugees and massive consequences for the health and well-being of millions of displaced people. The EMR now carries the largest burden of displaced populations globally.…”