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. 2013 Nov;10(11):e1001547.
doi: 10.1371/journal.pmed.1001547. Epub 2013 Nov 5.

Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010

Alize J Ferrari  1 , Fiona J Charlson, Rosana E Norman, Scott B Patten, Greg Freedman, Christopher J L Murray, Theo Vos, Harvey A Whiteford
Affiliations

Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010

Alize J Ferrari et al. PLoS Med. 2013 Nov.

Abstract

Background: Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.

Methods and findings: Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8%) of global YLDs and dysthymia for 1.4% (0.9%-2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2%) of global DALYs and dysthymia for 0.5% (0.3%-0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8%) to 3.8% (3.0%-4.7%) of global DALYs.

Conclusions: GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. Please see later in the article for the Editors' Summary.

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Conflict of interest statement

The authors declare that no competing interests exist.

Figures

Figure 1
Figure 1. YLDs by age and sex for MDD and dysthymia in 1990 and 2010.
Figure 2
Figure 2. YLD rates (per 100,000) by region for MDD and dysthymia in 1990 and 2010.
95% UI, 95% uncertainty interval; AP-HI, Asia Pacific, high income; As-C, Asia Central; AS-E, Asia East; AS-S, Asia South; A-SE, Asia Southeast; Aus, Australasia; Caribb, Caribbean; Eur-C, Europe Central; Eur-E, Europe Eastern; Eur-W, Europe Western; LA-An, Latin America, Andean; LA-C, Latin America, Central; LA-Sth, Latin America, Southern; LA-Trop, Latin America, Tropical; Nafr-ME, North Africa/Middle East; Nam-HI, North America, high income; Oc, Oceania; SSA-C, Sub-Saharan Africa, Central; SSA-E, Sub-Saharan Africa, East; SSA-S, Sub-Saharan Africa Southern; SSA-W, Sub-Saharan Africa, West.
Figure 3
Figure 3. YLD rates (per 100,000) by country for depressive disorders in 2010.
Low, statistically lower YLD rates compared to global mean; middle, YLD rates not statistically different to global mean; high, statistically higher YLD rates compared to global mean.
See this image and copyright information in PMC

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References

    1. Ferrari AJ, Somerville AJ, Baxter AJ, Norman R, Patten SB, et al. (2013) Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psycho Med 43: 471–481. - PubMed
    1. Ferrari AJ, Charlson FJ, Norman R, Flaxman AD, Patten SB, et al. (2013) The epidemiological modelling of major depressive disorder: application for the Global Burden of Disease Study 2010. PLoS ONE 8: e69637 doi:10.1371/journal.pone.0069637 - DOI - PMC - PubMed
    1. Charlson FJ, Ferrari AJ, Somerville AJ, Norman R, Patten SB, et al. (2013) The epidemiological modelling of dysthymia: application for the Global Burden of Disease 2010 Study. J Affect Disord 151: 111–120. - PubMed
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    1. World Health Organization (2008) The Global Burden of Disease: 2004 update. Switzerland. Available: http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/

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Grants and funding

AJF, FJC, HAW are affiliated with the Queensland Centre for Mental Health Research, which obtains funding from the Queensland Department of Health. REN, GF, CJLM, and TV received funding for the Global Burden of Disease project from the Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.