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Multicenter Study
. 2014 Apr 2;9(4):e91936.
doi: 10.1371/journal.pone.0091936. eCollection 2014.

The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study 2010

Alize J Ferrari  1 , Rosana E Norman  2 , Greg Freedman  3 , Amanda J Baxter  1 , Jane E Pirkis  4 , Meredith G Harris  1 , Andrew Page  5 , Emily Carnahan  3 , Louisa Degenhardt  6 , Theo Vos  7 , Harvey A Whiteford  1
Affiliations
Multicenter Study

The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study 2010

Alize J Ferrari et al. PLoS One. .

Abstract

Background: The Global Burden of Disease Study 2010 (GBD 2010) identified mental and substance use disorders as the 5th leading contributor of burden in 2010, measured by disability adjusted life years (DALYs). This estimate was incomplete as it excluded burden resulting from the increased risk of suicide captured elsewhere in GBD 2010's mutually exclusive list of diseases and injuries. Here, we estimate suicide DALYs attributable to mental and substance use disorders.

Methods: Relative-risk estimates of suicide due to mental and substance use disorders and the global prevalence of each disorder were used to estimate population attributable fractions. These were adjusted for global differences in the proportion of suicide due to mental and substance use disorders compared to other causes then multiplied by suicide DALYs reported in GBD 2010 to estimate attributable DALYs (with 95% uncertainty).

Results: Mental and substance use disorders were responsible for 22.5 million (14.8-29.8 million) of the 36.2 million (26.5-44.3 million) DALYs allocated to suicide in 2010. Depression was responsible for the largest proportion of suicide DALYs (46.1% (28.0%-60.8%)) and anorexia nervosa the lowest (0.2% (0.02%-0.5%)). DALYs occurred throughout the lifespan, with the largest proportion found in Eastern Europe and Asia, and males aged 20-30 years. The inclusion of attributable suicide DALYs would have increased the overall burden of mental and substance use disorders (assigned to them in GBD 2010 as a direct cause) from 7.4% (6.2%-8.6%) to 8.3% (7.1%-9.6%) of global DALYs, and would have changed the global ranking from 5th to 3rd leading cause of burden.

Conclusions: Capturing the suicide burden attributable to mental and substance use disorders allows for more accurate estimates of burden. More consideration needs to be given to interventions targeted to populations with, or at risk for, mental and substance use disorders as an effective strategy for suicide prevention.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Suicide DALYs attributable to mental and substance use disorders by age and sex, in 2010.
Figure 2
Figure 2. Suicide DALYs attributable to mental and substance use disorders by region, in 2010.
Figure 3
Figure 3. Suicide DALYs (rates per 100,000) attributable to mental and substance use disorders by country, in 2010.
Figure 4
Figure 4. Suicide DALYs attributable to mental and substance use disorders by disorder, in 2010.
See this image and copyright information in PMC

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References

    1. Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR, et al. (2012) Age-specifi c and sex-specifi c mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2071–2094. - PubMed
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, et al. (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2163–2196. - PMC - PubMed
    1. Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, et al. (2012) Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. Lancet 380: 2144–2162. - PubMed
    1. Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M, et al. (2012) Common values in assessing health outcomes from disease and injury:disability weights measurement study for the Global Burden of Disease 2010. Lancet 380: 2129–2143. - PubMed
    1. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, et al. (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2197–2223. - PubMed

Publication types

Grants and funding

AJF, AJB, MGH and HAW are associated with the Queensland Centre for Mental Health Research which acquires funding from the Queensland Department of Health. REN, GF, EC and TV received funding for the Global Burden of Disease project from the Bill and Melinda Gates Foundation. LD is supported by an Australian National Health and Medical Research Council (NHMRC) Principal Research Fellowship. The National Drug and Alcohol Research Centre at the University of NSW is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript