. 2022 Apr 1:16:100341.

doi: 10.1016/j.lanepe.2022.100341. eCollection 2022 May.

The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019

Giulio Castelpietra¹, Ann Kristin Skrindo Knudsen², Emilie E Agardh³, Benedetta Armocida⁴, Massimiliano Beghi⁵, Kim Moesgaard Iburg⁶, Giancarlo Logroscino^{7

8}, Rui Ma⁹, Fabrizio Starace¹⁰, Nicholas Steel^{11

12}, Giovanni Addolorato¹³, Catalina Liliana Andrei¹⁴, Tudorel Andrei¹⁵, Jose L Ayuso-Mateos^{16

17}, Maciej Banach^{18

19}, Till Winfried Bärnighausen^{20

21}, Francesco Barone-Adesi²², Akshaya Srikanth Bhagavathula^{23

24}, Felix Carvalho²⁵, Márcia Carvalho^{25

26}, Joht Singh Chandan²⁷, Vijay Kumar Chattu^{28

29}, Rosa A S Couto³⁰, Natália Cruz-Martins^{31

32}, Paul I Dargan^{33

34}, Keshab Deuba^{35

3}, Diana Dias da Silva³⁶, Adeniyi Francis Fagbamigbe^{37

38}, Eduarda Fernandes³⁹, Pietro Ferrara⁴⁰, Florian Fischer⁴¹, Peter Andras Gaal^{42

43}, Alessandro Gialluisi⁴⁴, Juanita A Haagsma⁴⁵, Josep Maria Haro^{46

47}, M Tasdik Hasan^{48

49}, Syed Shahzad Hasan⁵⁰, Sorin Hostiuc^{51

52}, Licia Iacoviello^{44

53}, Ivo Iavicoli⁵⁴, Elham Jamshidi^{55

56}, Jost B Jonas^{57

58}, Tamas Joo⁴², Jacek Jerzy Jozwiak⁵⁹, Srinivasa Vittal Katikireddi⁶⁰, Joonas H Kauppila^{61

62}, Moien A B Khan^{63

64}, Adnan Kisa^{65

66}, Sezer Kisa⁶⁷, Mika Kivimäki^{68

69}, Kamrun Nahar Koly^{70

71}, Ai Koyanagi^{72

73}, Manasi Kumar^{74

75}, Tea Lallukka⁶⁹, Berthold Langguth⁷⁶, Caterina Ledda⁷⁷, Paul H Lee⁷⁸, Ilaria Lega⁷⁹, Christine Linehan⁸⁰, Joana A Loureiro^{81

82}, Áurea M Madureira-Carvalho^{39

83}, Jose Martinez-Raga^{84

85}, Manu Raj Mathur^{86

87}, John J McGrath^{88

89}, Enkeleint A Mechili^{90

91}, Alexios-Fotios A Mentis⁹², Tomislav Mestrovic^{93

94}, Bartosz Miazgowski⁹⁵, Andreea Mirica⁹⁶, Antonio Mirijello⁹⁷, Babak Moazen^{20

98}, Shafiu Mohammed^{99

100}, Francesk Mulita^{101

102}, Gabriele Nagel¹⁰³, Ionut Negoi^{104

105}, Ruxandra Irina Negoi^{106

107}, Vincent Ebuka Nwatah^{108

109}, Alicia Padron-Monedero¹¹⁰, Songhomitra Panda-Jonas¹¹¹, Shahina Pardhan¹¹², Maja Pasovic⁹, Jay Patel^{113

114}, Ionela-Roxana Petcu⁹⁶, Marina Pinheiro¹¹⁵, Richard Charles G Pollok¹¹⁶, Maarten J Postma¹¹⁷, David Laith Rawaf¹¹⁸, Salman Rawaf^{119

120

121}, Esperanza Romero-Rodríguez¹²², Luca Ronfani¹²³, Dominic Sagoe¹²⁴, Francesco Sanmarchi¹²⁵, Michael P Schaub¹²⁶, Nigussie Tadesse Sharew^{127

128}, Rahman Shiri¹²⁹, Farhad Shokraneh^{130

131}, Inga Dora Sigfusdottir^{132

133}, João Pedro Silva²⁵, Renata Silva¹³⁴, Bogdan Socea¹³⁵, Miklós Szócska¹³⁶, Rafael Tabarés-Seisdedos^{85

137}, Marco Torrado^{138

139}, Marcos Roberto Tovani-Palone^{140

141}, Tommi Juhani Vasankari^{142

143}, Massimiliano Veroux¹⁴⁴, Russell M Viner¹⁴⁵, Andrea Werdecker¹⁴⁶, Andrea Sylvia Winkler^{147

148}, Simon I Hay¹⁴⁹, Alize J Ferrari^{9

150}, Mohsen Naghavi¹⁴⁹, Peter Allebeck³, Lorenzo Monasta¹²³

Affiliations

¹ Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy.
² Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
³ Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
⁴ Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy.
⁵ Department of Mental Health, AUSL Romagna, Ravenna, Italy.
⁶ Department of Public Health, Aarhus University, Aarhus, Denmark.
⁷ Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
⁸ Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy.
⁹ Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
¹⁰ Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy.
¹¹ Department of Primary Care and Public Health, University of East Anglia, Norwich, UK.
¹² Public Health England, London, UK.
¹³ Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
¹⁴ Cardiology Department Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹⁵ Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies, Bucharest, Romania.
¹⁶ CIBERSAM, Institute of Health Carlos III, Madrid, Spain.
¹⁷ Department of Psychiatry, Universidad Autónoma de Madrid (Autonomous University of Madrid), Madrid, Spain.
¹⁸ Department of Hypertension, Medical University of Lodz, Lodz, Poland.
¹⁹ Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland.
²⁰ Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
²¹ T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
²² Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
²³ Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic.
²⁴ Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates.
²⁵ Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal.
²⁶ Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.
²⁷ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
²⁸ Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago.
²⁹ Independent Consultant, Athens, Greece.
³⁰ Department of Chemical Sciences, University of Porto, Porto, Portugal.
³¹ Department of Medicine (Prof N Cruz-Martins PhD), University of Porto, Porto, Portugal.
³² Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Famalicão, Portugal.
³³ Faculty of Life Sciences and Medicine, King's College London, London, UK.
³⁴ Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
³⁵ National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal.
³⁶ Laboratory of Toxicology, University of Porto, Porto, Portugal.
³⁷ Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria.
³⁸ Population and Behavioural Sciences, University of St Andrews, St Andrews, UK.
³⁹ Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal.
⁴⁰ Research Center on Public Health, University of Milan Bicocca, Monza, Italy.
⁴¹ Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany.
⁴² Health Services Management Training Centre, Semmelweis University, Budapest, Hungary.
⁴³ Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania.
⁴⁴ Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy.
⁴⁵ Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
⁴⁶ Research Unit, University of Barcelona, Barcelona, Spain.
⁴⁷ Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain.
⁴⁸ Department of Pharmacy, University of Huddersfield, Huddersfield, UK.
⁴⁹ School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia.
⁵⁰ Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
⁵¹ Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁵² Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania.
⁵³ Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
⁵⁴ Department of Public Health, University of Naples Federico II, Naples, Italy.
⁵⁵ Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehram, Iran.
⁵⁶ Division of Pulmonary Medicine, University of Lausanne (UNIL), Lausanne, Switzerland.
⁵⁷ Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
⁵⁸ Department of Ophthalmology, Heidelberg University, Mannheim, Germany.
⁵⁹ Department of Family Medicine and Public Health, University of Opole, Opole, Poland.
⁶⁰ MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
⁶¹ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
⁶² Surgery Research Unit, University of Oulu, Oulu, Finland.
⁶³ Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates.
⁶⁴ Primary Care Department, NHS North West London, London, UK.
⁶⁵ School of Health Sciences, Kristiania University College, Oslo, Norway.
⁶⁶ Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA.
⁶⁷ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁶⁸ Department of Epidemiology and Public Health University College London, London, UK.
⁶⁹ Department of Public Health, University of Helsinki, Helsinki, Finland.
⁷⁰ Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
⁷¹ Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK.
⁷² Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
⁷³ Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
⁷⁴ Division of Psychology and Language Sciences, University College London, London, UK.
⁷⁵ Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁷⁶ Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
⁷⁷ Clinical and Experimental Medicine, University of Catania, Catania, Italy.
⁷⁸ Department of Health Sciences, University of Leicester, Leicester, UK.
⁷⁹ National Center for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Insitute of Health, Rome, Italy.
⁸⁰ UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland.
⁸¹ Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE) University of Porto, Porto, Portugal.
⁸² School of Health, Polytechnic Institute of Porto, Portugal.
⁸³ Institute for Research and Advanced Training in Health Sciences and Technologies, Instituto Universitário de Ciências da Saúde (University Institute of Health Sciences), Gandra, Portugal.
⁸⁴ Psychiatry Department, Hospital Universitario Doctor Peset, Valencia, Spain.
⁸⁵ Department of Medicine, University of Valencia, Valencia, Spain.
⁸⁶ Health Policy Research Public Health Foundation of India, Gurugram, India.
⁸⁷ Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
⁸⁸ Queensland Brain Institute, School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
⁸⁹ National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
⁹⁰ Department of Healthcare, University of Vlora, Vlora city, Albania.
⁹¹ Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece.
⁹² University Research Institute, National and Kapodistrian University of Athens, Athens, Greece.
⁹³ Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia.
⁹⁴ University Centre Varazdin, University North, Varazdin, Croatia.
⁹⁵ Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland.
⁹⁶ Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania.
⁹⁷ Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy.
⁹⁸ Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany.
⁹⁹ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
¹⁰⁰ Department of Health Care Management, Technical University of Berlin, Berlin, Germany.
¹⁰¹ Department of Surgery, General University Hospital of Patras, Patras, Greece.
¹⁰² Medical School, University of Thessaly, Larissa, Greece.
¹⁰³ Institute of Epidemiology and Medical Biometry Ulm University, Ulm, Germany.
¹⁰⁴ Department of General Surgery Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹⁰⁵ Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
¹⁰⁶ Department of Anatomy and Embryology Romania, Bucharest, Romania.
¹⁰⁷ Cardio-Aid, Bucharest, Romania.
¹⁰⁸ Department of Pediatrics, National Hospital, Abuja, Nigeria.
¹⁰⁹ Department of International Public Health, University of Liverpool, Liverpool, UK.
¹¹⁰ National School of Public Health Institute of Health Carlos III, Madrid, Spain.
¹¹¹ Privatpraxis, Heidelberg, Germany.
¹¹² Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.
¹¹³ Global Health Governance Programme, University of Edinburgh, Edinburgh, UK.
¹¹⁴ School of Dentistry, University of Leeds, Leeds, UK.
¹¹⁵ Department of Chemistry, University of Porto, Porto, Portugal.
¹¹⁶ Institute of Infection and Immunity, St George's University of London, London, UK.
¹¹⁷ University Medical Center Groningen, School of Economics and Business University of Groningen, Groningen, Netherlands.
¹¹⁸ WHO Collaborating Centre for Public Health Education and Training Imperial College London, London, UK.
¹¹⁹ Department of Primary Care and Public Health, Imperial College London, London, UK.
¹²⁰ University College London Hospitals, London, UK.
¹²¹ Academic Public Health England, London, UK.
¹²² Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
¹²³ Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.
¹²⁴ Department of Psychosocial Science University of Bergen, Bergen, Norway.
¹²⁵ Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
¹²⁶ Swiss Research Institute for Public Health and Addiction University of Zürich, Zurich, Switzerland.
¹²⁷ Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) University of Groningen, Groningen, Netherlands.
¹²⁸ Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia.
¹²⁹ Finnish Institute of Occupational Health, Helsinki, Finland.
¹³⁰ London Institute for Healthcare Engineering, King's College London, London, UK.
¹³¹ Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
¹³² Department of Psychology, Reykjavik University, Reykjavik, Iceland.
¹³³ Department of Health and Behavior Studies, Columbia University, New York, NY, USA.
¹³⁴ Department of Biological Sciences, University of Porto, Porto, Portugal.
¹³⁵ Surgery, "Sf. Pantelimon" Emergency Clinical Hospital Bucharest, Bucharest, Romania.
¹³⁶ Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary.
¹³⁷ Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
¹³⁸ Psychiatry and Medical Psychology Department, University of Lisbon, Lisbon, Portugal.
¹³⁹ Child and Adolescent Mental Health Services (CAMHS), Hospital Garcia de Orta, Almada, Portugal.
¹⁴⁰ Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil.
¹⁴¹ Modestum LTD, London, UK.
¹⁴² UKK Institute, Tampere, Finland.
¹⁴³ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
¹⁴⁴ Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
¹⁴⁵ UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
¹⁴⁶ Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany.
¹⁴⁷ Institute of Health and Society, University of Oslo, Oslo, Norway.
¹⁴⁸ Department of Neurology, Technical University of Munich, Munich, Germany.
¹⁴⁹ Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
¹⁵⁰ School of Public Health (A J Ferrari PhD), The University of Queensland, Brisbane, QLD, Australia.

PMID: 35392452
PMCID: PMC8980870
DOI: 10.1016/j.lanepe.2022.100341

The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019

Giulio Castelpietra et al. Lancet Reg Health Eur. 2022.

. 2022 Apr 1:16:100341.

doi: 10.1016/j.lanepe.2022.100341. eCollection 2022 May.

Authors

Affiliations

¹ Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy.
² Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
³ Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
⁴ Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy.
⁵ Department of Mental Health, AUSL Romagna, Ravenna, Italy.
⁶ Department of Public Health, Aarhus University, Aarhus, Denmark.
⁷ Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
⁸ Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy.
⁹ Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
¹⁰ Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy.
¹¹ Department of Primary Care and Public Health, University of East Anglia, Norwich, UK.
¹² Public Health England, London, UK.
¹³ Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
¹⁴ Cardiology Department Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹⁵ Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies, Bucharest, Romania.
¹⁶ CIBERSAM, Institute of Health Carlos III, Madrid, Spain.
¹⁷ Department of Psychiatry, Universidad Autónoma de Madrid (Autonomous University of Madrid), Madrid, Spain.
¹⁸ Department of Hypertension, Medical University of Lodz, Lodz, Poland.
¹⁹ Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland.
²⁰ Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
²¹ T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
²² Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
²³ Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic.
²⁴ Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates.
²⁵ Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal.
²⁶ Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.
²⁷ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
²⁸ Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago.
²⁹ Independent Consultant, Athens, Greece.
³⁰ Department of Chemical Sciences, University of Porto, Porto, Portugal.
³¹ Department of Medicine (Prof N Cruz-Martins PhD), University of Porto, Porto, Portugal.
³² Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Famalicão, Portugal.
³³ Faculty of Life Sciences and Medicine, King's College London, London, UK.
³⁴ Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
³⁵ National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal.
³⁶ Laboratory of Toxicology, University of Porto, Porto, Portugal.
³⁷ Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria.
³⁸ Population and Behavioural Sciences, University of St Andrews, St Andrews, UK.
³⁹ Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal.
⁴⁰ Research Center on Public Health, University of Milan Bicocca, Monza, Italy.
⁴¹ Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany.
⁴² Health Services Management Training Centre, Semmelweis University, Budapest, Hungary.
⁴³ Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania.
⁴⁴ Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy.
⁴⁵ Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
⁴⁶ Research Unit, University of Barcelona, Barcelona, Spain.
⁴⁷ Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain.
⁴⁸ Department of Pharmacy, University of Huddersfield, Huddersfield, UK.
⁴⁹ School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia.
⁵⁰ Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
⁵¹ Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁵² Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania.
⁵³ Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
⁵⁴ Department of Public Health, University of Naples Federico II, Naples, Italy.
⁵⁵ Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehram, Iran.
⁵⁶ Division of Pulmonary Medicine, University of Lausanne (UNIL), Lausanne, Switzerland.
⁵⁷ Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
⁵⁸ Department of Ophthalmology, Heidelberg University, Mannheim, Germany.
⁵⁹ Department of Family Medicine and Public Health, University of Opole, Opole, Poland.
⁶⁰ MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
⁶¹ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
⁶² Surgery Research Unit, University of Oulu, Oulu, Finland.
⁶³ Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates.
⁶⁴ Primary Care Department, NHS North West London, London, UK.
⁶⁵ School of Health Sciences, Kristiania University College, Oslo, Norway.
⁶⁶ Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA.
⁶⁷ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁶⁸ Department of Epidemiology and Public Health University College London, London, UK.
⁶⁹ Department of Public Health, University of Helsinki, Helsinki, Finland.
⁷⁰ Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
⁷¹ Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK.
⁷² Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
⁷³ Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
⁷⁴ Division of Psychology and Language Sciences, University College London, London, UK.
⁷⁵ Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁷⁶ Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
⁷⁷ Clinical and Experimental Medicine, University of Catania, Catania, Italy.
⁷⁸ Department of Health Sciences, University of Leicester, Leicester, UK.
⁷⁹ National Center for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Insitute of Health, Rome, Italy.
⁸⁰ UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland.
⁸¹ Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE) University of Porto, Porto, Portugal.
⁸² School of Health, Polytechnic Institute of Porto, Portugal.
⁸³ Institute for Research and Advanced Training in Health Sciences and Technologies, Instituto Universitário de Ciências da Saúde (University Institute of Health Sciences), Gandra, Portugal.
⁸⁴ Psychiatry Department, Hospital Universitario Doctor Peset, Valencia, Spain.
⁸⁵ Department of Medicine, University of Valencia, Valencia, Spain.
⁸⁶ Health Policy Research Public Health Foundation of India, Gurugram, India.
⁸⁷ Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
⁸⁸ Queensland Brain Institute, School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
⁸⁹ National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
⁹⁰ Department of Healthcare, University of Vlora, Vlora city, Albania.
⁹¹ Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece.
⁹² University Research Institute, National and Kapodistrian University of Athens, Athens, Greece.
⁹³ Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia.
⁹⁴ University Centre Varazdin, University North, Varazdin, Croatia.
⁹⁵ Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland.
⁹⁶ Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania.
⁹⁷ Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy.
⁹⁸ Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany.
⁹⁹ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
¹⁰⁰ Department of Health Care Management, Technical University of Berlin, Berlin, Germany.
¹⁰¹ Department of Surgery, General University Hospital of Patras, Patras, Greece.
¹⁰² Medical School, University of Thessaly, Larissa, Greece.
¹⁰³ Institute of Epidemiology and Medical Biometry Ulm University, Ulm, Germany.
¹⁰⁴ Department of General Surgery Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹⁰⁵ Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
¹⁰⁶ Department of Anatomy and Embryology Romania, Bucharest, Romania.
¹⁰⁷ Cardio-Aid, Bucharest, Romania.
¹⁰⁸ Department of Pediatrics, National Hospital, Abuja, Nigeria.
¹⁰⁹ Department of International Public Health, University of Liverpool, Liverpool, UK.
¹¹⁰ National School of Public Health Institute of Health Carlos III, Madrid, Spain.
¹¹¹ Privatpraxis, Heidelberg, Germany.
¹¹² Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.
¹¹³ Global Health Governance Programme, University of Edinburgh, Edinburgh, UK.
¹¹⁴ School of Dentistry, University of Leeds, Leeds, UK.
¹¹⁵ Department of Chemistry, University of Porto, Porto, Portugal.
¹¹⁶ Institute of Infection and Immunity, St George's University of London, London, UK.
¹¹⁷ University Medical Center Groningen, School of Economics and Business University of Groningen, Groningen, Netherlands.
¹¹⁸ WHO Collaborating Centre for Public Health Education and Training Imperial College London, London, UK.
¹¹⁹ Department of Primary Care and Public Health, Imperial College London, London, UK.
¹²⁰ University College London Hospitals, London, UK.
¹²¹ Academic Public Health England, London, UK.
¹²² Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
¹²³ Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.
¹²⁴ Department of Psychosocial Science University of Bergen, Bergen, Norway.
¹²⁵ Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
¹²⁶ Swiss Research Institute for Public Health and Addiction University of Zürich, Zurich, Switzerland.
¹²⁷ Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) University of Groningen, Groningen, Netherlands.
¹²⁸ Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia.
¹²⁹ Finnish Institute of Occupational Health, Helsinki, Finland.
¹³⁰ London Institute for Healthcare Engineering, King's College London, London, UK.
¹³¹ Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
¹³² Department of Psychology, Reykjavik University, Reykjavik, Iceland.
¹³³ Department of Health and Behavior Studies, Columbia University, New York, NY, USA.
¹³⁴ Department of Biological Sciences, University of Porto, Porto, Portugal.
¹³⁵ Surgery, "Sf. Pantelimon" Emergency Clinical Hospital Bucharest, Bucharest, Romania.
¹³⁶ Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary.
¹³⁷ Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
¹³⁸ Psychiatry and Medical Psychology Department, University of Lisbon, Lisbon, Portugal.
¹³⁹ Child and Adolescent Mental Health Services (CAMHS), Hospital Garcia de Orta, Almada, Portugal.
¹⁴⁰ Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil.
¹⁴¹ Modestum LTD, London, UK.
¹⁴² UKK Institute, Tampere, Finland.
¹⁴³ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
¹⁴⁴ Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
¹⁴⁵ UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
¹⁴⁶ Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany.
¹⁴⁷ Institute of Health and Society, University of Oslo, Oslo, Norway.
¹⁴⁸ Department of Neurology, Technical University of Munich, Munich, Germany.
¹⁴⁹ Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
¹⁵⁰ School of Public Health (A J Ferrari PhD), The University of Queensland, Brisbane, QLD, Australia.

PMID: 35392452
PMCID: PMC8980870
DOI: 10.1016/j.lanepe.2022.100341

Abstract

Background: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time.

Methods: Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated.

Findings: In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs.

Interpretation: Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people.

Funding: The Bill and Melinda Gates Foundation.

Keywords: Europe; Mental disorders; Mental health; Self-harm; Substance use; Young people.

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Conflict of interest statement

T W Bärnighausen reports Research grants from the European Union (Horizon 2020 and EIT Health), German Research Foundation (DFG), US National Institutes of Health, German Ministry of Education and Research, Alexander von Humboldt Foundation, Else-Kröner-Fresenius-Foundation, Wellcome Trust, Bill & Melinda Gates Foundation, KfW, UNAIDS, and WHO; consulting fees from KfW on the OSCAR initiative in Vietnam; participation on a Data Safety Monitoring Board or Advisory Board with NIH-funded study “Healthy Options” as Chair, Data Safety and Monitoring Board (DSMB) for the German National Committee on the “Future of Public Health Research and Education”, Chair of the scientific advisory board to the EDCTP Evaluation, Member of the UNAIDS Evaluation Expert Advisory Committee, National Institutes of Health Study Section Member on Population and Public Health Approaches to HIV/AIDS (PPAH), US National Academies of Sciences, Engineering, and Medicine's Committee for the “Evaluation of Human Resources for Health in the Republic of Rwanda under the President's Emergency Plan for AIDS Relief (PEPFAR)”, University of Pennsylvania Population Aging Research Center (PARC) External Advisory Board Member; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as Co-chair of the Global Health Hub Germany, initiated by the German Ministry of Health); all outside the submitted work. J S Chandan reports grants or contracts from the National Institute of Health Research and has been awarded funds from the NIHR and the Youth Endowment Fund, outside the submitted work. J J Jozwiak reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing or educational events from Teva, Amgen, Synexus, Boehringer Ingelheim, ALAB Laboratories, and Zentiva, all as personal fees and outside the submitted work. S V Katikireddi reports support for the present manuscript form Medical Research Council and the Scottish Government Chief Scientist Office as funding to their institution. J H Kauppila reports grants or contracts from The Finnish Cancer Foundation, and Sigrid Juselius Foundation as payments made to their institution, outside the submitted work. M Kivimäki reports grants or contracts form Wellcome Trust, UK (221854/Z/20/Z), and the Medical Research Council, UK (MR/R024227/1, MR/S011676/1) as the PI of research funding for their university, outside the submitted work. G Logroscino reports honoraria for lectures from Amplifon, outside the submitted work. J A Louriero reports support for the present manuscript from Fundação para a Ciência e Técnologia (FCT) under the Scientific Employment Stimulus [CEECINST/00049/2018]. A-F A Mentis reports grants or contracts from ‘MilkSafe: A novel pipeline to enrich formula milk using omics technologies’, a research co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH - CREATE - INNOVATE (project code: T2EDK-02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860); stock or stock options in a family winery; all outside the submitted work. M J Postma reports stock or stock options from Health-Ecore and PAG, outside the submitted work. N Steel reports grants from Public Health England to their institution, outside the submitted work. R M Viner reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Canadian Academy of Child & Adolescent Psychiatry for lecture on mental health aspects of COVID-19 pandemic; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as the President of Royal College of Paediatrics & Child Health, 2018-2021; all outside the submitted work.

Figures

**Figure 1**
Prevalence per 100,000 population aged 10-24 years of common, severe and other mental disorders (MDs), alcohol and drug use disorders, and incidence rate of self-harm in 31 European countries, both sexes, age 10-24, year 2019. Common MDs: anxiety and depressive disorders; Severe MDs: schizophrenia and bipolar disorder; Other MDs: eating disorders, attention deficit/hyperactivity disorder, autism spectrum disorder, conduct disorders, idiopathic developmental intellectual disability, other mental disorders.

**Figure 2**
Disability Adjusted Life Years (DALYs) divided in Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) for mental disorders, substance use disorders and self-harm in 31 European countries, females and males, age 10-24, year 2019.

**Figure 3**
Prevalence for mental disorders, substance use disorders, and incidence for self-harm in European Union, Iceland, Norway and Switzerland, years 1990-2019, males and females, age 10-14, 15-19, 20-24 percentage change over time.

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The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019

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The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019

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