The burden of mental illness on health and productivity in the United States and throughout the world has long been underestimated. Data developed by the massive Global Burden of Disease study conducted by the World Health Organization, the World Bank, and Harvard University, reveal that mental illness, including suicide, accounts for over 15 percent of the burden of disease in established market economies, such as the United States. This is more than the disease burden caused by all cancers.

This Global Burden of Disease study developed a single measure to allow comparison of the burden of disease across many different disease conditions by including both death and disability. This measure was called Disability Adjusted Life Years (DALYs). DALYs measure lost years of healthy life regardless of whether the years were lost to premature death or disability. The disability component of this measure is weighted for severity of the disability. For example, disability caused by major depression was found to be equivalent to blindness or paraplegia whereas active psychosis seen in schizophrenia produces disability equal to quadriplegia.

Using the DALYs measure, major depression ranked second only to ischemic heart disease in magnitude of disease burden in established market economies. Schizophrenia, bipolar disorder, obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder also contributed significantly to the total burden of illness attributable to mental disorders.

The projections show that with the aging of the world population and the conquest of infectious diseases, psychiatric and neurological conditions could increase their share of the total global disease burden by almost half, from 10.5 percent of the total burden to almost 15 percent in 2020.

Facts

  • Major depression is the leading cause of disability (measured by the number of years lived with a disabling condition) worldwide among persons age five and older.
  • For women throughout the world as well as those in established market economies, depression is the leading cause of DALYs. In established market economies, schizophrenia and bipolar disorder are also among the top ten causes of DALYs for women.
The Leading Sources of Disease Burden in Established Market Economies, 1990
(measured in DALYs*)
Rank Disease Total
(millions)
Percent
of Total
All Causes 98.7 No Value
1 Ischemic Heart Disease 8.9 9.0
2 Unipolar Major Depression 6.7 6.8
3 Cardiovascular Disease 5.0 5.0
4 Alcohol Use 4.7 4.7
5 Road Traffic Accidents 4.3 4.4
6 Lung & UR Cancers 3.0 3.0
7 dementia & Degenerative CNS 2.9 2.9
8 Osteoarthritis 2.7 2.7
9 Diabetes 2.4 2.4
10 COPD 2.3 2.3
Disease Burden by Selected Illness Categories in Established Market Economies, 1990
(measured in DALYs*)
Disease
Category
Percent
of Total
All cardiovascular conditions 18.6
All mental illness including suicide 15.4
All malignant disease (cancer) 15.0
All respiratory conditions 4.8
All alcohol use 4.7
All infectious and parasitic disease 2.8
All drug use 1.5
Mental Illness as a Source of Disease Burden in Established Market Economies, 1990
(measured in DALYs*)
Disease Total
(millions)
Percent
of Total
All Causes 98.7 No Value
Unipolar major depression 6.7 6.7
Schizophrenia 2.3 2.3
Bipolar disorder 1.7 1.7
obsessive-compulsive disorder 1.5 1.5
panic disorder .7 .7
Post-traumatic stress disorder .3 .3
Self-inflicted injuries (suicide) 2.2 2.2
All mental disorders 15.3 15.4

*DALYs measure lost years of healthy life regardless of whether the years were lost to premature death or disability.

For More Information

National Institute of mental health (NIMH)
Office of Communications and Public Liaison
Public Inquiries: (301) 443-4513
Media Inquiries: (301) 443-4536
E-mail: nimhinfo@nih.gov
Web site: http://www.nimh.nih.gov

Global Burden of Disease Web site:
http://www.who.int/msa/mnh/ems/dalys/intro.htm

All material in this fact sheet is in the public domain and may be copied or reproduced without permission from the Institute. Citation of the source is appreciated.

NIH Publication No. 01-4586

Reference

Murray CJL, Lopez AD, eds. The global burden of disease and injury series, volume 1: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press, 1996.