Neuropsychiatric Disorders Dominate Disease Burden in Europe

PARIS – Brain disorders cause more disease burden in Europe than any other type of disorder, including cancer or cardiovascular disease, based on results from the ECNP/European Brain Council report released Sept. 5.

The new data showed that in 2010, the combined category of mental health and neurologic disorders caused 23% of the disability-adjusted life-years lost (DALY) among European men and 30% of the DALY in European women, a measure that takes into account life-years lost because of either premature death or disability. In a second measure of disease impact, years lost to disability (YLD) only, neuropsychiatric disorders accounted for 42% of the total European YLD burden, Jürgen Rehm, Ph.D., said at the meeting.

"This is by far the disease category that has the most disability and disease burden associated with it, more so than cancer or cardiovascular disease," said Dr. Rehm, professor and chairman of addiction policy at the University of Toronto.

"You should not disregard [neuropsychiatric disorders] just because they are not as fatal as cancers or cardiovascular disease. The mental and neurologic disorders have their impact through the burden on people who live with them. They create a huge burden on society, on the health care system, and on families, and it is something that we need to put way more emphasis on," he said in an interview.

The survey measured the prevalence of 28 mental and neurologic diseases among more than 500 million Europeans residing in all 27 European Union countries as well as Iceland, Norway, and Switzerland. Concurrent with the presentation of the results at the meeting, the findings appeared in a published article (Eur. Neuropsychopharmacol. 2011;21:655-79).

Because neuropsychiatric disorders are not as fatal as other types of diseases, they have generally been relatively neglected for research funding. "The problem is that our societies have built their concept of what are the main diseases, the most problematic diseases, the diseases to be funded based mainly on mortality."

This has created two shortcomings in addressing the impact of mental and neurologic disorders: "We have to increase the treatment rate overall." Currently, "only 10% of patients suffering from mental or neurologic disorders get treated," he noted. In addition, "we have to invest in improving treatment. We need more personalized treatment and more preventive interventions. In cardiovascular disease, for example, a lot more is known about the genetics, which means more personalized treatment. In neuropsychiatric diseases, we give the same types of treatments to everyone."

One explanation for the high societal impact of neuropsychiatric disorders is their ubiquity and persistence across all age groups, noted Dr. Hans-Ulrich Wittchen, principal investigator of the study and professor and chairman of the Institute of Clinical Psychology and Psychotherapy and the Center of Clinical Epidemiology and Longitudinal Studies at the Dresden (Germany) University of Technology.

"Some [neuropsychiatric diseases] are highly prevalent from childhood and adolescence" through advanced adulthood "with significant impairment and disability, and persistent relapses," Dr. Wittchen said. Another factor contributing to the high disease burden is underdiagnosis and undertreatment, he said. Overall, mental and neurologic disorders "are much more prevalent than previously thought, and are more disabling than we thought." The numbers seen in 2010 matched earlier projections for 2030, Dr. Wittchen noted.

Another striking finding of the survey showed a marked difference in the major neuropsychiatric diseases affecting women and men. Among women, unipolar depression was by far the most prevalent, responsible for 134 DALY for each 10,000 women. The next most prevalent disorder was dementia, accounting for 69 DALY per 10,000 women. Among men, the alcohol use disorders came out most prevalent, causing 83 DALY for each 10,000 men, followed by unipolar depression causing 71 DALY per 10,000.

The relatively high prevalence of unipolar depression and alcohol use disorders make them the logical initial targets for intensified intervention, said Dr. Rehm, who is also professor of epidemiology at the Dresden University of Technology.

"If you tackle these two first, you would do something to improve population health and you would also improve the overall burden of a lot of additional conditions that are not part of the [reported] statistics," such as the criminal justice system burden and the consequences of violence created by alcohol use disorders, and the ischemic heart disease attributable to depression.

Dr. Rehn and Dr. Wittchen both said they had no relevant financial disclosures.

PARIS – Brain disorders cause more disease burden in Europe than any other type of disorder, including cancer or cardiovascular disease, based on results from the ECNP/European Brain Council report released Sept. 5.

The new data showed that in 2010, the combined category of mental health and neurologic disorders caused 23% of the disability-adjusted life-years lost (DALY) among European men and 30% of the DALY in European women, a measure that takes into account life-years lost because of either premature death or disability. In a second measure of disease impact, years lost to disability (YLD) only, neuropsychiatric disorders accounted for 42% of the total European YLD burden, Jürgen Rehm, Ph.D., said at the meeting.

"This is by far the disease category that has the most disability and disease burden associated with it, more so than cancer or cardiovascular disease," said Dr. Rehm, professor and chairman of addiction policy at the University of Toronto.

"You should not disregard [neuropsychiatric disorders] just because they are not as fatal as cancers or cardiovascular disease. The mental and neurologic disorders have their impact through the burden on people who live with them. They create a huge burden on society, on the health care system, and on families, and it is something that we need to put way more emphasis on," he said in an interview.

The survey measured the prevalence of 28 mental and neurologic diseases among more than 500 million Europeans residing in all 27 European Union countries as well as Iceland, Norway, and Switzerland. Concurrent with the presentation of the results at the meeting, the findings appeared in a published article (Eur. Neuropsychopharmacol. 2011;21:655-79).

Because neuropsychiatric disorders are not as fatal as other types of diseases, they have generally been relatively neglected for research funding. "The problem is that our societies have built their concept of what are the main diseases, the most problematic diseases, the diseases to be funded based mainly on mortality."

This has created two shortcomings in addressing the impact of mental and neurologic disorders: "We have to increase the treatment rate overall." Currently, "only 10% of patients suffering from mental or neurologic disorders get treated," he noted. In addition, "we have to invest in improving treatment. We need more personalized treatment and more preventive interventions. In cardiovascular disease, for example, a lot more is known about the genetics, which means more personalized treatment. In neuropsychiatric diseases, we give the same types of treatments to everyone."

One explanation for the high societal impact of neuropsychiatric disorders is their ubiquity and persistence across all age groups, noted Dr. Hans-Ulrich Wittchen, principal investigator of the study and professor and chairman of the Institute of Clinical Psychology and Psychotherapy and the Center of Clinical Epidemiology and Longitudinal Studies at the Dresden (Germany) University of Technology.

"Some [neuropsychiatric diseases] are highly prevalent from childhood and adolescence" through advanced adulthood "with significant impairment and disability, and persistent relapses," Dr. Wittchen said. Another factor contributing to the high disease burden is underdiagnosis and undertreatment, he said. Overall, mental and neurologic disorders "are much more prevalent than previously thought, and are more disabling than we thought." The numbers seen in 2010 matched earlier projections for 2030, Dr. Wittchen noted.

Another striking finding of the survey showed a marked difference in the major neuropsychiatric diseases affecting women and men. Among women, unipolar depression was by far the most prevalent, responsible for 134 DALY for each 10,000 women. The next most prevalent disorder was dementia, accounting for 69 DALY per 10,000 women. Among men, the alcohol use disorders came out most prevalent, causing 83 DALY for each 10,000 men, followed by unipolar depression causing 71 DALY per 10,000.

The relatively high prevalence of unipolar depression and alcohol use disorders make them the logical initial targets for intensified intervention, said Dr. Rehm, who is also professor of epidemiology at the Dresden University of Technology.

"If you tackle these two first, you would do something to improve population health and you would also improve the overall burden of a lot of additional conditions that are not part of the [reported] statistics," such as the criminal justice system burden and the consequences of violence created by alcohol use disorders, and the ischemic heart disease attributable to depression.

Dr. Rehn and Dr. Wittchen both said they had no relevant financial disclosures.

PARIS – Brain disorders cause more disease burden in Europe than any other type of disorder, including cancer or cardiovascular disease, based on results from the ECNP/European Brain Council report released Sept. 5.

The new data showed that in 2010, the combined category of mental health and neurologic disorders caused 23% of the disability-adjusted life-years lost (DALY) among European men and 30% of the DALY in European women, a measure that takes into account life-years lost because of either premature death or disability. In a second measure of disease impact, years lost to disability (YLD) only, neuropsychiatric disorders accounted for 42% of the total European YLD burden, Jürgen Rehm, Ph.D., said at the meeting.

"This is by far the disease category that has the most disability and disease burden associated with it, more so than cancer or cardiovascular disease," said Dr. Rehm, professor and chairman of addiction policy at the University of Toronto.

"You should not disregard [neuropsychiatric disorders] just because they are not as fatal as cancers or cardiovascular disease. The mental and neurologic disorders have their impact through the burden on people who live with them. They create a huge burden on society, on the health care system, and on families, and it is something that we need to put way more emphasis on," he said in an interview.

The survey measured the prevalence of 28 mental and neurologic diseases among more than 500 million Europeans residing in all 27 European Union countries as well as Iceland, Norway, and Switzerland. Concurrent with the presentation of the results at the meeting, the findings appeared in a published article (Eur. Neuropsychopharmacol. 2011;21:655-79).

Because neuropsychiatric disorders are not as fatal as other types of diseases, they have generally been relatively neglected for research funding. "The problem is that our societies have built their concept of what are the main diseases, the most problematic diseases, the diseases to be funded based mainly on mortality."

This has created two shortcomings in addressing the impact of mental and neurologic disorders: "We have to increase the treatment rate overall." Currently, "only 10% of patients suffering from mental or neurologic disorders get treated," he noted. In addition, "we have to invest in improving treatment. We need more personalized treatment and more preventive interventions. In cardiovascular disease, for example, a lot more is known about the genetics, which means more personalized treatment. In neuropsychiatric diseases, we give the same types of treatments to everyone."

One explanation for the high societal impact of neuropsychiatric disorders is their ubiquity and persistence across all age groups, noted Dr. Hans-Ulrich Wittchen, principal investigator of the study and professor and chairman of the Institute of Clinical Psychology and Psychotherapy and the Center of Clinical Epidemiology and Longitudinal Studies at the Dresden (Germany) University of Technology.

"Some [neuropsychiatric diseases] are highly prevalent from childhood and adolescence" through advanced adulthood "with significant impairment and disability, and persistent relapses," Dr. Wittchen said. Another factor contributing to the high disease burden is underdiagnosis and undertreatment, he said. Overall, mental and neurologic disorders "are much more prevalent than previously thought, and are more disabling than we thought." The numbers seen in 2010 matched earlier projections for 2030, Dr. Wittchen noted.

Another striking finding of the survey showed a marked difference in the major neuropsychiatric diseases affecting women and men. Among women, unipolar depression was by far the most prevalent, responsible for 134 DALY for each 10,000 women. The next most prevalent disorder was dementia, accounting for 69 DALY per 10,000 women. Among men, the alcohol use disorders came out most prevalent, causing 83 DALY for each 10,000 men, followed by unipolar depression causing 71 DALY per 10,000.

The relatively high prevalence of unipolar depression and alcohol use disorders make them the logical initial targets for intensified intervention, said Dr. Rehm, who is also professor of epidemiology at the Dresden University of Technology.

"If you tackle these two first, you would do something to improve population health and you would also improve the overall burden of a lot of additional conditions that are not part of the [reported] statistics," such as the criminal justice system burden and the consequences of violence created by alcohol use disorders, and the ischemic heart disease attributable to depression.

Dr. Rehn and Dr. Wittchen both said they had no relevant financial disclosures.