Epidemiology and Burden (MDD)

Presentation

Epidemiology and Burden (MDD)

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Epidemiology and Burden of
 Major Depressive Disorder (MDD)
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Depression is a highly prevalent disorder
References
  1. Depression. Factsheet no. 369. Available at: http://www.who.int/mediacentre/factsheets/fs369/en/. Accessed April 2016
  2. Ferrari AJ, et al. 2010. PLoS One. 2013a;8(7):e69637
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Depression is a highly prevalent disorder
Slide information
References

Lifetime prevelance: The proportion of individuals in a population that at some point in their life up to the time of assessment have experienced MDD.

  1. Wittchen HU et al. Eur Neuropsychopharmacol 2011;21:655-79
  2. Hasin DS et al. Arch Gen Psychiatry 2005;62:1097-106
  3. Kessler RC et al. Arch Gen Psychiatry 2005;62:593-602
  4. Bromet E et al. BMC Med 2011;9:90
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12 month prevelance of mental disorders in Europe in 2011#
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Burden of Major Depressive Disorder (MDD)
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Quote from WHO Fact Sheet No. 369
References
  1. Depression. Factsheet no. 369. Available at: http://www.who.int/mediacentre/factsheets/fs369/en/ Accessed April 2016
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MDD is a leading cause of burden
Slide information
References

Source (slide): 1. Ferrari et al. PLoS One 2013; 8 (7): e69637; page 9 (‘Final prevalence output’ section); 2. Ferrari et al. PLoS Med 2013; 10 (11): e1001547; page 5 (‘Direct burden of depressive disorders’ section); 3. WHO. The Global Burden of Disease 2004 update: page 50 (‘Halving the contribution of Group 1 causes‘ section) and Figure 27; 4. Vos et al. Lancet 2012; 380: 2163–2196; Figure 4.

Source (notes): Ferrari et al., PLoS One 2013 p9; Ferrari et al., PLoS Med 2013 p4/5; WHO, 2008 p50.

MDD has a worldwide prevalence of 4.4%, corresponding to 298 million people (estimate from 2010 Global Burden of Disease Study [GBDS]).(Ferrari et al., PLoS One 2013) Overall, prevalence is higher in females (5.5%) than in males (3.2%), corresponding to 187 million females and 111 million males worldwide.(Ferrari et al., PLoS One 2013) Prevalence peaks between the ages of 20 and 64 years; the highest number of prevalent cases is in the age group 25–34 years (57 million cases).(Ferrari et al., PLoS One 2013)

Disease burden can be compared across diseases and injuries using the ‘disability-adjusted life-year’ (DALY). One DALY represents the loss of one healthy year of life; it is the sum of the years of life lived with disability (YLD) and years of life lost due to premature mortality.(Ferrari et al., PLoS Med 2013) MDD accounts for 2.5% of global DALYs, making it the eleventh leading cause of disease burden worldwide (estimate from 2010 GBDS).(Ferrari et al., PLoS Med 2013) By 2030, unipolar depressive disorders including MDD are predicted to become the leading cause of DALYs (estimate from 2004 GBDS; not re-estimated following 2010 GBDS).(WHO, 2008) In terms of YLDs, MDD is the second leading cause of burden (accounting for 8.2% of global YLDs), after lower back pain (estimate from 2010 GBDS).(Ferrari et al., PLoS Med 2013)

  1. Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med 2013; 10 (11): e1001547
  2. Ferrari AJ, Charlson FJ, Norman RE, et al. The epidemiological modelling of major depressive disorder: application for the Global Burden of Disease Study 2010. PLoS One 2013; 8 (7): e69637
  3. Vos T, Flaxman AD, Naghavi M, et al. 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 2012; 380 (9859): 2163–2196
  4. World Health Organization (WHO). The global burden of disease: 2004 update. © World Health Organization 2008
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Contribution of Non-communicable diseases disability-adjusted life years
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References

Amongst the classes of non-communicable disease, neuropsychiatric disorders are the largest contributor to the global disease burden, accounting for 28% of disability-adjusted life years (DALYS) – ahead of cardiovascular disease (22%) and cancer (11%).1 Latest estimates indicate that depression accounts for approximately one third of this neuropsychiatric burden and, by the year 2030, depression is projected to be the largest contributor to the global burden of disease.1,2

  1. Prince M, Patel V, Saxena S, et al. No health without mental health. Lancet 2007; 370: 859–877
  2. World Health Organization (WHO). Global Burden of Disease, 2004 Update. Published 2008
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The burden associated with depression is large and increasing
References
  1. Ratnasingham S et al. Opening Eyes, Opening Minds: The Ontario Burden of Mental Illness and Addictions Report. Institute for Clinical Evaluative Sciences and Public Health Ontario, 2012
  2. Wittchen HU et al. Eur Neuropsychopharmacol 2011;21:655-79

 

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Depression is the most burdensome disorder of all brain diseases in the EU
Slide information

2. Wittchen HU et al. Eur Neuropsychopharmacol 2011;21:655-79

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Depression has detrimental effects on overall health
References
  1. Moussavi S, et al. Lancet. 2007;370:851-8
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Depression is associated with significant personal and societal consequences
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Health Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013
  2. Krol M, et al. Pharmacoeconomics. 2011;29(7):601–19
  3. Marcus M, et al. 2012. http://www.who.int/mental_health/management/depression/who_paper_depress... Accessed April 16, 2014
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The personal burden of MDD can be significant and wide-ranging
References
  1. Kessler RC. Psychiatr Clin North Am 2012;35(1):1–14. 2
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MDD has significant costs to society
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References

This slides illustrates the global social burden of MDD. The data are based on a systematic review of epidemiological data by Ferrari et al 2013. For this data were pooled using a Bayesian meta-regression. 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

Country data for key countries also exist.

  1. World Health Organization (WHO). Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. 2011. http://apps.who.int/gb/ebwha/pdf_files/EB130/B130_9-en.pdf. Accessed June 2015
  2. WHO. The Global Burden of Disease 2004 Update. http://www.who.int/healthinfo/global_burden_dis ease/2004_report_update/en/. Accessed July 2015 
  3. Ferrari AJ et al. PLoS Medi 2013;10:e1001547
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MDD has significant costs to society: EU
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References

This slides illustrates European burden of MDD with a focus on costs inferred due to impact on work. Note that: Absenteeism = lost days of work. Presenteeism = low performance while at work, which is transformed into lost day equivalents.

 

  1. Hughes S. MEP: Depression in the Workplace. http://www.enwhp.org/fileadmin/user_upload/pdf/Policy_recommendations_de.... Accessed July 2015
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Depression is associated with significant economic costs
References
  1. Collins PY, et al. Nature. 2011;475:27–30
  2. Sobocki P, et al. J Ment Health Policy Econ. 2006;9:87-98
  3. Stewart WF, et al. JAMA. 2003; 289: 3135-44; One Mind for Research. A Ten-Year Plan for Neuroscience: From Molecules to Brain Health. Available at: http://www.1mind4research.org/sites/1mind4research.org/files/files/Full%...
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Cost per patient of brain disorders in Europe in 2010#
References
  1. Gustavsson et al., Eur Neuropsychopharm (2011)21,718-779
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Cost per patient of mental disorders in Europe in 2010#
References
  1. Gustavsson et al., Eur Neuropsychopharm (2011)21,718-779
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Number of persons with disorders of the brain in Europe 2010#
References
  1. Gustavsson et al., Eur Neuropsychopharm (2011)21,718-779
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Mood disorders bears the highest total costs of brain disorders in Europe 2010#
References
  1. Gustavsson et al., Eur Neuropsychopharm (2011)21,718-779
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Mood disorders bears the highest total costs of mental disorders in Europe 2010#
References
  1. Gustavsson et al., Eur Nerropsychopharm (2011)21,718-779
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Depressive symptoms persist during periods of remission and subsequent depressive episodes
References
  1. Conradi HJ, et al. Psychol Med. 2011;41:1165-1174
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Cognitive impairment is among the most common residual symptoms in MDD*
References

McClintock SM, et al. J Clin Psychopharmacol. 2011;31:180-6

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Patients with cognitive symptoms of depression often have deficits in overall functioning1,2
Slide information
  1. Marazziti D, et al. Eur J Pharmacol. 2010;626:83-86
  2. Millan MJ, et al. Nat Rev Drug Discov. 2012;141-168
  3. American Psychiatric Association. Diagnostical Manual of Mental Disorders, Fifth Edition. Arlington, VA: APA 2013
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Depression costs more to employers than is spent on managing it
Slide information
  1. Olesen J, et al. Eur J Neurol. 2012;19:155-162
  2. Stewart WF, et al. JAMA. 2003;289(23):3135-3144
  3. Perkins M, Back A. Mental health failing costs business $ 11b. 2014. Retrieved from: http://www.smh.com.au/national/mental-healthfailing-costs-business-11b-2.... Accessed May 2015
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Depression directly impacts working time
References
  1. IDEA: Impact of Depression at Work in Europe Audit Final report. Ipsos Healthcare. October 2012.
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