Epidemiology of mood disorders

Peter R. Joyce Bipolar ..disorders

Diagnosticjs.sues

Prevalence

Comorbidity yseofhealth.. .services Riskfactors Organiciactors Oíh.e„r.„b,io!pgi.c.a!..fa^ct.ors

Lifeevents

Childhood. .experiences

Subthreshold ..symptoms

Depressive. .disorders Diagnosticjs.sues

Prevalence Risk„fac,tors

Genetics Gender

Childhood. .experiences Personality Social. environment Physjcaljllness

An. integrated ..a,etio!o,gic,a!.m,o,de! Comorbidity

Useofhealth.. services Chapter.. References

The Global Burden of Disease, which is a comprehensive assessment of mortality and disability from diseases and injuries in 1990 and projected to 2020, highlights the importance of mood disorders for the world. Using the measure of disability-adjusted life years, it was determined that unipolar major depression was the fourth leading cause of disease burden in the world. It was also projected that, in the year 2020, unipolar major depression would be the second leading cause of disease burden in the world. Disability-adjusted life years is based on both mortality and disability. If one looks at disability alone, then unipolar major depression was the leading cause of disability in the world in 1990, and bipolar disorder was the sixth leading cause. Across the world, 10.7 per cent of disability can be attributed to unipolar major depression and, in developed countries, unipolar major depression contributes to nearly 20 per cent of disease burden in women aged from 15 to 44 years.(!)

The mood disorders have received considerable attention in psychiatric epidemiology over the last two decades. These received particular attention in the five-site United States National Institutes of Mental Health Epidemiologic Catchment Area Study ( ECA), as well as the epidemiological studies in other countries around the world that used the ECA methodology. Mood disorders also received particular attention in the National Comorbidity Survey ( NCS) in the United States and in the National Psychiatric Morbidity Survey of Great Britain. Thus there is substantial data from around the world on the epidemiology of these disorders. In addition, many of the population-based twin registries, such as in Virginia, in the United States, have also paid particular interest to mood disorders and have the additional advantage of being able to consider genetic as well as environmental risk factors.

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