Mental disorders on the rise in high-income countries. The next big “epidemic”

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According to a report by the Harvard School of Public Health and the World Economic Forum, recently taken up by the Economist in an article entitled “Mental illness. The age of unreason “, between 2011 and 2030 the cost of mental illness worldwide will be more than 16 trillion dollars in terms of lost production (in 2010 dollars), more than oncological, cardiovascular, chronic respiratory and diabetes.

Mental disorders, understood both as psychiatric pathologies such as anxiety

depression or bipolar disorders, and neurological disorders, such as Alzheimer’s and dementia, are already the main cause of loss of years of life due to premature death and disability in high-income countries (17.4 %), followed by cancer (15.9%), cardiovascular diseases (14.8%), injuries (12.9%) and musculoskeletal diseases (9.2%).

According to data provided by the OECD

the Organization for Economic Co-operation and Development, in its focus “Coping with mental health”, severe depression, bipolar disorder, schizophrenia and other serious mental illnesses reduce the average life expectancy of 20 years compared to the general population, similar to chronic diseases such as cardiovascular disease. 5% of the world population of working age have severe mental illness and a further 15% have a more common form. One in two people will experience a mental health problem in their lifetime and this will reduce employment prospects, productivity and wages.

The direct and indirect costs of mental illness,

according to OECD statistics, can exceed 4% of the Gross Domestic Product (GDP). Indirect costs include medical expenses, due to an increased need for health care, and costs for health and social services such as long-term care. Mental health can also raise the cost of treatments for other diseases, for example diabetes treatment is more expensive when the patient also suffers from depression and people with poor mental health are more likely to also suffer from cancer and cardiovascular diseases.

About half of adults with mental illness developed it before the age of 15,

so early identification and treatment can also help reduce costs. Among mental illnesses, dementia is the second leading cause of disability among the population over the age of 70 globally, with an estimated 44 million people suffering from dementia worldwide. Dementia is set to become 50% most common in high-income countries and 80% most common in low- and middle-income countries by 2030. It is the leading cause of the world’s fastest growing disability, and the cost to the company – already estimated at 645 billion US dollars – is set to grow further.

For health systems and drug regulatory agencies, these data confirm the need to address the impact of these diseases not only on the health and quality of life of the population, but also on the sustainability of the costs of assistance and drug therapies. and support, also in consideration of the still too low levels of adherence to treatments that are recorded for example in Italy.

Summary

With reference to depression, several observational studies conducted on the Italian territory have shown that the share of patients who take antidepressants continuously and appropriately is just 20%, while about 50% stop treatment in the first 3 months of therapy and beyond 70% in the first 6 months. This leads to a reduced effectiveness of pharmacological treatment with a consequent increase in complications, as well as an increase in expenditure for the National Health Service.

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