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. 2015 Apr;24(2):121-40.
doi: 10.1017/S2045796014000687. Epub 2014 Dec 15.

Excess mortality from mental, neurological and substance use disorders in the Global Burden of Disease Study 2010

F J Charlson  1 , A J Baxter  1 , T Dua  2 , L Degenhardt  3 , H A Whiteford  1 , T Vos  3
Affiliations

Excess mortality from mental, neurological and substance use disorders in the Global Burden of Disease Study 2010

F J Charlson et al. Epidemiol Psychiatr Sci. 2015 Apr.

Abstract

Aims: Mortality-associated burden of disease estimates from the Global Burden of Disease 2010 (GBD 2010) may erroneously lead to the interpretation that premature death in people with mental, neurological and substance use disorders (MNSDs) is inconsequential when evidence shows that people with MNSDs experience a significant reduction in life expectancy. We explore differences between cause-specific and excess mortality of MNSDs estimated by GBD 2010.

Methods: GBD 2010 cause-specific death estimates were produced using the International Classification of Diseases death-coding system. Excess mortality (all-cause) was estimated using natural history models. Additional mortality attributed to MNSDs as underlying causes but not captured through GBD 2010 methodology is quantified in the comparative risk assessments.

Results: In GBD 2010, MNSDs were estimated to be directly responsible for 840 000 deaths compared with more than 13 million excess deaths using natural history models.

Conclusions: Numbers of excess deaths and attributable deaths clearly demonstrate the high degree of mortality associated with these disorders. There is substantial evidence pointing to potential causal pathways for this premature mortality with evidence-based interventions available to address this mortality. The life expectancy gap between persons with MNSDs and the general population is high and should be a focus for health systems reform.

Keywords: neuropsychiatry.

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Figures

Fig. 1.
Fig. 1.
Age-standardised YLL rates (per 100 000 population) for MNSDs by GBD super-region and disorder, 2010.
Fig. 2.
Fig. 2.
Age-standardised YLL rates (per 100 000) for MNSDs by GBD super-region and sex, 2010.
Fig. 3.
Fig. 3.
Numbers of cause-specific and excess deaths attributed to mental disorders in 2010, by age with upper and lower 95% CI. *Note: ADHD, CD and anxiety not shown as there were no cause-specific or excess mortality estimated (Table 1).
Fig. 4.
Fig. 4.
Numbers of cause-specific and excess deaths attributed to substance use disorders in 2010, by age and with upper and lower 95% CI. *Note: Cannabis not shown as there was no cause-specific or excess mortality.
Fig. 5.
Fig. 5.
Numbers of cause-specific and excess deaths attributed to neurological disorders in 2010, by age and with upper and lower 95% CI. *Note: Migraine not shown as there was no cause-specific or excess mortality.
Fig. 6.
Fig. 6.
YLL rates (per 100 000 population) for deaths directly associated with MNSDs and indirect deaths for MNSDs as risk factors for other health outcomes, 2010. Note: Indirect deaths include deaths attributable to alcohol and drug use from CRA study; suicide deaths attributable to mental and substance use disorders; and ischaemic heart disease deaths attributable to major depression (see Table above for specific fatal outcomes)
See this image and copyright information in PMC

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