Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 1:16:100341.
doi: 10.1016/j.lanepe.2022.100341. eCollection 2022 May.

The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019

Giulio Castelpietra  1 , Ann Kristin Skrindo Knudsen  2 , Emilie E Agardh  3 , Benedetta Armocida  4 , Massimiliano Beghi  5 , Kim Moesgaard Iburg  6 , Giancarlo Logroscino  7   8 , Rui Ma  9 , Fabrizio Starace  10 , Nicholas Steel  11   12 , Giovanni Addolorato  13 , Catalina Liliana Andrei  14 , Tudorel Andrei  15 , Jose L Ayuso-Mateos  16   17 , Maciej Banach  18   19 , Till Winfried Bärnighausen  20   21 , Francesco Barone-Adesi  22 , Akshaya Srikanth Bhagavathula  23   24 , Felix Carvalho  25 , Márcia Carvalho  25   26 , Joht Singh Chandan  27 , Vijay Kumar Chattu  28   29 , Rosa A S Couto  30 , Natália Cruz-Martins  31   32 , Paul I Dargan  33   34 , Keshab Deuba  35   3 , Diana Dias da Silva  36 , Adeniyi Francis Fagbamigbe  37   38 , Eduarda Fernandes  39 , Pietro Ferrara  40 , Florian Fischer  41 , Peter Andras Gaal  42   43 , Alessandro Gialluisi  44 , Juanita A Haagsma  45 , Josep Maria Haro  46   47 , M Tasdik Hasan  48   49 , Syed Shahzad Hasan  50 , Sorin Hostiuc  51   52 , Licia Iacoviello  44   53 , Ivo Iavicoli  54 , Elham Jamshidi  55   56 , Jost B Jonas  57   58 , Tamas Joo  42 , Jacek Jerzy Jozwiak  59 , Srinivasa Vittal Katikireddi  60 , Joonas H Kauppila  61   62 , Moien A B Khan  63   64 , Adnan Kisa  65   66 , Sezer Kisa  67 , Mika Kivimäki  68   69 , Kamrun Nahar Koly  70   71 , Ai Koyanagi  72   73 , Manasi Kumar  74   75 , Tea Lallukka  69 , Berthold Langguth  76 , Caterina Ledda  77 , Paul H Lee  78 , Ilaria Lega  79 , Christine Linehan  80 , Joana A Loureiro  81   82 , Áurea M Madureira-Carvalho  39   83 , Jose Martinez-Raga  84   85 , Manu Raj Mathur  86   87 , John J McGrath  88   89 , Enkeleint A Mechili  90   91 , Alexios-Fotios A Mentis  92 , Tomislav Mestrovic  93   94 , Bartosz Miazgowski  95 , Andreea Mirica  96 , Antonio Mirijello  97 , Babak Moazen  20   98 , Shafiu Mohammed  99   100 , Francesk Mulita  101   102 , Gabriele Nagel  103 , Ionut Negoi  104   105 , Ruxandra Irina Negoi  106   107 , Vincent Ebuka Nwatah  108   109 , Alicia Padron-Monedero  110 , Songhomitra Panda-Jonas  111 , Shahina Pardhan  112 , Maja Pasovic  9 , Jay Patel  113   114 , Ionela-Roxana Petcu  96 , Marina Pinheiro  115 , Richard Charles G Pollok  116 , Maarten J Postma  117 , David Laith Rawaf  118 , Salman Rawaf  119   120   121 , Esperanza Romero-Rodríguez  122 , Luca Ronfani  123 , Dominic Sagoe  124 , Francesco Sanmarchi  125 , Michael P Schaub  126 , Nigussie Tadesse Sharew  127   128 , Rahman Shiri  129 , Farhad Shokraneh  130   131 , Inga Dora Sigfusdottir  132   133 , João Pedro Silva  25 , Renata Silva  134 , Bogdan Socea  135 , Miklós Szócska  136 , Rafael Tabarés-Seisdedos  85   137 , Marco Torrado  138   139 , Marcos Roberto Tovani-Palone  140   141 , Tommi Juhani Vasankari  142   143 , Massimiliano Veroux  144 , Russell M Viner  145 , Andrea Werdecker  146 , Andrea Sylvia Winkler  147   148 , Simon I Hay  149 , Alize J Ferrari  9   150 , Mohsen Naghavi  149 , Peter Allebeck  3 , Lorenzo Monasta  123
Affiliations

The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019

Giulio Castelpietra et al. Lancet Reg Health Eur. .

Abstract

Background: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time.

Methods: Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated.

Findings: In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs.

Interpretation: Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people.

Funding: The Bill and Melinda Gates Foundation.

Keywords: Europe; Mental disorders; Mental health; Self-harm; Substance use; Young people.

PubMed Disclaimer

Conflict of interest statement

T W Bärnighausen reports Research grants from the European Union (Horizon 2020 and EIT Health), German Research Foundation (DFG), US National Institutes of Health, German Ministry of Education and Research, Alexander von Humboldt Foundation, Else-Kröner-Fresenius-Foundation, Wellcome Trust, Bill & Melinda Gates Foundation, KfW, UNAIDS, and WHO; consulting fees from KfW on the OSCAR initiative in Vietnam; participation on a Data Safety Monitoring Board or Advisory Board with NIH-funded study “Healthy Options” as Chair, Data Safety and Monitoring Board (DSMB) for the German National Committee on the “Future of Public Health Research and Education”, Chair of the scientific advisory board to the EDCTP Evaluation, Member of the UNAIDS Evaluation Expert Advisory Committee, National Institutes of Health Study Section Member on Population and Public Health Approaches to HIV/AIDS (PPAH), US National Academies of Sciences, Engineering, and Medicine's Committee for the “Evaluation of Human Resources for Health in the Republic of Rwanda under the President's Emergency Plan for AIDS Relief (PEPFAR)”, University of Pennsylvania Population Aging Research Center (PARC) External Advisory Board Member; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as Co-chair of the Global Health Hub Germany, initiated by the German Ministry of Health); all outside the submitted work. J S Chandan reports grants or contracts from the National Institute of Health Research and has been awarded funds from the NIHR and the Youth Endowment Fund, outside the submitted work. J J Jozwiak reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing or educational events from Teva, Amgen, Synexus, Boehringer Ingelheim, ALAB Laboratories, and Zentiva, all as personal fees and outside the submitted work. S V Katikireddi reports support for the present manuscript form Medical Research Council and the Scottish Government Chief Scientist Office as funding to their institution. J H Kauppila reports grants or contracts from The Finnish Cancer Foundation, and Sigrid Juselius Foundation as payments made to their institution, outside the submitted work. M Kivimäki reports grants or contracts form Wellcome Trust, UK (221854/Z/20/Z), and the Medical Research Council, UK (MR/R024227/1, MR/S011676/1) as the PI of research funding for their university, outside the submitted work. G Logroscino reports honoraria for lectures from Amplifon, outside the submitted work. J A Louriero reports support for the present manuscript from Fundação para a Ciência e Técnologia (FCT) under the Scientific Employment Stimulus [CEECINST/00049/2018]. A-F A Mentis reports grants or contracts from ‘MilkSafe: A novel pipeline to enrich formula milk using omics technologies’, a research co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH - CREATE - INNOVATE (project code: T2EDK-02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860); stock or stock options in a family winery; all outside the submitted work. M J Postma reports stock or stock options from Health-Ecore and PAG, outside the submitted work. N Steel reports grants from Public Health England to their institution, outside the submitted work. R M Viner reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Canadian Academy of Child & Adolescent Psychiatry for lecture on mental health aspects of COVID-19 pandemic; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as the President of Royal College of Paediatrics & Child Health, 2018-2021; all outside the submitted work.

Figures

Figure 1
Figure 1
Prevalence per 100,000 population aged 10-24 years of common, severe and other mental disorders (MDs), alcohol and drug use disorders, and incidence rate of self-harm in 31 European countries, both sexes, age 10-24, year 2019. Common MDs: anxiety and depressive disorders; Severe MDs: schizophrenia and bipolar disorder; Other MDs: eating disorders, attention deficit/hyperactivity disorder, autism spectrum disorder, conduct disorders, idiopathic developmental intellectual disability, other mental disorders.
Figure 2
Figure 2
Disability Adjusted Life Years (DALYs) divided in Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) for mental disorders, substance use disorders and self-harm in 31 European countries, females and males, age 10-24, year 2019.
Figure 3
Figure 3
Prevalence for mental disorders, substance use disorders, and incidence for self-harm in European Union, Iceland, Norway and Switzerland, years 1990-2019, males and females, age 10-14, 15-19, 20-24 percentage change over time.
See this image and copyright information in PMC

References

    1. Reiner RC, Jr., Olsen HE, Ikeda CT, et al. Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study. JAMA pediatrics. 2019;173(6) - PMC - PubMed
    1. Mokdad AH, Forouzanfar MH, Daoud F, et al. Global burden of diseases, injuries, and risk factors for young people's health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England) 2016;387(10036):2383–2401. - PubMed
    1. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England) 2020;396(10258):1204–1222. - PMC - PubMed
    1. Kieling C, Baker-Henningham H, Belfer M, et al. Child and adolescent mental health worldwide: evidence for action. Lancet (London, England) 2011;378(9801):1515–1525. - PubMed
    1. Erskine HE, Moffitt TE, Copeland WE, et al. A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth. Psychological medicine. 2015;45(7):1551–1563. - PMC - PubMed