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Schizophrenia, Personality Disorders Present Highest Disability Burdens in Mental Health
Schizophrenia and personality disorders had the highest burdens of disability among individuals with mental health or substance use disorders, according to a new analysis published in The Lancet Psychiatry.
“Traditionally the impact of mental disorders has been presented for an entire nation, but in this study, we focused on people with different types of mental and substance use disorders at an individual level,” said researcher John McGrath, MD, a professor at the University of Queensland in Australia. “We found that schizophrenia and personality disorders were the most disabling mental conditions and showed how disorders like autism, anxiety disorders, and schizophrenia contribute to disability at different ages.”
The study included a cohort of 6.9 million Danish residents, of whom 5.9% had a diagnosis for a mental or substance use disorder in the Danish Psychiatric Central Research Register. Researchers calculated years lived with a disability (YLD), the duration of disease multiplied by a disability weight, for 18 different mental and substance use disorders for the study. In addition, they calculated a novel measure called the Health Loss Proportion (HeLP), which were estimated as YLDs associated with an index disorder and comorbid mental and substance use disorders divided by person-years at risk in patients with the index disorder.
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“Our new measure known as HeLP allows us to measure the average disability for different disorders at the individual level,” Dr. McGrath explained, “which means that individuals who experience more inherent disability, and more comorbid conditions, will have a higher HeLP weighting, and therefore a higher measure of disability.”
Among the 18 disorders evaluated, schizophrenia was the leading cause of YLDs, researchers reported. A person diagnosed with schizophrenia lost the equivalent of 73% of healthy life per year, according to the study. Personality disorders were the second leading cause of YLDs. However, opioid use disorders ranked second among the various disorders for HeLP, with people with opioid use disorder losing the equivalent of 67% of healthy life per year.
“Schizophrenia was by far the leading cause of YLDs in both sexes as estimated by both types of population-level YLDs, accounting for 42% of all YLDs among males and 30% among females,” researchers wrote. “The high burden of schizophrenia is partly explained by the disabling nature of the disease (disability weight 0.71), early onset (median age of onset is 22 years), and the relatively low remission rates compared to many other mental and substance use disorders.”
—Jolynn Tumolo
References
Weye N, Santomauro DF, Agerbo E, et al. Register-based metrics of years lived with disability associated with mental and substance use disorders: a register-based cohort study in Denmark. The Lancet Psychiatry. 2021;8(4):310-319.
