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PLoS One. 2014 Apr 2;9(4):e91936. doi: 10.1371/journal.pone.0091936. eCollection 2014.

The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study 2010.

Author information

1
University of Queensland, School of Population Health, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
2
University of Queensland, School of Population Health, Herston, Queensland, Australia; Queensland Children's Medical Research Institute, University of Queensland, Herston, Queensland, Australia.
3
Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America.
4
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
5
School of Science and Health, University of Western Sydney, Campbelltown, New South Wales, Australia.
6
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
7
University of Queensland, School of Population Health, Herston, Queensland, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America.

Abstract

BACKGROUND:

The Global Burden of Disease Study 2010 (GBD 2010) identified mental and substance use disorders as the 5th leading contributor of burden in 2010, measured by disability adjusted life years (DALYs). This estimate was incomplete as it excluded burden resulting from the increased risk of suicide captured elsewhere in GBD 2010's mutually exclusive list of diseases and injuries. Here, we estimate suicide DALYs attributable to mental and substance use disorders.

METHODS:

Relative-risk estimates of suicide due to mental and substance use disorders and the global prevalence of each disorder were used to estimate population attributable fractions. These were adjusted for global differences in the proportion of suicide due to mental and substance use disorders compared to other causes then multiplied by suicide DALYs reported in GBD 2010 to estimate attributable DALYs (with 95% uncertainty).

RESULTS:

Mental and substance use disorders were responsible for 22.5 million (14.8-29.8 million) of the 36.2 million (26.5-44.3 million) DALYs allocated to suicide in 2010. Depression was responsible for the largest proportion of suicide DALYs (46.1% (28.0%-60.8%)) and anorexia nervosa the lowest (0.2% (0.02%-0.5%)). DALYs occurred throughout the lifespan, with the largest proportion found in Eastern Europe and Asia, and males aged 20-30 years. The inclusion of attributable suicide DALYs would have increased the overall burden of mental and substance use disorders (assigned to them in GBD 2010 as a direct cause) from 7.4% (6.2%-8.6%) to 8.3% (7.1%-9.6%) of global DALYs, and would have changed the global ranking from 5th to 3rd leading cause of burden.

CONCLUSIONS:

Capturing the suicide burden attributable to mental and substance use disorders allows for more accurate estimates of burden. More consideration needs to be given to interventions targeted to populations with, or at risk for, mental and substance use disorders as an effective strategy for suicide prevention.

PMID:
24694747
PMCID:
PMC3973668
DOI:
10.1371/journal.pone.0091936
[Indexed for MEDLINE]
Free PMC Article

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