Citation

Baxter AJ, Charlson FJ, Somerville AJ, Whiteford HA. BMC Med. 2011; 9(1): 134.

Copyright

(Copyright © 2011, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1741-7015-9-134

PMID

22176705

PMCID

PMC3305628

Abstract

BACKGROUND: Mental disorders are themselves associated with considerable burden as well as being risk factors for other health outcomes. The new Global Burden of Disease (GBD) study will make estimates for both the disability and mortality directly associated with mental disorders, and the attributable burden due to other health outcomes. We discuss the process by which health outcomes, where mental disorders are risk factors, were selected for inclusion in the GBD study. Suggestions for future research are made in order to strengthen the body of evidence for mental disorders as risk factors. METHODS: A list of potential associations between mental disorders and subsequent health outcomes were identified based on a review of the literature and consultation with mental health experts. A two-stage filter was applied to identify mental disorders and health outcomes that met the criteria for inclusion in the GBD study. Major limitations in the current literature are discussed and illustrated with examples identified from our review. Results and Discussion Only two associations are included in the new GDB study. These are the increased risk of ischemic heart disease (IHD) with major depression and mental disorders as a risk factor for suicide. There is evidence that mental disorders are independent risk factors for cardiovascular disease (CVD), type 2 diabetes and injuries. However, these associations were unable to be included due to insufficient data. The most common reasons for exclusion were inconsistent identification of 'cases'; uncertain validity of health outcomes; lack of generalizability; insufficient control for confounding factors; and lack of evidence for temporality. CONCLUSIONS: Cardiovascular disease (CVD), type 2 diabetes and injury are important areas for public health policy. Prospective community studies of outcomes in mental disorders are required and their design must address a range of confounding factors.

Language: en