期刊
BIOLOGICAL PSYCHIATRY
卷 72, 期 3, 页码 228-237出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2012.03.009
关键词
Cross-national; early-onset; income; epidemiology; mental disorders; WHO World Mental Health (WMH)
资金
- U.S. National Institute of Mental Health [R01MH070884]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- U.S. Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center [FIRCA R03-TW006481]
- Pan American Health Organization
- Eli Lilly & Company Foundation
- Ortho-McNeil Pharmaceutical
- GlaxoSmithKline
- Bristol-Myers Squibb
- Shire
- State of Sao Paulo Research Foundation [03/00204-3]
- Ministry of Health
- National Center for Public Health Protection
- Shenzhen Bureau of Health
- Shenzhen Bureau of Science, Technology, and Information
- Ministry of Social Protection
- European Commission [QLG5-1999-01042, SANCO 2004123, EAHC 20081308]
- Piedmont Region (Italy)
- Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain [FIS 00/0028]
- Ministerio de Ciencia y Tecnologia, Spain [SAF 2000 158-CE]
- Departament de Salut, Generalitat de Catalunya, Spain
- Instituto de Salud Carlos III [CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP]
- World Health Organization (India)
- Japanese Funds through United Nations Development Group Iraq Trust Fund
- European Funds through United Nations Development Group Iraq Trust Fund
- Israel National Institute for Health Policy and Health Services Research
- National Insurance Institute of Israel
- Japan Ministry of Health, Labour and Welfare [H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013]
- Lebanese Ministry of Public Health
- WHO (Lebanon)
- Fogarty International
- Act for Lebanon
- Janssen Cilag
- Eli Lilly
- Roche
- Novartis
- National Institute of Psychiatry Ramon de la Fuente [INPRFMDIES 4280]
- National Council on Science and Technology [CONACyT-G30544-H]
- New Zealand Ministry of Health, Alcohol Advisory Council
- Health Research Council
- WHO (Geneva)
- WHO (Nigeria)
- Federal Ministry of Health, Abuja, Nigeria
- Champalimaud Foundation
- Gulbenkian Foundation
- Foundation for Science and Technology
- Ministry of Public Health
- Eli Lilly Romania
- U.S. National Institute of Mental Health (NIMH) [R01-MH059575]
- National Institute of Drug Abuse
- South African Department of Health
- University of Michigan
- U.S. NIMH [RO1-MH61905]
- NIMH [U01-MH60220]
- Substance Abuse and Mental Health Services Administration
- Robert Wood Johnson Foundation [044708]
- John W. Alden Trust
- Ministry of Education, Culture, Sports, Science and Technology, Japan [4102-21119001]
- Analysis Group Inc.
- Eli Lilly Company
- EPI-Q
- Johnson & Johnson Pharmaceuticals
- Ortho-McNeil Janssen Scientific Affairs
- Pfizer Inc.
- Sanofi-Aventis Groupe
- Shire US, Inc.
- MRC [G0901530] Funding Source: UKRI
- Medical Research Council [G0901530] Funding Source: researchfish
- Grants-in-Aid for Scientific Research [21119003] Funding Source: KAKEN
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [03/00204-3] Funding Source: FAPESP
Background: Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy makers to the value of expanding initiatives for early detection and treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income. Methods: Data come from the World Health Organization (WHO) World Mental Health Surveys in 11 high-income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents aged 18 to 64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income. Results: Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16% to 33% of median within-country household income, and population-level effect sizes are in the range 1.0% to 1.4% of gross household income. Conclusions: Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy makers should take these associations into consideration in making health care research and treatment resource allocation decisions.
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