https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)61729-2.pdf

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.

Summary Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services. Funding Bill & Melinda Gates Foundation.

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Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61238-0.pdf

No health without mental health.

Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.

/pdf/suicide-and-suicidal-behavior-41x9ufvkfm.pdf

Suicide and Suicidal Behavior

Across the world, mental health has entered an historic era. Over the past 50 years, demographic factors such as population growth and ageing, poverty, urbanization and `modernization' of rural communities have increased the burden of mental problems. As we enter the 21st century, ®ve of the 10 leading causes of disability worldwide are mental disorders. The rapid rise of non-communicable diseases (NCDs) represents one of the major challenges to global development: it is estimated that by 2020 over 70% of the global burden of disease will be caused by NCDs, and neuropsychiatric disorders will account for 14% of all disease burden. As such, mental and neurological disorders represent a major source of disability and lost productivity (1). The World Health Organization recognizes this juncture, and has de®ned Mental Health as a top priority for its global strategy to improve health. The Director of WHO, Dr Gro Harlem Brundtland has selected mental health as the topic for two of the 2001 major events: the World Health Report and World Health Day (7 April). This is an unequivocal statement of the commitment of the WHO leadership to mental health. Over the course of 2001, there will be an increasing effort to use the World Health Day and the World Health Report to capture the attention of the public as well as governments. Many challenges exist in improving mental health, worldwide. Cost-effective treatments are available for our most serious disorders, but most people who need these services do not receive them. Persistent and troubling barriers to receiving care remain: stigma and discrimination, which inhibit seeking help; public attitudes driven by fear and misinformation still dominate public discourse. All service delivery systems are being challenged to do more, often without signi®cant new resources, and they are being held accountable for their performance. The way systems are organized and ®nanced may also serve to obstruct access by limiting coverage for mental health or by requiring impossibly expensive user payments. WHO has developed a strategy that responds to these diverse challenges. In many places, policies need to be developed or modernized to improve their responsiveness to the people they serve. In other areas, creative and innovative programmes already exist and need to be empowered (as in many developing countries where outstanding and innovative practices are in place but need to be supported). Indeed, we should recognize the important lessons that the South of the world could teach to the North, in areas such as community work, integrated primary health care, and family and consumer involvement. Similarly, the North could contribute fundamentally in the areas of neuroscience, genetics, pharmacology and research methodology. The challenges to researchers in developing countries and the speci®c needs of vulnerable groups in today's world have been discussed in this journal by Norman Sartorius in 1998 (2) and Gro Harlem Brundtland in 2000 (3) respectively. WHO will focus its action on assisting countries in mental health policy formulation, which should include human rights protection and in development and dissemination of evidencebased interventions with special emphasis on substance dependence, depression, suicide prevention, schizophrenia, epilepsy and dementia. Through its regional and country of®ces, WHO is seeking the collaboration of governments, international and local NGOs and research institutions. At WHO we stand ready to do our part in providing global leadership to ensure that this opportunity is maximized. The slogan of WHO World Health Day 2001 captures this imperative: `Stop exclusion, dare to care'.

World Health Day, 7 April 2001.

9.7 Public mental health

En la inauguracion, Alberto Fernandez Liria, Presidente de la AEN, destaco la existencia actual de un consenso entre las CC.AA., plasmado en la Estrategia en Salud Mental del Sistema Nacional de Salud, acerca de la necesidad de un modelo comunitario para el que existe un conocido soporte empirico. Y exponia la situacion de Madrid, donde en este momento de consenso, los poderes politicos y las circunstancias economicas promueven estrategias y modelos que llevan a la incertidumbre, por no saber si este sistema de recursos en red va a poder seguir funcionando. A continuacion, Antonio Burgueno, Director General de Hospitales de Madrid, se refirio a la Jornada como un foro altamente oportuno ya que en este momento se ha propuesto hacer una revision de nuestro sistema de Salud Mental, enmarcado en un Plan que toca revisar. Animo a los presentes a que se le hicieran llegar las conclusiones y comento su intencion de desarrollar una herramienta util a la CAM. Pablo Rivero, Director General de Calidad y Cohesion del Sistema Nacional de Salud, expuso la necesidad de defender los avances logrados en el estado de bienestar, el SNS, y seguir avanzando sin caer en la autocomplacencia, en unos momentos de incertidumbre internacional. Destaco la importancia de haber desarrollado de manera cooperativa la Estrategia en Salud Mental del Sistema Nacional de Salud y la necesidad de que este consenso llegue a dar herramientas a los profesionales y ciudadanos.

https://scielo.isciii.es/pdf/neuropsiq/v29n1/v29n1a17.pdf

Jornada sobre modelos y estrategias en salud mental

Abstract Since 1989, the major professional organization of psychiatrists has expressed concern for the human rights of people with mental disorders: “Involuntary intervention is a great infringement of the human rights and the fundamental freedom of a patient. Therefore, specific, and carefully defined criteria and safeguards are needed for such intervention. Hospitalization or treatment against the will of a patient should not be conducted unless the patient suffers from serious mental illness. Involuntary intervention must be conducted in accordance with the least restrictive principle.

Benedetto Saraceno

Papers

World Health Day, 7 April 2001.

9.7 Public mental health

Jornada sobre modelos y estrategias en salud mental

Human rights of persons with mental disability: from discourse to reality

Laying foundations for improved care of the mentally ill.