The Lancet Regional Health. Europe (May 2022)
The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: Findings from the Global Burden of Disease Study 2019
- Giulio Castelpietra,
- Ann Kristin Skrindo Knudsen,
- Emilie E. Agardh,
- Benedetta Armocida,
- Massimiliano Beghi,
- Kim Moesgaard Iburg,
- Giancarlo Logroscino,
- Rui Ma,
- Fabrizio Starace,
- Nicholas Steel,
- Giovanni Addolorato,
- Catalina Liliana Andrei,
- Tudorel Andrei,
- Jose L Ayuso-Mateos,
- Maciej Banach,
- Till Winfried Bärnighausen,
- Francesco Barone-Adesi,
- Akshaya Srikanth Bhagavathula,
- Felix Carvalho,
- Márcia Carvalho,
- Joht Singh Chandan,
- Vijay Kumar Chattu,
- Rosa A.S. Couto,
- Natália Cruz-Martins,
- Paul I. Dargan,
- Keshab Deuba,
- Diana Dias da Silva,
- Adeniyi Francis Fagbamigbe,
- Eduarda Fernandes,
- Pietro Ferrara,
- Florian Fischer,
- Peter Andras Gaal,
- Alessandro Gialluisi,
- Juanita A. Haagsma,
- Josep Maria Haro,
- M. Tasdik Hasan,
- Syed Shahzad Hasan,
- Sorin Hostiuc,
- Licia Iacoviello,
- Ivo Iavicoli,
- Elham Jamshidi,
- Jost B. Jonas,
- Tamas Joo,
- Jacek Jerzy Jozwiak,
- Srinivasa Vittal Katikireddi,
- Joonas H. Kauppila,
- Moien A.B. Khan,
- Adnan Kisa,
- Sezer Kisa,
- Mika Kivimäki,
- Kamrun Nahar Koly,
- Ai Koyanagi,
- Manasi Kumar,
- Tea Lallukka,
- Berthold Langguth,
- Caterina Ledda,
- Paul H. Lee,
- Ilaria Lega,
- Christine Linehan,
- Joana A. Loureiro,
- Áurea M Madureira-Carvalho,
- Jose Martinez-Raga,
- Manu Raj Mathur,
- John J. McGrath,
- Enkeleint A. Mechili,
- Alexios-Fotios A. Mentis,
- Tomislav Mestrovic,
- Bartosz Miazgowski,
- Andreea Mirica,
- Antonio Mirijello,
- Babak Moazen,
- Shafiu Mohammed,
- Francesk Mulita,
- Gabriele Nagel,
- Ionut Negoi,
- Ruxandra Irina Negoi,
- Vincent Ebuka Nwatah,
- Alicia Padron-Monedero,
- Songhomitra Panda-Jonas,
- Shahina Pardhan,
- Maja Pasovic,
- Jay Patel,
- Ionela-Roxana Petcu,
- Marina Pinheiro,
- Richard Charles G. Pollok,
- Maarten J. Postma,
- David Laith Rawaf,
- Salman Rawaf,
- Esperanza Romero-Rodríguez,
- Luca Ronfani,
- Dominic Sagoe,
- Francesco Sanmarchi,
- Michael P Schaub,
- Nigussie Tadesse Sharew,
- Rahman Shiri,
- Farhad Shokraneh,
- Inga Dora Sigfusdottir,
- João Pedro Silva,
- Renata Silva,
- Bogdan Socea,
- Miklós Szócska,
- Rafael Tabarés-Seisdedos,
- Marco Torrado,
- Marcos Roberto Tovani-Palone,
- Tommi Juhani Vasankari,
- Massimiliano Veroux,
- Russell M. Viner,
- Andrea Werdecker,
- Andrea Sylvia Winkler,
- Simon I. Hay,
- Alize J. Ferrari,
- Mohsen Naghavi,
- Peter Allebeck,
- Lorenzo Monasta
Affiliations
- Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy; Corresponding author at: Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Trieste 34100, Italy.
- Ann Kristin Skrindo Knudsen
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
- Emilie E. Agardh
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Benedetta Armocida
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
- Massimiliano Beghi
- Department of Mental Health, AUSL Romagna, Ravenna, Italy
- Kim Moesgaard Iburg
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy
- Rui Ma
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
- Fabrizio Starace
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
- Nicholas Steel
- Department of Primary Care and Public Health, University of East Anglia, Norwich, UK; Public Health England, London, UK
- Giovanni Addolorato
- Department of Internal Medicine, Catholic University of Rome, Rome, Italy
- Catalina Liliana Andrei
- Cardiology Department Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Tudorel Andrei
- Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies, Bucharest, Romania
- Jose L Ayuso-Mateos
- CIBERSAM, Institute of Health Carlos III, Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (Autonomous University of Madrid), Madrid, Spain
- Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland; Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
- Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany; T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Francesco Barone-Adesi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
- Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic; Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
- Felix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
- Márcia Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal; Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
- Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Vijay Kumar Chattu
- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago; Independent Consultant, Athens, Greece
- Rosa A.S. Couto
- Department of Chemical Sciences, University of Porto, Porto, Portugal
- Natália Cruz-Martins
- Department of Medicine (Prof N Cruz-Martins PhD), University of Porto, Porto, Portugal; Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Famalicão, Portugal
- Paul I. Dargan
- Faculty of Life Sciences and Medicine, King's College London, London, UK; Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Keshab Deuba
- National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal; Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Diana Dias da Silva
- Laboratory of Toxicology, University of Porto, Porto, Portugal
- Adeniyi Francis Fagbamigbe
- Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria; Population and Behavioural Sciences, University of St Andrews, St Andrews, UK
- Eduarda Fernandes
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
- Pietro Ferrara
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
- Florian Fischer
- Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
- Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary; Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
- Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
- Juanita A. Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain
- M. Tasdik Hasan
- Department of Pharmacy, University of Huddersfield, Huddersfield, UK; School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
- Syed Shahzad Hasan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
- Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy; Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
- Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
- Elham Jamshidi
- Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehram, Iran; Division of Pulmonary Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
- Jost B. Jonas
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
- Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Joonas H. Kauppila
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Surgery Research Unit, University of Oulu, Oulu, Finland
- Moien A.B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates; Primary Care Department, NHS North West London, London, UK
- Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway;; Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
- Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Mika Kivimäki
- Department of Epidemiology and Public Health University College London, London, UK; Department of Public Health, University of Helsinki, Helsinki, Finland
- Kamrun Nahar Koly
- Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
- Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Manasi Kumar
- Division of Psychology and Language Sciences, University College London, London, UK; Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Caterina Ledda
- Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
- Ilaria Lega
- National Center for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Insitute of Health, Rome, Italy
- Christine Linehan
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
- Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE) University of Porto, Porto, Portugal; School of Health, Polytechnic Institute of Porto, Portugal;
- Áurea M Madureira-Carvalho
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal; Institute for Research and Advanced Training in Health Sciences and Technologies, Instituto Universitário de Ciências da Saúde (University Institute of Health Sciences), Gandra, Portugal
- Jose Martinez-Raga
- Psychiatry Department, Hospital Universitario Doctor Peset, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
- Manu Raj Mathur
- Health Policy Research Public Health Foundation of India, Gurugram, India; Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
- John J. McGrath
- Queensland Brain Institute, School of Public Health, The University of Queensland, Brisbane, QLD, Australia; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Enkeleint A. Mechili
- Department of Healthcare, University of Vlora, Vlora city, Albania; Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece
- Alexios-Fotios A. Mentis
- University Research Institute, National and Kapodistrian University of Athens, Athens, Greece
- Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia; University Centre Varazdin, University North, Varazdin, Croatia
- Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Andreea Mirica
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
- Antonio Mirijello
- Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy
- Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany; Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
- Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria; Department of Health Care Management, Technical University of Berlin, Berlin, Germany
- Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece; Medical School, University of Thessaly, Larissa, Greece
- Gabriele Nagel
- Institute of Epidemiology and Medical Biometry Ulm University, Ulm, Germany
- Ionut Negoi
- Department of General Surgery Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
- Ruxandra Irina Negoi
- Department of Anatomy and Embryology Romania, Bucharest, Romania; Cardio-Aid, Bucharest, Romania
- Vincent Ebuka Nwatah
- Department of Pediatrics, National Hospital, Abuja, Nigeria; Department of International Public Health, University of Liverpool, Liverpool, UK
- Alicia Padron-Monedero
- National School of Public Health Institute of Health Carlos III, Madrid, Spain
- Songhomitra Panda-Jonas
- Privatpraxis, Heidelberg, Germany
- Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
- Maja Pasovic
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
- Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, UK; School of Dentistry, University of Leeds, Leeds, UK
- Ionela-Roxana Petcu
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
- Marina Pinheiro
- Department of Chemistry, University of Porto, Porto, Portugal
- Richard Charles G. Pollok
- Institute of Infection and Immunity, St George's University of London, London, UK
- Maarten J. Postma
- University Medical Center Groningen, School of Economics and Business University of Groningen, Groningen, Netherlands
- David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training Imperial College London, London, UK
- Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK; University College London Hospitals, London, UK; Academic Public Health England, London, UK
- Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
- Dominic Sagoe
- Department of Psychosocial Science University of Bergen, Bergen, Norway
- Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Michael P Schaub
- Swiss Research Institute for Public Health and Addiction University of Zürich, Zurich, Switzerland
- Nigussie Tadesse Sharew
- Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) University of Groningen, Groningen, Netherlands; Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
- Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
- Farhad Shokraneh
- London Institute for Healthcare Engineering, King's College London, London, UK; Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Health and Behavior Studies, Columbia University, New York, NY, USA
- João Pedro Silva
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
- Renata Silva
- Department of Biological Sciences, University of Porto, Porto, Portugal
- Bogdan Socea
- Surgery, ''Sf. Pantelimon'' Emergency Clinical Hospital Bucharest, Bucharest, Romania
- Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
- Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain; Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Marco Torrado
- Psychiatry and Medical Psychology Department, University of Lisbon, Lisbon, Portugal; Child and Adolescent Mental Health Services (CAMHS), Hospital Garcia de Orta, Almada, Portugal
- Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil; Modestum LTD, London, UK
- Tommi Juhani Vasankari
- UKK Institute, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
- Russell M. Viner
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Andrea Werdecker
- Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany
- Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Neurology, Technical University of Munich, Munich, Germany
- Simon I. Hay
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Alize J. Ferrari
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; School of Public Health (A J Ferrari PhD), The University of Queensland, Brisbane, QLD, Australia
- Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
- Journal volume & issue
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Vol. 16
p. 100341
Abstract
Summary: Background: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods: Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings: In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 – 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432–912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9–412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (–29·1%;23·8-38·5). YLLs decreased in self-harm (–27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation: Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding: The Bill and Melinda Gates Foundation
