La charge des troubles mentaux dans les Etats de l'Inde : l'etude Global Burden of Disease 1990-2017

Titre original en anglais : The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017

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Sagar, R., Dandona, R., Gururaj, G., Dhaliwal, R. S., Singh, A., Ferrari, A., Dua, T., Ganguli, A., Varghese, M., Chakma, J. K., Kumar, G. A., Shaji, K. S., Ambekar, A., Rangaswamy, T., Vijayakumar, L., Agarwal, V., Krishnankutty, R. P., Bhatia, R., Charlson, F.,..., & Dandona, L. (2019). The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017. The Lancet Psychiatry, 7(2), 148-161. https://doi.org/10.1016/s2215-0366(19)30475-4

Date de publication: 23/12/2019 Ajout dans AutiHub: 29/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
42
Auteur·ices de la publication identifié·es comme autistes
1 / 42 (2,4 %)
  1. Rajesh Sagar
  2. Rakhi Dandona
  3. Gopalkrishna Gururaj
  4. R S Dhaliwal
  5. Aditya Singh
  6. Alize Ferrari
  7. Tarun Dua
  8. Atreyi Ganguli
  9. Mathew Varghese
  10. Joy K Chakma
  11. G Anil Kumar
  12. K S Shaji
  13. Atul Ambekar
  14. Thara Rangaswamy
  1. Lakshmi Vijayakumar
  2. Vivek Agarwal
  3. Rinu P Krishnankutty
  4. Rohit Bhatia
  5. Fiona Charlson
  6. Neerja Chowdhary
  7. Holly E. Erskine
  8. Scott D Glenn
  9. Varsha Krish
  10. Ana M Mantilla Herrera
  11. Parul Mutreja
  12. Christopher M Odell
  13. Pramod K Pal
  14. Sanjay Prakash
  1. Damian Santomauro *
  2. D K Shukla
  3. Ravinder Singh
  4. R K Lenin Singh
  5. J S Thakur
  6. Akhil S ThekkePurakkal
  7. Chris M Varghese
  8. K Srinath Reddy
  9. Soumya Swaminathan
  10. Harvey A. Whiteford
  11. Hendrik J Bekedam
  12. Christopher J L Murray
  13. Theo Vos
  14. Lalit Dandona

Résumé

CONTEXTE : Les troubles mentaux comptent parmi les principales causes de charge de morbidite non fatale en Inde, mais une comprehension systematique de leur prevalence, de leur charge de morbidite et de leurs facteurs de risque n'est pas facilement disponible pour chaque Etat de l'Inde. Dans ce rapport, nous decrivons la prevalence et la charge de morbidite de chaque trouble mental dans les Etats de l'Inde, de 1990 a 2017. METHODES : Nous avons utilise toutes les donnees accessibles provenant de sources multiples pour estimer la prevalence des troubles mentaux, les annees vecues avec incapacite (YLD) et les annees de vie ajustees sur l'incapacite (DALY) causees par ces troubles dans tous les Etats de l'Inde de 1990 a 2017, dans le cadre de la Global Burden of Diseases, Injuries, and Risk Factors Study. Nous avons evalue l'heterogeneite et les tendances temporelles des troubles mentaux dans les Etats de l'Inde. Nous avons regroupe les Etats sur la base de leur indice sociodemographique (SDI), qui est une mesure composite du revenu par habitant, de l'education moyenne et du taux de fecondite chez les femmes de moins de 25 ans. Nous avons egalement evalue l'association des principaux troubles mentaux avec les deces par suicide. Nous avons calcule des intervalles d'incertitude (UI) a 95 % pour les estimations ponctuelles. RESULTATS : En 2017, 197,3 millions (UI a 95 % 178,4-216,4) de personnes souffraient de troubles mentaux en Inde, dont 45,7 millions (42,4-49,8) de troubles depressifs et 44,9 millions (41,2-48,9) de troubles anxieux. Nous avons observe une correlation significative, mais modeste, entre la prevalence des troubles depressifs et le taux de mortalite par suicide au niveau des Etats chez les femmes (r2=0,33, p=0,0009) et les hommes (r2=0,19, p=0,015). La contribution des troubles mentaux au total des DALY en Inde est passee de 2,5 % (2,0-3,1) en 1990 a 4,7 % (3,7-5,6) en 2017. En 2017, les troubles depressifs contribuaient le plus au total des DALY attribuables aux troubles mentaux (33,8 %, 29,5-38,5), suivis des troubles anxieux (19,0 %, 15,9-22,4), de la deficience intellectuelle developpementale idiopathique (IDID ; 10,8 %, 6,3-15,9), de la schizophrenie (9,8 %, 7,7-12,4), du trouble bipolaire (6,9 %, 4,9-9,6), du trouble des conduites (5,9 %, 4,0-8,1), des troubles du spectre de l'autisme (3,2 %, 2,7-3,8), des troubles des conduites alimentaires (2,2 %, 1,7-2,8) et du trouble deficit de l'attention avec hyperactivite (ADHD ; 0,3 %, 0,2-0,5) ; les autres troubles mentaux representaient 8,0 % (6,1-10,1) des DALY. Presque tous (>99,9 %) ces DALY etaient constitues de YLD. Les estimations ponctuelles du taux de DALY pour les troubles mentaux debutant principalement pendant l'enfance et l'adolescence (IDID, trouble des conduites, troubles du spectre de l'autisme et ADHD) etaient plus elevees dans les Etats a faible SDI que dans les Etats a SDI intermediaire et a SDI eleve en 2017, tandis que la tendance etait inverse pour les troubles mentaux qui se manifestent principalement a l'age adulte. Bien que la prevalence des troubles mentaux debutant pendant l'enfance et l'adolescence ait diminue en Inde de 1990 a 2017, avec une diminution plus forte dans les Etats a SDI eleve et a SDI intermediaire que dans les Etats a faible SDI, la prevalence des troubles mentaux se manifestant principalement a l'age adulte a augmente au cours de cette periode. INTERPRETATION : Un Indien sur sept etait touche par des troubles mentaux de gravite variable en 2017. La contribution proportionnelle des troubles mentaux a la charge totale de morbidite en Inde a presque double depuis 1990. Des variations importantes existent entre les Etats dans la charge liee aux differents troubles mentaux et dans leurs tendances au fil du temps. Ces tendances propres a chaque Etat pour chaque trouble mental rapportees ici pourraient orienter des politiques appropriees et la reponse du systeme de sante afin de s'attaquer plus efficacement a la charge des troubles mentaux en Inde. FINANCEMENT : Bill & Melinda Gates Foundation ; et Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.

BACKGROUND: Mental disorders are among the leading causes of non-fatal disease burden in India, but a systematic understanding of their prevalence, disease burden, and risk factors is not readily available for each state of India. In this report, we describe the prevalence and disease burden of each mental disorder for the states of India, from 1990 to 2017. METHODS: We used all accessible data from multiple sources to estimate the prevalence of mental disorders, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by these disorders for all the states of India from 1990 to 2017, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We assessed the heterogeneity and time trends of mental disorders across the states of India. We grouped states on the basis of their Socio-demographic Index (SDI), which is a composite measure of per-capita income, mean education, and fertility rate in women younger than 25 years. We also assessed the association of major mental disorders with suicide deaths. We calculated 95% uncertainty intervals (UIs) for the point estimates. FINDINGS: In 2017, 197·3 million (95% UI 178·4-216·4) people had mental disorders in India, including 45·7 million (42·4-49·8) with depressive disorders and 44·9 million (41·2-48·9) with anxiety disorders. We found a significant, but modest, correlation between the prevalence of depressive disorders and suicide death rate at the state level for females (r2=0·33, p=0·0009) and males (r2=0·19, p=0·015). The contribution of mental disorders to the total DALYs in India increased from 2·5% (2·0-3·1) in 1990 to 4·7% (3·7-5·6) in 2017. In 2017, depressive disorders contributed the most to the total mental disorders DALYs (33·8%, 29·5-38·5), followed by anxiety disorders (19·0%, 15·9-22·4), idiopathic developmental intellectual disability (IDID; 10·8%, 6·3-15·9), schizophrenia (9·8%, 7·7-12·4), bipolar disorder (6·9%, 4·9-9·6), conduct disorder (5·9%, 4·0-8·1), autism spectrum disorders (3·2%, 2·7-3·8), eating disorders (2·2%, 1·7-2·8), and attention-deficit hyperactivity disorder (ADHD; 0·3%, 0·2-0·5); other mental disorders comprised 8·0% (6·1-10·1) of DALYs. Almost all (>99·9%) of these DALYs were made up of YLDs. The DALY rate point estimates of mental disorders with onset predominantly in childhood and adolescence (IDID, conduct disorder, autism spectrum disorders, and ADHD) were higher in low SDI states than in middle SDI and high SDI states in 2017, whereas the trend was reversed for mental disorders that manifest predominantly during adulthood. Although the prevalence of mental disorders with onset in childhood and adolescence decreased in India from 1990 to 2017, with a stronger decrease in high SDI and middle SDI states than in low SDI states, the prevalence of mental disorders that manifest predominantly during adulthood increased during this period. INTERPRETATION: One in seven Indians were affected by mental disorders of varying severity in 2017. The proportional contribution of mental disorders to the total disease burden in India has almost doubled since 1990. Substantial variations exist between states in the burden from different mental disorders and in their trends over time. These state-specific trends of each mental disorder reported here could guide appropriate policies and health system response to more effectively address the burden of mental disorders in India. FUNDING: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.

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64
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6
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3
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Sans identifiant stable
6
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7384
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7384
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499 / 7384 (6,8 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 6885 / 7384 (93,2 %) noms ne sont pas encore associés.
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Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 6 / 499 (1,2 %). Personnes distinctes identifiées comme autistes : 2 / 2219 (0,1 %).
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