A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth

Abstract

Background: Mental and substance use disorders are common and often persistent, with many emerging in early life. Compared to adult mental and substance use disorders, the global burden attributable to these disorders in children and youth has received relatively little attention.

Method: Data from the Global Burden of Disease Study 2010 was used to investigate the burden of mental and substance disorders in children and youth aged 0-24 years. Burden was estimated in terms of disability-adjusted life years (DALYs), derived from the sum of years lived with disability (YLDs) and years of life lost (YLLs).

Results: Globally, mental and substance use disorders are the leading cause of disability in children and youth, accounting for a quarter of all YLDs (54.2 million). In terms of DALYs, they ranked 6th with 55.5 million DALYs (5.7%) and rose to 5th when mortality burden of suicide was reattributed. While mental and substance use disorders were the leading cause of DALYs in high-income countries (HICs), they ranked 7th in low- and middle-income countries (LMICs) due to mortality attributable to infectious diseases.

Conclusions: Mental and substance use disorders are significant contributors to disease burden in children and youth across the globe. As reproductive health and the management of infectious diseases improves in LMICs, the proportion of disease burden in children and youth attributable to mental and substance use disorders will increase, necessitating a realignment of health services in these countries.

Keywords: mental and substance use disorders.

Conflict of interest statement

Declaration of Interest

None.

Figures

Fig. 1

Disability-adjusted life year (DALY) rates (per 100 000) and proportions (%) for mental and substance use disorders for persons in each age group across childhood and youth in 2010.

Fig. 2

Proportion of total disability-adjusted life years in high-income countries and low- and middle-income countries attributable to each main cause group for persons aged 0–24 years in 2010.

Fig. 3

Proportion of disability-adjusted life years attributable to mental and substance disorders in each country for children and youth in 2010. South Sudan, Western Sahara, and French Guiana were not included for burden calculations in GBD 2010.

Fig. 4

Additional suicide burden attributable to mental and substance use disorders for each age group across childhood and youth, over and above disability-adjusted life years (DALYs) assigned as a direct cause. Attributable suicides years of life lost (YLL) were only evident from the age of 5 years onwards.