Understanding the costs and economic impact of mental disorders in South Asia: A systematic review.

Autor: McDaid D; Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK. Electronic address: d.mcdaid@lse.ac.uk., Vidyasagaran AL; Department of Health Sciences, University of York, York, UK., Nasir M; Department of Economics, Institute of Business Administration (IBA), Karachi, Pakistan., Walker S; Centre for Health Economics, University of York, York, UK., Wright J; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK., Muliyala KP; Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India., Thekkumkara S; School of Health Sciences, University of Dundee, Dundee, UK., Huque R; ARK Foundation, Dhaka, Bangladesh., Faisal MR; Department of Health Sciences, University of York, York, UK., Benkalkar S; King's College London, Strand, London, UK., Kabir MA; Department of Economics, University of Dhaka, Dhaka, Bangladesh., Russell C; Metro North Hospital and Health Service, Queensland, Australia., Siddiqi N; Department of Health Sciences and Hull York Medical School (HYMS), York, UK; Bradford District Care NHS Foundation Trust (BDCFT), Bradford, UK.
Jazyk: angličtina
Zdroj: Asian journal of psychiatry [Asian J Psychiatr] 2024 Sep 16; Vol. 102, pp. 104239. Date of Electronic Publication: 2024 Sep 16.
DOI: 10.1016/j.ajp.2024.104239
Abstrakt: Background: Mental disorders remain the most significant contributor to years lived with disability in South Asia, yet governmental health expenditure on mental health in South Asia remains very low with limited strategic policy development. To strengthen the case for action it is important to better understand the profound economic costs associated with poor mental health.
Methods: We conducted a systematic review on the costs of all mental disorders, as well as intentional self-harm and suicide, in the World Bank South Asia Region. Ten global and South Asian databases as well as grey literature sources were searched.
Results: 72 studies were identified, including 38 meeting high quality criteria for good reporting of costs. Of these, 27 covered India, five Pakistan, four Nepal and three Bangladesh and Sri Lanka. Most studies focused on depressive disorders (15), psychoses (14) and harmful alcohol use (7); knowledge of economic impacts for other conditions was limited. Profound economic impacts within and beyond health care systems were found. In 15 of 18 studies which included productivity losses to individuals and/or carers, these costs more than outweighed costs of health care.
Conclusion: Mental disorders represent a considerable economic burden, but existing estimates are conservative as they do not consider long-term impacts or the full range of conditions. Modelling studies could be employed covering longer time periods and more conditions. Clear distinctions should be reported between out-of-pocket and health system costs, as well as between mental health service-specific and physical health-related costs.
Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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