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The toll of Schizophrenia and personality disorders

Schizophrenia and personality disorders are the most disabling mental health conditions to live with, according to scientists from The University of Queensland.

A Danish-Australian research team studied a cohort of 6.9 million Danish residents in the Danish Psychiatric Central Research Register to understand the burden of disability associated with 18 mental and substance use disorders.

Professor John McGrath from UQ Queensland Brain Institute’s and the Queensland Centre for Mental Health Research said the data was used to develop a new method for measuring disability that took comorbidities into account.

“Traditionally the impact of mental disorders has been presented for an entire nation, but in this study, we focussed on people with different types of mental and substance use disorders at an individual level,” Professor McGrath said.

“We found that schizophrenia and personality disorders were the most disabling mental conditions and showed how disorders like autism, anxiety disorders and schizophrenia contribute to disability at different ages.

“Our new measure known as the Health Loss Proportion (HeLP) allows us to measure the average disability for different disorders at the individual level, which means that individuals who experience more inherent disability, and more comorbid conditions, will have a higher HeLP weighting, and therefore a higher measure of disability.”

Professor McGrath said the new method complemented methods being used by the Global Burden of Disease Study to help policymakers and clinicians plan health system responses.

“The Global Burden of Disease Study uses top-down summary statistics to estimate the impact of mental disorders on societies, while we have used a ‘bottom-up’ method based on Danish registers to estimate how mental disorders impact individuals across their life span,” Professor McGrath said.

The team hopes that future register-based studies will create new knowledge about how comorbidity contributes to global disease burdens and apply this new method to disorders of interest.

“People with mental disorders lead valued and productive lives, despite a lack of social and economic support for their unmet needs,” Professor McGrath said.

“We hope our findings ensure more disabling disorders are given adequate attention, support, and funding.”

The study is a collaboration with researchers from the Queensland Centre for Mental Health Research, Denmark’s National Centre for Register-based Research and UQ’s Queensland Brain Institute.

This research is published in Lancet Psychiatry (DOI: 10.1016/S2215-0366(21)00029-8).

Funding was generously provided by The Danish National Research Foundation, Queensland Government Department of Health, European Union’s Horizon 2020, Lundbeck Foundation, and the Stanley Medical Research Institute.

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