Early-life mental disorders and adult household income in the World Mental Health Surveys
Open accessAbstract
Background Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy makers to the value of expanding initiatives for early detection and treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income.Methods Data come from the World Health Organization (WHO) World Mental Health Surveys in 11 high-income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents aged 18 to 64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income.Results Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16% to 33% of median within-country household income, and population-level effect sizes are in the range 1.0% to 1.4% of gross household income.Conclusions Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy makers should take these associations into consideration in making health care research and treatment resource allocation decisions.
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In the Framingham Heart Study cohort there was a 50% increased risk of dementia over a 17-year period among those with a diagnosis of depression at baseline compared with those without that diagnosis.
“In the Framingham Heart Study cohort 194 there was a 50% increased risk of dementia over a 17-year period among those with a diagnosis of depression at baseline compared with those without that diagnosis.”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [194]
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- Authors
- Kawakami, N., Abdulghani, E. A., Alonso, J., Bromet, E. J., Bruffaerts, R., Caldas-de-Almeida, J. M., Chiu, W. T., de Girolamo, G., de Graaf, R., Fayyad, J., Ferry, F., Florescu, S., Gureje, O., Hu, C., Lakoma, M. D., LeBlanc, W., Lee, S., Levinson, D., Malhotra, S., Matschinger, H., Medina-Mora, M. E., Nakamura, Y., Oakley Browne, M. A., Okoliyski, M., Posada-Villa, J., Sampson, N. A., Viana, M. C., & Kessler, R. C.
- Affiliations
- The University of Tokyo (JP)
- Ministry of Health (IQ)
- Universitat Pompeu Fabra (ES)
- Stony Brook University (US)
- KU Leuven (BE)
- Harvard University (US)
- Institute for Development, Research, Advocacy and Applied Care (LB)
- University of Ulster (GB)
- National School of Public Health, Management and Professional Development (RO)
- University of Ibadan (NG)
- Harvard Pilgrim Health Care (US)
- Chinese University of Hong Kong (HK)
- Israel Ministry of Health (IL)
- Post Graduate Institute of Medical Education and Research (IN)
- Leipzig University (DE)
- Jichi Medical University (JP)
- Corresponding author
- Kessler, Ronald C.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 72
- Issue
- 3
- Pages
- 228-237
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC3402018
- OpenAlex
- W2087594701
- Cited by
- 134
- References
- 45
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 9 · 2021: 13 · 2020: 10 · 2019: 5 · 2018: 5 · 2017: 44 · 2016: 3 · 2015: 3 · 2014: 9 · 2013: 10 · 2012: 4
- FWCI
- 12.51
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (acceptedVersion, other-oa)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion)
- Funders
- U.S. Public Health Service (R01 DA016558, R01-MH069864, R13-MH066849)
- University of Michigan
- Pfizer Foundation
- Ministry of Health
- Pan American Health Organization
- Fundação Champalimaud
- John D. and Catherine T. MacArthur Foundation
- John W. Alden Trust (4102-21119001)
- Bristol-Myers Squibb
- Jawaharlal Institute Of Postgraduate Medical Education and Research
- GlaxoSmithKline
- Regione Piemonte
- Novartis
- Departament de Salut, Generalitat de Catalunya (CB06/02/0046, RETICS RD06/0011 REM-TAP)
- World Health Organization
- Ministerio de Ciencia y Tecnología (SAF 2000 158-CE)
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
- National Institute on Drug Abuse
- National Institute of Mental Health (R01-MH059575, R01MH070884)
- Ministry of Health, Labour and Welfare
- Substance Abuse and Mental Health Services Administration
- Shire
- Fogarty International Center (FIRCA R03-TW006481)
- Ministry of Public Health
- Robert Wood Johnson Foundation (044708)
- Instituto de Salud Carlos III (FIS 00/0028)
- National Insurance Institute of Israel (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013)
- European Commission (EAHC 20081308, QLG5-1999-01042)
- Health Research Council of New Zealand
- Ministry of Education, Culture, Sports, Science and Technology
- Fundação para a Ciência e a Tecnologia
- Consejo Nacional de Ciencia y Tecnología (CONACyT-G30544- H)
- Ministry of Health, New Zealand
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- early-onset mental disorders, household income, economic burden of mental illness, human capital costs, unemployment, earnings, spousal earnings, marriage, gender differences, income decomposition, income inequality, low- and middle-income countries
- MeSH terms
- Adolescent, Psychology, Adolescent, Adult, Mental Disorders, Developing Countries, Educational Status, Employment, Female, Health Surveys, Humans, Income, Male, Mental Health, Middle Aged, Models, Psychological, Population, Socioeconomic Factors, Unemployment, World Health Organization, Age of Onset, Risk Assessment, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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