Cited by 1,503Mental Health Treatment and AccessHealth and Medical StudiesPsychiatric care and mental health services

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Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies

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Wittchen, Hans-Ulrich, Jacobi, Frank·2005·European Neuropsychopharmacology

DOI 10.1016/j.euroneuro.2005.04.012

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Abstract

Epidemiological data on a wide range of mental disorders from community studies conducted in European countries are presented to determine the availability and consistency of prevalence, disability and treatment findings for the EU. Using a stepwise multimethod approach, 27 eligible studies with quite variable designs and methods including over 150,000 subjects from 16 European countries were identified. Prevalence: On the basis of meta-analytic techniques as well as on reanalyses of selected data sets, it is estimated that about 27% (equals 82.7 million; 95% CI: 78.5-87.1) of the adult EU population, 18-65 of age, is or has been affected by at least one mental disorder in the past 12 months. Taking into account the considerable degree of comorbidity (about one third had more than one disorder), the most frequent disorders are anxiety disorders, depressive, somatoform and substance dependence disorders. When taking into account design, sampling and other methodological differences between studies, little evidence seems to exist for considerable cultural or country variation. Disability and treatment: despite very divergent and fairly crude assessment strategies, the available data consistently demonstrate (a) an association of all mental disorders with a considerable disability burden in terms of number of work days lost (WLD) and (b) generally low utilization and treatment rates. Only 26% of all cases had any consultation with professional health care services, a finding suggesting a considerable degree of unmet need. The paper highlights considerable future research needs for coordinated EU studies across all disorders and age groups. As prevalence estimates could not simply be equated with defined treatment needs, such studies should determine the degree of met and unmet needs for services by taking into account severity, disability and comorbidity. These needs are most pronounced for the new EU member states as well as more generally for adolescent and older populations.

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“In many countries, mental disorders are also associated with low utilisation of services and poor access to treatment.(7) To make psychiatric services more widely available, health systems have increasingly turned to technology(1)Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA (2)Ha…”
Background
The Distinction Between “Medically Unexplained” and “Medically Explained” in the Context of Somatoform Disorders
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The molecular aspects of oxidative & nitrosative stress and the tryptophan catabolites pathway (TRYCATs) as potential causes of depression
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Social anhedonia in major depressive disorder: a symptom-specific neuroimaging approach
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Ghrelin Plasma Levels Are Not Altered in Major Depression
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“6% (Alonso and Lepine, 2007; Blazer, et al., 1991b; Carter, et al., 2001; Kessler, et al., 2005a,c; Offord, et al., 1996; Wittchen and Jacobi, 2005).”
BackgroundInfluential
Daily intake of soft drinks is associated with symptoms of anxiety and depression in Chinese adolescents
Zhang, X., Huang, X., Xiao, Y., Jing, D., Huang, Y., Chen, L., Luo, D., Chen, X. '., & Shen, M. (2019) · Public Health Nutrition · doi:10.1017/s1368980019001009 · Cited by 64
“Depression and anxiety that occur during the teen years are considered an important public health problem because of the heavy disease burden for the family(7).”
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Evaluating New Proposals for the Psychiatric Classification of Patients With Multiple Somatic Symptoms
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“1% of the general population fulfill these criteria, yet more than 10% report multiple somatic symptoms requiring medical attention (5,6).”
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Predictors of the Course of Anxiety Disorders in Adolescents and Young Adults
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“9% was observed in a study of 17 European countries (5).”
Background
Development of an item bank for the assessment of depression in persons with mental illnesses and physical diseases using Rasch analysis.
Forkmann, T., Boecker, M., Norra, C., Eberle, N., Kircher, T. T. J., SCHAUERTE, P. N., Mischke, K., Westhofen, M., Gauggel, S., & Wirtz, M. A. (2009) · Rehabilitation Psychology · doi:10.1037/a0015612 · Cited by 61
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“Anxiety disorders such as panic disorder, generalized anxiety disorder, social phobia, and specific phobias are common diseases with a 12-month prevalence of about 12–14% (cf. Wittchen and Jacobi, 2005; Wittchen et al, 2011).”
Background
WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on depression
Rugulies, R., Ando, E., Ayuso‐Mateos, J. L., Bonafede, M., Cabello, M., Tecco, C. D., Dragano, N., Durand-Moreau, Q. V., Eguchi, H., Gao, J., et al. (2019) · Environment International · doi:10.1016/j.envint.2018.11.011 · Cited by 64
“It is well established that women and individuals of low socioeconomic position have a higher risk of depression than men and individuals of high socioeconomic position (Kessler et al., 2003; Lorant et al., 2003; Wittchen and Jacobi, 2005).”
Background
New women-specific diagnostic modules: the Composite International Diagnostic Interview for Women (CIDI-VENUS)
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Self-reported Life Satisfaction and Alcohol use: A 15-year follow-up of Healthy Adult Twins
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The structure of mental disorders re‐examined: Is it developmentally stable and robust against additions?
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Validation of the Rasch-based Depression Screening in a large scale German general population sample
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“DIF analyses were performed for gender and age for three reasons: Firstly, many studies showed that prevalence of depression depends on age and gender [34,35].”
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Comprehensive determinants of health service utilisation for mental health reasons in a canadian catchment area
Fleury, M., Grenier, G., Bamvita, J., Perreault, M., Kestens, Y., & Caron, J. (2012) · International Journal for Equity in Health · doi:10.1186/1475-9276-11-20 · Cited by 64
“A recent meta-analysis of 27 studies found that 26% of Europeans sought healthcare for a mental disorder in a 12-month period [10].”
A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study
Sadeniemi, M., Almeda, N., Salinas-Pérez, J. A., Gutiérrez-Colosía, M. R., GARCÍA-ALONSO, C. R., Ala-Nikkola, T., Joffe, G., Pirkola, S. P., Wahlbeck, K., Cid, J., et al. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15061133 · Cited by 60
“The prevalence of mental health disorders in Spain and Finland is approximately the same [43,44].”
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Building a new Rasch-based self-report inventory of depression
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Does Pharmacogenetic Testing for CYP 450 2 D 6 and 2 C 19 Among Patients with Diagnoses within the Schizophrenic Spectrum Reduce Treatment Costs?
Herbild, L., Andersen, S. E., Werge, T. M., Rasmussen, H. B., & Jűrgens, G. (2013) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/bcpt.12093 · Cited by 58
Self-reported depression in first-year nursing students in relation to socio-demographic and educational factors: a nationwide cross-sectional study in Sweden
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Limitations of current medical treatments for depression: Disturbed circadian rhythms as a possible therapeutic target
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Efficacy and safety of pregabalin in generalised anxiety disorder: A critical review of the literature
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“Generalised anxiety disorder (GAD) is notable for its high prevalence (lifetime, 1.5–3.1%; Kessler and Wang, 2008; Wittchen and Jacobi, 2005), high degree of chronicity (median duration, >10 years; Bruce et al., 2005) and high degree of co-morbidity, most notably with other anxiety disorders and…”
BackgroundInfluential
The economic burden of schizophrenia in Germany: A population-based retrospective cohort study using genetic matching
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“80% [75] of the German population, i.”
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“These figures are notably higher than those reported in the general population, where prevalence rates of depression and bipolar disorder are estimated at up to 7% and 1%, respectively (Wittchen & Jacobi, 2005).”
Background
The epidemiology of mood disorders
Merikangas, K. R., & Low, N. C. P. (2004) · Current Psychiatry Reports · doi:10.1007/s11920-004-0004-1 · Cited by 59
General practitioners' opinions on how to improve treatment of mental disorders in primary health care. Interviews with one hundred Norwegian general practitioners
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“Yet, several studies have demonstrated that depression is subject to under-treatment [2,5].”
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“Anxiety disorders cause significant quality-oflife impairment [4] and are associated with immense health care costs [1, 5].”
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Decreased Zinc and Increased Copper in Individuals with Anxiety
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Patient Health Questionnaire: Greek language validation and subscale factor structure
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“7 million European adults are found to have been affected by at least one mental disorder in the previous 12 months, and one-third of them struggle with psychiatric comorbidity [1].”
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An epidemiologic and clinical overview of medical and psychopathological comorbidities in major psychoses
Altamura, A. C., Serati, M., Albano, A., Paoli, R. A., Glick, I. D., & Dell’Osso, B. M. (2011) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-011-0196-4 · Cited by 56
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Risk Factors for Long-Term Absence Due To Psychiatric Sickness: A Register-Based 5-Year Follow-Up From the Oslo Health Study
Foss, L., Gravseth, H. M., Kristensen, P., Claussen, B., Mehlum, I. S., & Skyberg, K. (2010) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3181e98731 · Cited by 54

Authors: Wittchen, H.-U., & Jacobi, F.
Affiliations: Max Planck Institute of Psychiatry (DE)
ORCID: Jacobi, Frank
Venue: European Neuropsychopharmacology
Publisher: Elsevier BV
Published: 2005-08
Volume: 15
Issue: 4
Pages: 357-376
ISSN: 0924-977X (ISSN-L)
DOI: 10.1016/j.euroneuro.2005.04.012
OpenAlex: W2107900025
Cited by: 1,503
References: 140
Citations by year: 2026: 14 · 2025: 31 · 2024: 43 · 2023: 64 · 2022: 48 · 2021: 46 · 2020: 57 · 2019: 58 · 2018: 64 · 2017: 75 · 2016: 83 · 2015: 84 · 2014: 103 · 2013: 110 · 2012: 121
FWCI: 96.18
Type: journal article
Language: en
Open access: green
tud.qucosa.de
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: European Neuropsychopharmacology (publishedVersion)
PubMed (publishedVersion)
Max Planck Institute for Plasma Physics (submittedVersion)
Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Medical Studies
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: mental illness, prevalence, disability burden, treatment utilization, unmet needs, comorbidities, anxiety disorders, depression, somatoform disorders, substance dependence, lost workdays, European Union, cross-national comparison, adolescent mental health, older adults
MeSH terms: Absenteeism, Adolescent, Adult, Age Factors, Aged, Mental Disorders, Disability Evaluation, Europe, Female, Humans, Male, Mental Health Services, Middle Aged, Quality of Life, Residence Characteristics, Review Literature as Topic, Sex Factors, Comorbidity, Prevalence, Cost of Illness, Diagnosis, Dual (Psychiatry), Quality-Adjusted Life Years

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Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies

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