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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Hendriks, A. M., Bartels, M., Stevens, G. W. J. M., Walsh, S. D., Torsheim, T., Elgar, F. J., & Finkenauer, C. (2019) · The Journal of Early Adolescence · doi:10.1177/0272431619858413 · Cited by 25
“…informs governments about the mental health needs of adolescents in a country and potential gaps for prevention and intervention strategies, which may have implications that affect adolescent mental health at the organizational level (Jenkins, 2003; Wittchen & Jacobi, 2005; Wittchen et al., 2011).”
Background
Employee Mental Illness: Managing the Hidden Epidemic
Lorenzo, M. S. D. (2013) · Employee Responsibilities and Rights Journal · doi:10.1007/s10672-013-9226-x · Cited by 23
“Similarly, Wittchen and Jacobi (2005) found that 27.4 % of persons in the European Union (EU) aged 18 years to 65 years had experienced at least one mental illness in the previous 12 months.”
BackgroundInfluential
Prevalence of Mental Disorders in the Elderly in the Community of Madrid: Results of the Mentdis_ICF65+ Study
Ausín, B., Muñoz, M., Santos‐Olmo, A. B., Santos, E. P., & Castellanos, M. Á. (2017) · The Spanish Journal of Psychology · doi:10.1017/sjp.2017.3 · Cited by 22
Epidemiologie psychischer Störungen
Jacobi, F., Becker, M., Müllender, S., Bretschneider, J., Thom, J., & Fichter, M. M. (2017) · Springer eBooks · doi:10.1007/978-3-662-49295-6_4 · Cited by 22
Self-citation
Effort-Reward Imbalance and Affective Disorders
Rugulies, R., Aust, B., & Madsen, I. E. H. (2016) · Aligning perspectives on health, safety and well-being · doi:10.1007/978-3-319-32937-6_6 · Cited by 22
The meteoric rise of mental illness in America and implications for other countries
Stolzer, J. M. (2016) · The European Journal of Counselling Psychology · doi:10.5964/ejcop.v4i2.77 · Cited by 23
Generalised anxiety and panic symptoms in the German National Cohort (NAKO)
Erhardt, A., Gelbrich, G., Klinger-König, J., Streit, F., Kleineidam, L., Riedel-Heller, S. G., NAKO Investigators, Schmidt, B., Schmiedek, F., Wagner, M., et al. (2021) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2021.2011409 · Cited by 24
“However, clinical studies have shown that a relevant number of patients do not receive either an appropriate diagnosis or the recommended treatment promptly after the onset of symptomatology (Wittchen and Jacobi 2005; Rayner et al. 2019).”
Background
Psychoeducation in anxiety disorders: Results of a survey of all psychiatric institutions in Germany, Austria and Switzerland
Rummel‐Kluge, C., Pitschel‐Walz, G., & Kissling, W. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2008.10.016 · Cited by 21
“Anxiety disorders are the most frequent mental disorders in Europe with a 12-month prevalence of 12% for adults (Wittchen and Jacobi, 2005) and contribute significantly to health care costs (Kessler et al.”
Background
Experiences of a Mental Health First Aid Training Program in Sweden: A Descriptive Qualitative Study
Svensson, B., Hansson, L. I., & Stjernswärd, S. (2015) · Community Mental Health Journal · doi:10.1007/s10597-015-9840-1 · Cited by 21
“In an epidemiological study in the EU a 12-month incidence rate for mental disorders of 27 % was found (Wittchen and Jacobi 2005), which was subsequently revised to 38.2 % (Wittchen et al. 2011).”
BackgroundInfluential
Somatoforme Symptome, Angst und Depression bei Migranten aus der Türkei, aus Osteuropa und aus der ehemaligen Sowjetunion
Mewes, R., Rief, W., Martin, A., Glaesmer, H., & Brähler, E. (2010) · Zeitschrift für Psychiatrie Psychologie und Psychotherapie · doi:10.1024/1661-4747.a000024 · Cited by 21
User value and usability of a web-based mindfulness intervention for families living with mental health problems
Stjernswärd, S., & Hansson, L. I. (2016) · Health & Social Care in the Community · doi:10.1111/hsc.12360 · Cited by 21
“The 12-month incidence of mental disorders in the European Union (EU) population has been estimated to be 27%–38.2%, representing a major source of burden (Wittchen & Jacobi 2005, Wittchen et al. 2011).”
BackgroundInfluential
Towards an animal model of callousness
Hernandez-Lallement, J., van Wingerden, M., & Kalenscher, T. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.12.029 · Cited by 23
“The prevalence rate of CD has increased in the last decades Wittchen and Jacobi, 2005, but see also Canino et al., 2010), rovoking incremental societal costs caused by the material and sychological impact of aggression, violence and bullying.”
Background
Slow vs standard up‐titration of paroxetine in the treatment of panic disorder: A prospective randomized trial
Buoli, M., Dell’Osso, B. M., Bosi, M. F., & Altamura, C. A. (2010) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2010.02136.x · Cited by 21
The relationship between body mass index and health-related quality of life in urban disadvantaged children
Wynne, C., Comiskey, C. M., Hollywood, E., Quirke, M. B., O’Sullivan, K., & McGilloway, S. (2014) · Quality of Life Research · doi:10.1007/s11136-014-0634-7 · Cited by 21
“However, the 17 % (N = 36) of parents with moderate-to-severe symptoms is greater than the estimated prevalence of depressive disorders in general populations [56, 57] and similar to that in disadvantaged populations [22, 58].”
Background
Self medication with St. John's wort in depressive disorders: An observational study in community pharmacies
Linden, M., Wurzendorf, K., Ploch, M., & Schaefer, M. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.07.019 · Cited by 22
Depression in early adulthood: prevalence and psychosocial correlates among young Swiss men
Barth, J., Hofmann, K., & Schori, D. (2014) · Swiss Medical Weekly · doi:10.4414/smw.2014.13945 · Cited by 23
Anorexia nervosa.
Fitzpatrick, K. K., & Lock, J. (2011) · Europe PMC (PubMed Central) · Cited by 21
The emerging mental health strategy of the European Union: A multi-level work-in-progress
Kelly, B. D. (2007) · Health Policy · doi:10.1016/j.healthpol.2007.06.005 · Cited by 20
Effects of Mineralocorticoid Receptor Overexpression on Anxiety and Memory after Early Life Stress in Female Mice
Kanatsou, S., ter Horst, J. P., Harris, A. P., Seckl, J. R., Krugers, H. J., & Joëls, M. (2016) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00374 · Cited by 21
Cost of disorders of the brain in Switzerland wth a focus on mental disorders
Sobocki, P. (2008) · Swiss Medical Weekly · doi:10.4414/smw.2008.11910 · Cited by 20
Population-level prevalence estimate and characteristics of psychiatric disability among Chinese adults
Li, N., Chen, G., Du, W., Song, X., Zhang, L., & Zheng, X. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.07.001 · Cited by 20
Pattern of healthcare resource utilization and direct costs associated with manic episodes in Spain
Tafalla, M., Salvador‐Carulla, L., Sáiz-Ruiz, J., Díez, T., & Cordero, L. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-31 · Cited by 21
“4 million people are affected by the disorder [3].”
Background
Trastornos mentales más frecuentes: prevalencia y algunos factores sociodemográficos asociados
Campo‐Arias, A., & Cassiani-Miranda, C. A. (2008) · Redalyc (Universidad Autónoma del Estado de México) · Cited by 20
Obsessive-Compulsive Disorder: Diagnosis, Epidemiology, Etiology, and Treatment
Sassano-Higgins, S. A., & Pato, M. T. (2015) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.130211 · Cited by 19
Multidisciplinary View of Alcohol Use Disorder: From a Psychiatric Illness to a Major Liver Disease
Gitto, S., Golfieri, L., Caputo, F., Grandi, S., & Andreoné, P. (2016) · Biomolecules · doi:10.3390/biom6010011 · Cited by 20
New Developments in Cognitive-Behavioral Therapy for Social Anxiety Disorder
Stangier, U. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0667-4 · Cited by 21
Is trazodone more effective than clomipramine in major depressed outpatients? A single-blind study with intravenous and oral administration
Buoli, M., Rovera, C., Pozzoli, S. M., Fiorentini, A., Cremaschi, L., Caldiroli, A., & Altamura, A. C. (2017) · CNS Spectrums · doi:10.1017/s1092852917000773 · Cited by 20
“Major depressive disorder (MDD) is a prevalent and disabling condition that accounts for high social costs and significant impairment of patients’ quality of life and functioning.(1) It has been estimated that less than 25% of MDD patients receive proper treatment and that up to 20–30% of those adequately treated show…”
Background
Association between insomnia symptoms and cognitive impairment in the Cretan Aging Cohort
Basta, M., Simos, P. G., Bertsias, A., Duijker, G., Zaganas, I. V., Koutentaki, E., Anastasaki, M., Mavroidis, G., Kalomoiri, G., Panagiotakis, S. H., et al. (2018) · European Geriatric Medicine · doi:10.1007/s41999-018-0086-7 · Cited by 21
Prevalence of depression among women with obstetric fistula in low-income African countries: a systematic review and meta-analysis
Duko, B., Wolka, S., Siyoum, M., & Tantu, T. (2020) · Archives of Women s Mental Health · doi:10.1007/s00737-020-01028-w · Cited by 20
Depressive Störungen: Major Depression und Dysthymie
Beesdo‐Baum, K., & Wïttchen, H. (2011) · Springer-Lehrbuch · doi:10.1007/978-3-642-13018-2_40 · Cited by 22
State-based differences in the prevalence and characteristics of untreated persons with serious psychological distress
Strine, T. W., Dhingra, S. S., Okoro, C. A., Zack, M. M., Balluz, L. S., Berry, J. T., & Mokdad, A. H. (2009) · International Journal of Public Health · doi:10.1007/s00038-009-0001-6 · Cited by 20
Costs of brain disorders in Finland
Sillanpää, M. L., Andlin‐Sobocki, P., & Lönnqvist, J. K. (2008) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2007.00973.x · Cited by 20
Updating medical school psychiatry curricula to meet projected mental health needs
Thomas, S. J., Pai, N. B., Dawes, K., Wilson, C. J., & Williams, V. (2013) · Australasian Psychiatry · doi:10.1177/1039856213500092 · Cited by 20
Disrupted dynamic local brain functional connectivity patterns in generalized anxiety disorder
Cui, Q., Chen, Y., Tang, Q., Han, S., Hu, S., Pang, Y., Lu, F., Nan, X., Sheng, W., Shen, Q., et al. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2019.109833 · Cited by 20
Die Kosten von "Gehirnerkrankungen" in Österreich im Jahr 2004
Wancata, J., Andlin‐Sobocki, P., & Katschnig, H. (2007) · Wiener klinische Wochenschrift · doi:10.1007/s00508-006-0725-8 · Cited by 20
Do nurses working in adult psychiatry take into consideration the support network of families affected by parental mental disorder?
Korhonen, T., Vehviläinen-Julkunen, K. M., & Pietilä, A. (2008) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2008.01309.x · Cited by 20
Where have they been? Service use of regular substance users with and without abuse and dependence
Perkonigg, A., Settele, A., Pfister, H., Höfler, M., Fröhlich, C., Zimmermann, P., Lieb, R., & Wittchen, H.-U. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0044-4 · Cited by 20
Epidemiologie psychisch komorbider Störungen bei chronisch körperlichen Erkrankungen
Beutel, M. E., & Schulz, H. (2011) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1191-z · Cited by 28
Associations between mental and oral health in Spain: a cross-sectional study of more than 23,000 people aged 15 years and over
Jacob, L., Sánchez, G. F. L., Carvalho, A. F., Shin, J. I., Oh, H. Y., Yang, L., Veronese, N., Soysal, P., Grabovac, I., Koyanagi, A., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.085 · Cited by 19
Zebrafish, a biological model for pharmaceutical research for the management of anxiety
Chahardehi, A. M., Hosseini, Y., Mahdavi, S. M., & Naseh, I. (2023) · Molecular Biology Reports · doi:10.1007/s11033-023-08263-1 · Cited by 19

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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