Wittchen HU, Jacobi F. Size and burden of mental disorders in Europe-a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 15: 357-376

Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany.
European Neuropsychopharmacology (Impact Factor: 4.37). 09/2005; 15(4):357-76. DOI: 10.1016/j.euroneuro.2005.04.012
Source: PubMed


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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    • "Based on this analysis, a follow-up study was initiated. Using a multi-method approach including literature research, the analysis of epidemiologic data and country-specific expert surveys, the 12 month prevalence of the disorders included in the first report [6] as well as 14 new disorders for EU-27 plus Norway, Switzerland und Iceland was estimated [7]. Addition‐ ally the age group covered was extended to the major mental disorders for children and adolescents (2-17), adults (18-65) and elderly (65+years). "

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    • "Interest in novel treatment approaches for patients with anxiety disorders is high. Anxiety disorders are the most common mental health condition, with a year-prevalence of 12–18% (Wittchen and Jacobi, 2005; Kessler et al., 2011, 2012). Moreover, 16–47% of these patients cannot be treated successfully with a currently standard treatment such as cognitive behavior therapy (Ost, 2008). "
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    • "Obsessive–compulsive disorder (OCD) is a common and often enduring neuropsychiatric disorder. It affects 2–3% of the adult population (and 1% of children) regardless of ethnicity, geography or socioeconomic status (Robins et al., 1984; Weissman et al., 1994; Heyman et al., 2003; Wittchen and Jacobi, 2005). The magnitude of psychosocial impairment is high (Hollander et al, 2010). "
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