Lifetime Risk of Mental Health, Socioeconomic Difficulties Higher than Reported

Lars Vedel Kessing, DMSc

Credit: Dagens Medicin

A recent investigation conducted in Denmark has shed light on the lifetime risk of experiencing mental health disorders and receiving psychotropic medication, as well as the long-term socioeconomic difficulties associated with it.¹

The findings showed the prevalence of mental health disorders and the use of psychotropic medication are considerably higher than previously reported, with approximately 80% of the population seeking treatment for a mental health disorder.

The rates of mental health disorders are known to have been rising, prompting the US Preventive Services Task Force (USPSTF) to publish new guidelines urging for more primary care screenings for major depression disorder (MDD) and anxiety.²

The current study, which analyzed data from a nationwide population-based register, included a randomly selected sample of 1.5 million individuals from Denmark between 1995 and 2018.¹

A team of investigators led by Lars Vedel Kessing, DMSc, from Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, evaluated the lifetime incidence of treated mental health disorders and their correlation with socioeconomic functioning.

The research accounted for the competing risk of all-cause death and examined various measures, including hospital diagnoses, prescription statistics, and socioeconomic indicators such as education, employment, income, residential status, and marital status.

Among the 462,864 individuals in the sample with a mental health disorder, the median age was 36.6 years, and approximately 50.5% were men. The cumulative incidence of a hospital-diagnosed mental health disorder was found to be 29.0%, with slightly higher rates for women (31.8%) compared with men (26.1%).

However, when psychotropic prescriptions were also considered, the cumulative incidence of any mental health disorder or psychotropic prescription increased significantly to 82.6%, with women showing a higher incidence (87.5%) than males (76.7%).

Investigators also observed a strong association between mental health disorders/psychotropic prescriptions and long-term socioeconomic difficulties. Individuals with mental health disorders were more likely to experience lower income, unemployment or disability benefit reliance, living alone, and being unmarried during the follow-up period.

Across sensitivity analyses, the results were consistent while highlighting the far-reaching impact of mental health disorders on various aspects of individuals' lives.

Investigators noted the significance of the implications of this study. The high lifetime incidence of mental health disorders, coupled with the observed socioeconomic difficulties, calls for a shift in societal attitudes and increased mental health literacy.

By acknowledging the prevalence of mental health disorders and the associated challenges individuals face, society can work towards reducing stigma and promoting primary prevention measures, according to the study.

"These findings may be used to change attitudes toward mental health disorders, promote greater mental health literacy, and promote policies to support needed services," investigators wrote.

The team further stated these findings provide a basis for reframing perceptions of mental health, fostering a greater understanding of mental illness, and advocating for comprehensive mental health support.

References:

1. Kessing LV, Ziersen SC, Caspi A, Moffitt TE, Andersen PK. Lifetime Incidence of Treated Mental Health Disorders and Psychotropic Drug Prescriptions and Associated Socioeconomic Functioning. JAMA Psychiatry. Published online July 12, 2023. doi:10.1001/jamapsychiatry.2023.2206
2. Walter K. USPSTF Announces New Guidance for Depression, Anxiety Screenings. HCPLive. June 20, 2023. https://www.hcplive.com/view/uspstf-announces-new-guidance-depression-anxiety-screenings