Epidemiological Research on Mental Disorders at McGill: Insights and Reflections
Mental and behavioral disorders, including psychiatric and neuropsychiatric conditions, pose a significant burden globally. Conditions like depression and schizophrenia affect millions of people, yet access to appropriate treatment remains a challenge. Understanding the causes, burden, and implications of these disorders is crucial for effective prevention, early diagnosis, and treatment strategies.
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Epidemiological Research on Mental Disorders at McGill Reflections on our 50 Reflections on our 50- -year life year life- -span span trajectory trajectory Can this inform our future Can this inform our future ? ? Rebecca Fuhrer, Rebecca Fuhrer, Ph.D Ph.D Professor and Director, Professor and Director, MScPH MScPHProgram Program McGill University McGill University
What are Mental and behavioral disorders ? Psychiatric disorders ? Neuropsychiatric disorders ? A mental disorder is conceptualized as a clinically significant behavior or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g. Painful symptom) or disability (e.g. impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. How do we define a case ? on thoughts, behaviors, feelings, and rarely supported by objective lab results Distinctive feature of these disorders is that their diagnosis generally depends Why would we want to study the causes ? Understanding ? Primary prevention? Early diagnosis and treatment? Cure or Chronicity?
Burden of disease Global Global Mental illness accounts for 4 of the 10 leading causes of years lost due to Mental illness accounts for 4 of the 10 leading causes of years lost due to disability in the disability in the world world1 1 approximately 300 million people worldwide 300 million people worldwide2 2 Depression affects Depression affects approximately Less than 50% of those affected have access to appropriate treatment Less than 50% of those affected have access to appropriate treatment and health and health care care2 2 worldwide5 5 Schizophrenia affects approximately 21 million people Schizophrenia affects approximately 21 million people worldwide Surveys carried out in various countries Surveys carried out in various countries consistently show rates per year of schizophrenia in adults within the rates per year of schizophrenia in adults within the range 100,000 100,0003 3 consistently show incidence range of 10 to 40 per incidence of 10 to 40 per 1. Langlois, et al 2012 2. Mathers et al 2004 3. Barbato et al 1998
Burden of disease Mathers, Boerma, & Ma Fat, (2004)
Burden of disease Neuropsychiatric Conditions WHO: Investing in Mental Health (2003)
Burden of disease Canada Canada 1 in 5 1 in 5 people will people will experience a mental illness in their experience a mental illness in their lifetime lifetime5 5 In 2003, the estimated economic burden of mental illness was $51 In 2003, the estimated economic burden of mental illness was $51 billion, (including direct and indirect costs) billion, (including direct and indirect costs)1 1 Mental illness is the second leading cause of hospital admission Mental illness is the second leading cause of hospital admission 445 5 among those aged 20 among those aged 20- -44 An estimated 4,000 individuals per year end their life through An estimated 4,000 individuals per year end their life through suicide suicide5 5 1. Langlois et al (2012) 5. Canadian Mental Health Association (2003)
Etiology Up to 70% of mental health problems or illnesses begin in Up to 70% of mental health problems or illnesses begin in childhood or adolescence childhood or adolescence6 6 As many as three in four children and youth with mental health problems As many as three in four children and youth with mental health problems and illnesses do not access services and illnesses do not access services and treatments and treatments6 6 More than 50% of individuals who experience one major More than 50% of individuals who experience one major depressive episode suffer from a recurrent depressive episode suffer from a recurrent episode episode1 1 Genetics Genetics first degree biological relatives of first degree biological relatives of people with more likely more likely to develop it than to develop it than the general f first degree biological relatives of those with major depression are 1.5 irst degree biological relatives of those with major depression are 1.5 - - 3 3 times more likely to experience major depression times more likely to experience major depression1 1 people with schizophrenia are 10 times schizophrenia are 10 times the general population population1 1 1. Langlois, et al, (2012) 6. Bartram, et al. (2012).
Study Design Data bases Data bases Departmental student database (SAO) Departmental student database (SAO) eScholarship eScholarship database (McGill Library) database (McGill Library) All theses: title and abstract All theses: title and abstract Search terms for mental health Search terms for mental health Mental health OR mental illness OR psychiatry OR Mental health OR mental illness OR psychiatry OR psychiatric OR drug abuse OR alcohol abuse OR alcoholism psychiatric OR drug abuse OR alcohol abuse OR alcoholism OR addiction OR depression OR anxiety OR psychosis OR OR addiction OR depression OR anxiety OR psychosis OR dementia OR dementia OR A Alzheimer s lzheimer s
Theses completed by years of admission, by degree (n=670) 100 94 90 85 83 80 70 60 50 43 42 42 38 37 40 32 31 28 27 30 22 20 20 14 13 9 7 10 3 0 MSC-T MSC-T, Intensive PhD
Categorization of completed theses n=647/670 120 103 97 94 100 86 80 67 59 60 51 42 40 19 17 20 12 0
Categorization of theses by subject area and type of research (n=647/670) 120 100 24 25 24 80 17 60 18 5 Health Services & Measurement Etiology/Treatment/Diagnosis 14 40 79 11 72 70 69 54 49 20 37 3 31 5 1 16 12 11 0
History at McGill Mental Health-related theses completed in the Department of EBOH, by year groups (n=647/670) 154 160 140 133 120 95 100 89 80 Total Mental Disorders 57 60 49 40 33 17 16 20 11 8 8 5 4 4 3 2 1 0 0 0
History of mental disorder research (n=42) Focus of research 16 14 14 14 12 11 10 8 6 4 3 2 0 Diagnosis/Measurement Etiology Health Services Treatment
History of mental disorder research (n=42) Types of mental disorders investigated Risk factor for other physical ailments 31% Common 50% Severe 19%
History of mental disorder research (n=42) Age Group Investigated Children 2% Adolescents 10% Older Adults 43% Adults 45%
Year of Mental Health - 2001 WHO: Investing in Mental Health (2003)
Health Research Funding for Major Chronic Diseases in Four Countries
ACCESS (Adolescent/young adult Connectionsto Community-driven Early Strengths-based and Stigma-free services) SPOR The first network launched under CIHR s Strategy for Patient-Oriented Research (SPOR) jointly funded with the Graham Boekh Foundation, Montreal Goal Transform the way youth access and use mental health services in real world settings and evaluate impact of implementation Who Multidisciplinary network of stakeholder groups across six provinces and one territory in Canada Objectives 1. Promote early identification 2. Provide timely access to services 3. Match needs with specific interventions 4. Eliminate service transitions at age 18
Acknowledgments Laura Morrison: Laura Morrison: MScPH MScPH Candidate Candidate Andre Yves Gagnon: Student Affairs Administrator Andre Yves Gagnon: Student Affairs Administrator Genevieve Gore: Liaison Librarian Genevieve Gore: Liaison Librarian Sarah Severson: Sarah Severson: Assistant Assistant Librarian Librarian
Selected References 1. 1. Langlois Langlois, K. A., Canadians Canadians: Mental illnesses : Mental illnesses. . , K. A., Samokhvalov Samokhvalov, A. V, , A. V, Rehm Rehm, J., Spence, S. T., & , J., Spence, S. T., & Gorber Gorber, S. C. , S. C. (2012) (2012). . Health state descriptions for Health state descriptions for 1. 1. Mathers Mathers, C., 2015, from 2015, from http , C., Boerma Boerma, T., & Ma http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en ://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/ / , T., & Ma Fat Fat, D. (2004). The Global Burden of Disease 2004 Update. Retrieved April 16, , D. (2004). The Global Burden of Disease 2004 Update. Retrieved April 16, 1. 1. Barbato Barbato, A. (1998). Schizophrenia and public health. Retrieved April 26, 2015, from , A. (1998). Schizophrenia and public health. Retrieved April 26, 2015, from http http://www.who.int/mental_health/media/en/55.pdf?ua= ://www.who.int/mental_health/media/en/55.pdf?ua=1 1 1. 1. Investing in Mental Health. (2003). Retrieved April 22, 2015, from Investing in Mental Health. (2003). Retrieved April 22, 2015, from http://www.who.int/mental_health/media/ http://www.who.int/mental_health/media/investing_mnh.pdf investing_mnh.pdf 1. 1. Mental Illness in Canada: Backgrounder Mental Illness in Canada: Backgrounder - - Canadian Mental Health Association. (2003, April 1). Retrieved April Canadian Mental Health Association. (2003, April 1). Retrieved April 16, 2015, from 16, 2015, from https://www.cmha.ca/public_policy/mental https://www.cmha.ca/public_policy/mental- -illness illness- -backgrounder backgrounder/ / 1. 1. Bartram, M., Bartram, M., Chodos DIRECTIONS The Mental Health Strategy for Canada. DIRECTIONS The Mental Health Strategy for Canada. Chodos, H., Gosling, S., , H., Gosling, S., Hardie Hardie, S. L., , S. L., Knoops Knoops, F., , F., Lapierre Lapierre, L., , L., Neuwelt Neuwelt, B. , B. (2012) (2012). . CHANGING CHANGING
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