WebMD Health News
Laura J. Martin, MD
June 6, 2011 -- The years from middle childhood to young adulthood, often viewed as some of the healthiest, are not always, according to a new global report from the World Health Organization (WHO).
In the report, researchers find three main causes of disability in those ages 10 through 24, says researcher Colin Mathers, PhD, a scientist at WHO in Geneva. The top three are neuropsychiatric disorders, unintentional injuries, and infectious and parasitic diseases.
The report refutes the stereotype of a carefree childhood and youth. "It highlights that disability, particularly due to mental health disorders and drug and alcohol problems, are a big problem for adolescents, as are injuries and death due particularly to motor vehicle accidents," Mathers tells WebMD. "This is also a period when young people are adopting behaviors such as smoking, poor diet, and inadequate exercise which will lead to substantial problems in later life."
The report is published online in The Lancet.
"This is the first time we have looked in depth at this age range," Mathers tells WebMD.
Researchers used data from the 2004 Global Burden of Disease for the study. They estimated the future impact of health and mental health problems as well as accidents and other problems on the youth.
They compute that by using what they called DALYS -- disability adjusted life-years. This measure takes into account estimates of both years of life lost due to premature deaths and years lost due to disability that are due to specific risk factors, such as depression.
Worldwide, the three main causes of years lost due to disability for the entire age range, 10 to 24, and their contribution, were:
Mental health problems included depression, bipolar disorder, schizophrenia, substance misuse, and other problems.
Unintentional injuries include road traffic crashes and other accidents.
Infectious diseases include sexually transmitted infections, respiratory infections, and parasitic infections, among others.
The major risk factors that lead to the disabilities include alcohol use, unsafe sex, iron deficiency, lack of contraception, and illicit drug use.
Mathers and colleagues found that the total DALYs were about 236 million for all those 10 to 24. That was about 15.5% of the total for all age groups.
Globally, the burden of disease was 12% higher in girls than in boys in the 15 to 19 age range.
While the burden of mental health problems probably will not surprise most mental health experts, Mathers says, it probably will surprise non-specialist doctors.
While the report spells out a need for public health officials to adopt prevention strategies that target teens and young adults, Mathers says the findings could also be a wake-up call for youth.
"The message for young people is, mental health problems arise in this period of life. Typically, if people are going to get such problems as schizophrenia, they tend to arise during this period."
Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI), reviewed the study findings.
He agrees that mental health experts will find no surprises in the finding that mental health problems contribute greatly to disability among youth.
"Increasingly, we are starting to realize the onset of about half of all lifetime cases of mental illness begin by age 14," he says.
The report found that the top three causes of disability in youth bore out globally. "It looks to me like the problems are universal to the human condition," Duckworth tells WebMD. "These are common problems."
For youth and parents, the message, he says, is "to be mindful of the fact that childhood is both a beautiful time and a time of some vulnerability around the mental health dimensions of life."
SOURCES:Gore, F. The Lancet, online, June 7, 2011.Santelli, J. The Lancet, online, June 7, 2011.Colin Mathers, PhD, scientist, World Health Organization, Geneva, Switzerland.Ken Duckworth, MD, medical director, National Alliance on Mental Illness.
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