Higher Prevalence of Mental Disorders in South India

Recently, a study by the India State-Level Disease Burden Initiative was published in the Lancet Psychiatry.

This is the first comprehensive estimate of disease burden due to mental disorders and their trends in every state of India from 1990.

India State-Level Disease Burden Initiative

It is a public private initiative launched in October 2015.
It is a collaboration between the Indian Council of Medical Research (ICMR), the Public Health Foundation of India (PHFI), Institute for Health Metrics and Evaluation (IHME) and other experts and stakeholders.
- PHFI is a response to redress the limited institutional capacity in India for strengthening training, research and policy development in the area of Public Health.

The study divided States into three categories on the basis of their Socio-Demographic Index (SDI), i.e low, medium and high SDI States.
- The SDI is a composite measure of per-capita income, mean education and fertility rate in women younger than 25 years and is calculated on a scale of one.
The study utilised all accessible relevant data from India over the past three decades and reports that mental disorders are the leading cause of non-fatal disease burden in India and their contribution to the total disease burden is increasing.

Depression and anxiety disorders are the commonest mental disorders in India. Their prevalence is increasing and is relatively higher in the southern states (Tamil Nadu, Kerala, Telangana, Karnataka and Andhra Pradesh) and in females.
Depression accounted for 33.8% of all mental disorder DALYs in India in 2017, followed by anxiety disorders (19%), idiopathic developmental intellectual disability (10.8%) and schizophrenia (9.8%).
The contribution of mental disorders to the total disease burden in India in terms of disability adjusted life years (DALYs) increased from 2.5% in 1990 to 4.7% in 2017.
- DALY is the sum of total years of life lost and years lived with disability. One DALY is at least one lost year of ‘healthy’ life.

Roughly one in seven Indians or 197 million people suffered from mental disorders of varying severity in 2017.
- These include depression, anxiety disorders, schizophrenia, bipolar disorders, idiopathic developmental intellectual disability, conduct disorders, and autism.
High SDI Group: Prevalence of depressive disorders was highest in Tamil Nadu. Anxiety disorders were found to be more common in Kerala, Himachal Pradesh, Tamil Nadu, Karnataka, Telangana and Maharashtra in the high SDI State group
Middle SDI Group: Prevalence of depressive disorders was highest in Andhra Pradesh. Anxiety disorders were found to be more common in Andhra Pradesh, Manipur and West Bengal in the middle SDI State group.

There is an urgent need to strengthen mental health services, integrate these with general healthcare and remove barriers such as stigma and access to treatment.
The high rate of depression among older adults needs attention through wider efforts in the community and health system.
Community-level mental health care and integration of mental health services with other aspects of healthcare should receive high priority from state governments.
Health officials should have an accurate accounting of how depression, anxiety and other mental disorders are distributed across the country.

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