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The concept of global burden of disease was first publicized in a landmark report commissioned by the World Bank The World Bank 1993 The measure developed in that report to operationalize the definition of disease burden combined the years lost due to premature mortality with those years lost due to living with disabling non-fatal conditions into a single measure of the impact of health conditions This measure was designed to assess the populations health gap taking into account not only mortality but also non-fatal decrements in health that result from health conditions As a continuation of that work the World Health Organization WHO and Harvard University published The Global Burden of Disease GBD study Murray Lopez 1996 as a systematic effort to estimate the leading causes of death globally and to combine these estimate with leading causes of disability The GBD study provided comprehensive estimates of the Disability-Adjusted Life Years DALYs lost due to more than 100 diseases and 19 risk factors The first publication of the GBD study showed that in 1990 unipolar major depression was the fourth leading cause of DALYs worldwide 37 exceeded only by respiratory infections 82 diarrheal diseases 72 and perinatal conditions 67 Projections estimated that unipolar major depression would be the leading cause of the total disability worldwide by the year 2030 World Health Organization 2008A subsequent systematic review of epidemiological studies of mental disorders examined estimates of frequency 1-year prevalence risk of mortality and disability associated with ten mental disorders Eaton et al 2007 In that review 1-year prevalence of major depressive disorders median of 42 studies was 53 of the adult population with a median excess risk of mortality of 70 OR 17 and a disability weight between 035 0 worst to 1 best and a Sheehan Disability Score of 58 0 worst 100 best As a consequence of their high frequency and associated significant disability the costs of mental disorders in
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