The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

Research output: Contribution to journalArticle


The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.


  • Raghid Charara
  • Mohammad Forouzanfar
  • Mohsen Naghavi
  • Maziar Moradi-Lakeh
  • Ashkan Afshin
  • Theo Vos
  • Farah Daoud
  • Haidong Wang
  • Charbel El Bcheraoui
  • Ibrahim Khalil
  • Randah R Hamadeh
  • Ardeshir Khosravi
  • Vafa Rahimi-Movaghar
  • Yousef Khader
  • Nawal Al-Hamad
  • Carla Makhlouf Obermeyer
  • Anwar Rafay
  • Rana Asghar
  • Saleem M Rana
  • Amira Shaheen
  • Niveen M E Abu-Rmeileh
  • Abdullatif Husseini
  • Laith J Abu-Raddad
  • Tawfik Khoja
  • Zulfa A Al Rayess
  • Fadia S AlBuhairan
  • Mohamed Hsairi
  • Mahmoud A Alomari
  • Raghib Ali
  • Gholamreza Roshandel
  • Abdullah Sulieman Terkawi
  • Samer Hamidi
  • Amany H Refaat
  • Ronny Westerman
  • Ali S Akanda
  • Syed Danish Ali
  • Umar Bacha
  • Alaa Badawi
  • Shahrzad Bazargan-Hejazi
  • Imad A D Faghmous
  • Seyed-Mohammad Fereshtehnejad
  • Florian Fischer
  • Jost B Jonas
  • Barthelemy Kuate Defo
  • Alem Mehari
  • Saad B Omer
  • Farshad Pourmalek
  • Olalekan A Uthman
  • Ali A Mokdad
  • Fadi T Maalouf
  • Foad Abd-Allah
  • Nadia Akseer
  • Dinesh Arya
  • Rohan Borschmann
  • Alexandra Brazinova
  • Traolach S Brugha
  • Ferrán Catalá-López
  • Louisa Degenhardt
  • Alize Ferrari
  • Josep Maria Haro
  • Masako Horino
  • John C Hornberger
  • Hsiang Huang
  • Christian Kieling
  • Daniel Kim
  • Yunjin Kim
  • Ann Kristin Knudsen
  • Philip B Mitchell
  • George Patton
  • Rajesh Sagar
  • Maheswar Satpathy
  • Kim Savuon
  • Soraya Seedat
  • Ivy Shiue
  • Jens Christoffer Skogen
  • Dan J Stein
  • Karen M Tabb
  • Harvey A Whiteford
  • Paul Yip
  • Naohiro Yonemoto
  • Christopher J L Murray
  • Ali H Mokdad
External organisations
  • Arabian Gulf University
  • Ministry of Health and Medical Education, Iran
  • Tehran University of Medical Sciences
  • Jordan University of Science and Technology
  • Public Authority for Food and Nutrition, Kuwait
  • American University of Beirut
  • Contech International Health Consultants, Lahore
  • South Asian Public Health Forum
  • An-Najah National University
  • Birzeit University
  • Harvard University
  • Executive Board of the Health Ministers' Council for Cooperation Council States
  • The Saudi Center for Evidence Based Healthcare
  • King Saud bin Abdulaziz University for Health Sciences
  • Ministry of Health Tunisia
  • University of Oxford
  • Golestan University of Medical Sciences
  • University of Virginia
  • Hamdan Bin Mohammed Smart University
  • Suez Canal University
  • Federal Institute for Population Research
  • University of Rhode Island
  • SIR Consultants, Sindh, Pakistan.
  • University of Management and Technology, Lahore
  • Public Health Agency of Canada
  • Charles R. Drew University of Medicine and Science
  • Karolinska Institutet
  • Bielefeld University
  • Heidelberg University
  • University Of Quebec In Montreal
  • Howard University
  • Simon Fraser University
  • University of Warwick
  • University of Texas Southwestern Medical Center
  • Cairo University
  • University of Toronto
  • Northern Territory Department of Health
  • Murdoch Children's Research Institute
  • University of Trnava
  • University of Leicester
  • University of Valencia
  • University of New South Wales
  • CIBER Salud Mental (CIBERSAM)
  • Nevada Division of Behavior and Public Health
  • National Institutes of Health, United States
  • Cambridge Health Alliance
  • Federal University of Rio Grande do Sul
  • Northeastern University
  • Southern University College, Malaysia
  • Norwegian Institute of Public Health
  • University of Melbourne
  • All India Institute of Medical Sciences
  • Utkal University
  • Ministry of Health, Cambodia
  • Stellenbosch University
  • Northumbria University
  • University of Cape Town
  • University of Illinois at Urbana-Champaign
  • University of Queensland
  • University of Hong Kong
  • Kyoto University
  • Institute for Health Metrics and Evaluation
  • Emory University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Psychiatry
  • Public Health, Global Health, Social Medicine and Epidemiology
Original languageEnglish
Article numbere0169575
JournalPLoS ONE
Issue number1
Publication statusPublished - 2017
Publication categoryResearch