The impact of brain related illnesses
The Statistics
- Brain disorders are chronic and debilitating, posing the highest health, economic and social capital attrition burden to Australia of any disease group, accounting for over 22% of the aggregate losses, well ahead of cancer (11.3%) or heart disease (9.9%).
- Brain disorders are predicted to contribute a progressively higher percentage of the burden of disease, so that by the year 2020 they will comprise 27%.
- Brain disorders affect as many as 1.5 billion people worldwide, and the number is expected to increase as life expectancy increases.
- In Australia , 2.6 million adults and 0.5 million children suffer from at least 1 mental illness episode per year.
The Global Impact
The nature of brain disorders changes across the human lifespan. The young have a higher incidence of psychiatric disorders, including depression, anxiety, schizophrenia and substance abuse. In contrast, the elderly suffer particularly from neurodegenerative conditions such as dementia or stroke. The demands of care, treatment and rehabilitation for brain disorders strain entire families, seriously diminishing their productivity and quality of life. Because of their early age of onset, and often chronic or relapsing nature, there is an immense social and personal impact of disability from brain disorders. This is reflected in the increases in disability support services (11.3% in 1997 to 15.1% in 2001) due to psychiatric disability.
The cost of lost productivity (lost earnings and household productivity) due to mental illnesses amounted to a staggering $34 billion per annum in Australia in 1998/99. Presumably the productivity losses of all mental health diseases combined would be several times higher. Moreover, brain disorders collectively take a major slice of the health care budget. The treatment and rehabilitation of individuals affected by brain disorders already accounts for well over 30% of the total health care budget in developed countries. In Australia , this amounts to over $4 billion in health system costs. Without new, cost-effective strategies to prevent, reduce or contain the chronic and debilitating consequences of brain related disorders, Australia risks both a blowout in health and aged care costs and indirect welfare and social security payments as well as a decreased revenue base over the next 40 years. This is exemplified in the Pharmaceutical Benefit Scheme (PBS) projections. Many of the new drugs that will be developed over the next decade will be targeted at brain disorders. This increases the Government's concern about rapidly increasing PBS costs, a major component of Australia 's overall health costs. PBS and the D isability Pension Scheme ( DPS) expenditure for mental health together accounted for $2.2 billion (0.3% GDP) in Australian Government MH-related expenditure in 2001/02, and antidepressant drugs are now one of the fastest growing areas of PBS expenditure. The need for more tailored treatments is reflected in the fact that pharmaceutical companies spend over $US7billion per annum on research and development for brain-related drugs. This amount is growing at 7% per year, spurred on by the plethora of new opportunities provided by both the Human Genome Project and Human Brain (neuroimaging) Project.
Impact on our youth
• The highest rate of brain disorders occurs in the 18-35 year olds. Conditions such as depression or anxiety, schizophrenia, and alcohol or substance abuse have their onset between ages 15 and 34 years of age.
• Young people with mental disorders suffer from aggression, attention difficulties, substance abuse, anxiety, and depression. These disorders contribute to poor educational achievement, reduced employment prospects, social isolation, violence, crime and suicide.
• Over 50% of young people attending a general practitioner have a significant psychological problem and 6% have made serious plans to take their own life.
• The prevalence of many of these problems of youth, particularly severe drug problems and attempted suicide, has increased steadily over the last three decades.
• In Australia , the youth suicide rate due to mental illness will soon exceed deaths by motor vehicle accidents.
The Brain Dynamics Centre focuses on disorder of youth, including Attention-deficit hyperactivity disorder (ADHD), schizophrenia and other psychotic illnesses (such as depression), and trauma disorders (s ee objectives and priorities ).
ADHD
• The most recent NHMRC survey revealed that up to 10% of adolescents and children have a diagnosis of ADHD.
• In 1999, over 50 million stimulant medication tablets for ADHD were dispensed in Australia , and this figure has been increasing.
Schizophrenia
• Schizophrenia, with 37,000 sufferers, costs the nation $1.85 billion pa
• Its onset is usually in the late teens or early twenties and is among the top 10 causes of burden of disease in young Australian men and women aged 15-24 and in the prime of life.
• In any one-month, some 58,000 Australian adults with schizophrenia or another psychotic illness will be in contact with mental health services.
• At any point in time, 72% of sufferers are unemployed; almost 50% are impaired in their capacity to carry out normal, routine activities; social isolation is prevalent; and one-third live alone, many in marginal accommodation. Two-thirds report side effects with medication severe enough to interfere with daily functioning.
Trauma and stress disorders
• The Australian National Survey of Mental Well Being found that 2% of males & 3% of females exposed to trauma in their lifetime had PTSD in past 12 months
• The estimated lifetime prevalence of PTSD among adults is approximately 8%, with women twice as likely as men to develop PTSD at some point in their lives
Impact on our older generations
• Adult mental illnesses include anxiety, depression, addiction, substance abuse, and psychosis. These disorders lead to a significant health service burden, social isolation, unemployment, and loss of productivity, violence, crime and suicide, and early death.
The Brain Dynamics Centre is focusing on depression in adulthood, and dementia (in particular, Alzheimer's disease) in older age groups.
Depression
• Depression ranked first for total years lost due to disability, fourth for disability adjusted life years, and suicide ranked fourth as cause of death ( Australian Institute of Health and Welfare Survey)
• Psychological autopsy indicates that at least 50% of people who commit suicide are suffering from depression at the time of their death.
• Worldwide, depression is predicted to be the second leading cause of all death and disability by the Year 2020.
• Around 1 in 6 Australian men suffer from depression.
• Severe depression will affect one in five persons in their lifetime. Over 800,000 adults and 100,000 young Australians experience this illness every year, with perhaps four times that number experiencing significant depressive symptoms.
• At least six million work days are lost each year and another 12 million days of reduced productivity are attributed to depression.
• Depression often leads to alcohol, tobacco and cannabis abuse, educational failure and unemployment. Depression disrupts physical health by a range of immune and nervous system mechanisms and is a risk factor for heart disease of the same order as smoking, high blood pressure and raised cholesterol.
Alzheimer's Disease
• One in 25 persons over sixty and one in five over eighty now suffer from dementia. Alzheimers Disease is the most common form of dementia, with about 10 million sufferers in the western world and 162,000 in Australia .
• It is estimated that over 50% of residential aged care patients suffer from Alzheimer's disease.
• A recent US study calculated total losses to American business, from this illness, at US$61 billion a year in caregiver time, productivity loss and medical expenses.
• Alzheimer's disease currently costs Australia $6.6 billion pa, increasing by 10% per year as a result of the ageing population. Trends analysis suggests that costs will escalate over the next 40-year to reach 6.4% of the total health and aged care costs by 2041/02 ($10.7 billion).
• It is projected that Australia will have 460,000 Alzheimers sufferers by 2042. While our total population will increase by only 40%, our population with dementia will increase by three and a half times due to the ageing population demographics.
• With this increase, the costs to Australian business in lost productivity from this disease alone can be predicted to rise from the current $4 billion to at least $12 billion by 2042, if no improved treatments are developed.
• Current treatments for Alzheimer's disesase are of limited effectiveness, cause side effects and do not halt the progressive downhill course of the disease.
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