FundaMentalHM · Innovative methods for better estimation of Fundamental Health Metrics associated with Mental disorders and other general medical conditions

FundaMentalHM: Innovative methods for better estimation of Fundamental Health Metrics associated with Mental disorders and other general medical conditions

The contribution of mental disorders to the Global Burden of Diseases (GBD) Study is now well recognized – mental disorders account for 6.8% of the total burden worldwide. Because the GBD’s health metric Disability-Adjusted Life Year (DALY) combines the impact of both morbidity (Years Lived with Disability; YLDs) and mortality (Years of Life Lost; YLLs), it has foregrounded the previously neglected contribution of mental disorders to the global disease burden. However, this health metric does not account for comorbidity adequately, which leads to an underestimation of excess morbidity and mortality associated with mental disorders. This bias has serious implications for service planning and resource allocation. The focus of FundaMentalHM is to use aggregated data from the GBD Study and register-based individual-level data from the whole Danish population to fill the existing methodological gaps, by developing and applying new methodologies in order to better estimate the burden of mental disorders. FundaMentalHM aims to (i) provide the most comprehensive detailed analysis of comorbidity between mental disorders and other general medical conditions, (ii) advance the area of science related to health metrics by incorporating dependent (instead of independent) comorbidity to the estimates, and (iii) use innovative methods to better estimate the excess mortality associated with mental disorders. In accomplishing FundaMentalHM’s objectives, I will provide a more accurate, unbiased view of the true burden – including true number of deaths – associated with mental disorders. FundaMentalHM has provided the most comprehensive register-based studies on mental health mortality to date with a landmark paper published in The Lancet and cited more than 200 times since it was published in 2019. This study has contributed greatly to the field of psychiatric epidemiology by providing an ‘atlas’ of mortality estimates for a comprehensive range of mental disorders. This paper reports (for the first time) an innovative measure that is better able to capture the impact of mental disorders on life expectancy (compared to relative risks such as Mortality Rate Ratios). Policy makers and politicians can readily understand this type of health measure. In order to facilitate the use of this new metric by other researchers, FundaMentalHM has developed an R package that is freely available online, and which has been downloaded more than 16,500 times and used in several scientific publications since it was released in early 2020. As part of this MSCA project, we have recently led a study published in PLOS Medicine applying this method to 1,800 different health conditions: the ‘Danish Atlas of Disease Mortality’ (http://nbepi.com/atlas). In addition to mortality, FundaMentalHM has also explored other types of outcomes, such as comorbidity. FundaMentalHM's studies on comorbidity (Momen et al. New England Journal of Medicine 2020; Plana-Ripoll et al. World Psychiatry 2020; Momen et al JAMA Psychiatry 2022) have used advanced designs, and have laid the foundations for other projects, not only in mental health, but also in other fields of medicine. Because comorbidity is common across the entire spectrum of health, FundaMentalHM has developed an informative metric (Weye et al. Lancet Psychiatry 2021) that estimates the contribution of (i) an index disorder (e.g. depression), and (ii) comorbid mental and other medical conditions (e.g. alcohol use disorders, diabetes). This measure shows never-before-seen details of the impact of comorbidity on disability.

Текст от CORDIS, на английски · Данни: CORDIS, © Европейски съюз