According to a recent study by the World Health Organization, the World Bank, and Harvard University, mental disorders account for 4 of the 10 leading causes of disability in established market economies worldwide. These disorders are: major depression, manic-depressive illness, schizophrenia, and obsessive-compulsive disorder. Other research has estimated that the cost of mental illnesses in the United States, including indirect costs such as days lost from work, was $148 billion in 1990, the last time the total bill was measured.

Depression

More than 19 million adult Americans age 18 and over will suffer from a depressive illness--major depression, bipolar disorder, or dysthymia--each year. Many of them will be unnecessarily incapacitated for weeks or months because their illness is untreated.

• The onset of depression may be occurring earlier in life in people born in recent decades compared to the past.
• Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive illness each year.
• Depression is a frequent and serious complication of heart attack, stroke, diabetes, and cancer, but is very treatable.
• Depression increases the risk of having a heart attack. According to one recent study that covered a 13-year period, individuals with a history of major depression were four times as likely to suffer a heart attack compared to people without such a history.
• Depression costs the nation more than $30 billion per year in direct and indirect costs, according to the most recent data available.
• Major depression is the leading cause of disability in the United States and worldwide, according to a recent study by the World Health Organization, the World Bank, and Harvard University.

• More than 2.3 million Americans ages 18 and over - about 1 percent of the population - suffer from manic-depressive illness.
• As many as 20 percent of people with manic-depressive illness die by suicide.
• Men and women are equally likely to develop manic-depressive illness.

• In 1996, approximately 31,000 people died from suicide in the United States.
• Almost all people who kill themselves have a diagnosable mental disorder, most commonly depression or a substance abuse disorder.
• The highest suicide rates in the United States are found in white men over age 85.
• The suicide rate in young people has increased dramatically in recent years. In 1996, the most recent year for which statistics are available, suicide was the 3^rd leading cause of death among 15 to 24 year olds.
• Men are more than four times as likely as women to commit suicide.

• More than 2 million adult Americans are affected by schizophrenia.
• In men, schizophrenia usually appears in the late teens or early twenties. The disorder usually shows up when women are in their twenties to early thirties.
• Schizophrenia affects men and women with equal frequency.
• Most people with schizophrenia suffer chronically throughout their lives.
• One of every 10 people with schizophrenia eventually commits suicide.
• Schizophrenia costs the nation $32.5 billion annually according to the most recently available data.

• More than 16 million adults ages 18 to 54 in the United States suffer from anxiety disorders, which include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social phobia, and generalized anxiety disorder.
• Anxiety disorders cost $46.6 billion in 1990.
• Anxiety disorders are frequently complicated by depression, eating disorders, or substance abuse. Many people have more than one anxiety disorder.

• Panic disorder affects about 1.7 percent of the U.S. adult population ages 18 to 54, or 2.4 million people, in a given year.
• Panic disorder typically strikes in young adulthood. Roughly half of all people who have panic disorder develop the condition before age 24.
• Women are twice as likely as men to develop panic disorder.
• People with panic disorder may also suffer from depression and substance abuse. About 30 percent of people with panic disorder abuse alcohol and 17 percent abuse drugs such as cocaine and marijuana.
• About one-third of all people with panic disorder develop agoraphobia, an illness in which they become afraid of being in any place or situation where escape might be difficult or help unavail-able in the event of a panic attack.

• About 2.3 percent of the U.S. adult population ages 18 to 54, approximately 3.3 million Americans, has OCD in a given year.
• OCD affects men and women with equal frequency.
• The nation's social and economic losses due to OCD totaled $8.4 billion in 1990.

• In the United States, about 3.6 per-cent of adults ages 18 to 54, or 5.2 million people, have PTSD during the course of a given year.
• PTSD can develop at any age, including childhood.
• PTSD is more likely to occur in women than in men.
• About 30 percent of men and women who have spent time in war zones experi-ence PTSD. The disorder also frequently occurs after violent personal assaults, such as rape or mugging or domestic violence; terrorism; natural or human-caused disasters; and accidents.
• Depression, alcohol or other substance abuse, or another anxiety disorder often accompany PTSD.

• About 3.7 percent of American adults ages 18 to 54, or 5.3 million people, have social phobia in a given year.
• Social phobia occurs in women twice as often as men, although a higher pro-portion of men seek help for this disorder.
• The disorder typically begins in childhood or early adolescence and rarely develops after age 25.
• Social phobia is often accompanied by depression and may lead to alcohol or other drug abuse.

• ADHD is one of the most common mental disorders in children, affecting 3 to 5 percent of school-age children.
• Two to three times more boys than girls are affected.
• ADHD has long-term adverse affects on success at school, work, and in social relationships.
• National public school expenditures on behalf of students with ADHD exceeded $3 billion in 1995.
• As they grow older, children with untreated ADHD who have a coexisting conduct disorder often experience drug abuse, antisocial behavior, teenage pregnancy, and injuries of all sorts.

• Autism and related disorders (also called autism spectrum disorders or pervasive developmental disorders) represent chronic and severely disabling developmental disorders. There is no known cure.
• There are 1 to 2 cases of autism per 1,000 people.
• These disorders develop in childhood and are generally apparent by age three.
• Autism is three to four times more common in boys than girls. Girls with the disorder, however, tend to have more severe symptoms and lower intelligence.
• These disorders present families with financially and emotionally costly challenges over the lifespan of their affected children. About 60 percent of adults with autism will require continued care throughout their lives.
• The cost of health and educational services to those affected by autism exceeds $3 billion each year.

NIH Publication No. NIH 99-4584

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