Major depressive disorder and anxiety are most common mental illnesses in China and India, according to a recent systematic analysis carried out by experts from Australia, China and India. To cater the needs of the patients and prevent the global disease burden, better mental health management interventions are required.
The systematic analysis, aiming to review ‘mental, neurological and substance use disorders’ in the region was a collaborative effort of research experts from University of Queensland, School of Public Health, Australia, Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, China, and Indian Institute of Public Health, Delhi, India, respectively.
41.2 million people in China and 48.5 million people in India are suffering from major depressive disorder. Also, 40.1 million Chinese and 36.8 million Indians were estimated to be suffering from anxiety.
The demographic distribution of these disorders is: Chinese and Indian men suffer majorly from depressive disorder (2.2% and 3.4% respectively), anxiety disorders (2% and 1.9% respectively) and alcohol dependence. For women, anxiety disorders, major depressive disorders and dysthymia (mild depression) were the most common ailments. 3.3% Chinese and 4.7% Indian women suffered from major depressive disorder. The percentages of women suffering from anxiety disorders stood at 3.3% in Chinese and 4.1% among Indian women.
In addition to these primary mental illnesses, the prevalence of schizophrenia was higher in China than in India. These data collections were also compared against BRICS countries which include Brazil, Russia and South Africa, other than India and China.
The study was aimed at understanding the epidemiological profiles of mental, neurological and substance abuse disorders in China and India. It was guided by the Conceptual Framework for Action of the Social Determinants of Health by World Health Organization (WHO). The data came from the Global Burden of Disease study (GBD) 2013. The findings of the study were recently published by the journal The Lancet Psychiatry.
The study discussed mental and neurological disorders, mood disorders, anxiety disorders, psychotic disorders, substance use disorders, conduct disorders, intellectual disability, epilepsy and dementia. Amongst them, schizophrenia, bipolar disorders, depressive disorders, anxiety disorders, attention-deficit hyperactivity disorder, conduct disorder, idiopathic intellectual disorders, autism spectrum disorder, alcohol dependence, illicit drug use disorders, dementia and epilepsy, out of which the above mentioned were the most common ailments.
Among the less common disorders a striking contrast was found in the prevalence rate of schizophrenia in China and India. Characterized by hallucinations and illusions, the rate of schizophrenia was 0.5% in Chinese population, while amongst Indians it remained as low as 0.2%.
During the eligibility determination stage, the previously present credible studies were included in the data collection. For the Chinese population analysis 65 relevant studies, and for the Indian population analysis 29 relevant studies were found which were published between 1990 and 2015.
While China and India have witnessed an economic boon in recent years, the demographics of these countries in relation with mental illnesses did not show coherence with high income countries. Out of these associations, substance abuse was more common in middle aged men in China than in India. While a positive correlation was recorded between depression and being married amongst the Indian women.
When socioeconomic associations were found with regards to less commonly prevalent disorders, the trends found in China and India were similar to those of global trends. Low education and poverty had a link with higher incidence rate of dementia in both countries. However the link was more pronounced in China.
Studies conducted in China also showed a variation amongst disorder prevalence across different regions and ethical groups. This finding in particular highlighted the need of tailor made treatment interventions for people coming from diverse backgrounds.
China and India have been steadily improving in the public health sector over the years and the disease burden has been shifted from communicable to non-communicable diseases. Amongst these non-communicable diseases, mental disorders run in the forefront of influencing the well-being of the societies at large. But, mental health problems remain largely ignored in Asian countries, and India and China are no different.
Therefore, it is of prime importance to collect data in accordance with socioeconomic status, age, sex and regions, to formulate an effective framework for diagnosis and treatment of these diseases.
As a result of mental health profiling, the experts will use the statistics to formulate a disease prevention framework which is particularly useful for the countries under discussion.
However, the average coverage of the mainland Chinese population (excluding Hong Kong and Macao) during the study was 15% and for Indian it remained at 1%, due to the ever increasing populations of these countries.
Currently, China tops the ranking for population and India follows it at number 2. 1.385 billion and 1.328 billion is their respective populations which unify to represent about 36% of the global population. Therefore, statistical analysis of such densely populated countries is a challenge, which also remained a limitation of this study which was jointly funded by China-India Mental Health Alliance and China Medical Board.
Mental health directly influences an individual’s health and if a population at large falls prey to health problems, reduced productivity at work, increased hostility, crime and violence can put a country’s economy at stake.
However, after this in depth study, it is hoped that the medical regulatory authorities in China and India will formulate frameworks to cater to the mental health need of the population. Furthermore, middle and low income countries will also seek help from such studies to combat increasing mental health problems in their territories.