Forty-percent of a population is a lot. Imagine a street filled with people—European people. Perhaps they are standing in line waiting for their free health care. Four out of ten of those poor souls suffer debilitating torments of the mind. Grab just five—of any age, toddlers included—and two of them will have brain damage of some kind or another.
That is the conclusion of H.U. Wittchen and more than a dozen co-authors of “The size and burden of mental disorders and other disorders of the brain in Europe 2010,” published in the European College of Neuropsychopharmacology. 
The actual percentage of those deranged (in whole or part) is 38.2%, which translates to “164.8 million persons affected.” European persons, that is: plus those in “Switzerland, Iceland and Norway.” That’s a sizable army of the touched.
What’s worse is that the same institution ran the same numbers just six years earlier (2005) and found only 27.4% were three eggs short of a dozen. What a jump! If this alarming trend continues—and why shouldn’t it?—by 2017 half of Europe will be certifiable.
Luckily, much—but not all—of the increase was due to the authors discovering new ways to define “mental illness.” They were able to add “14 new disorders also covering childhood/adolescence as well as the elderly.”
What’s wrong with these folks?
The most frequent disorders are anxiety disorders (14.0%), insomnia (7.0%), major depression (6.9%), somatoform (6.3%), alcohol and drug dependence (> 4%), ADHD (5%) in the young, and dementia (1-30%, depending on age).
Yes, the occasional sleepless night is now a mental disorder. As are “panic disorder,” epilepsy, agoraphobia, “cannabis dependence,” and multiple sclerosis. Because it’s better safe than sorry, toss in “hyperkinetic disorders/ADHD” and “conduct disorder.” Oh, yes, headache, too. All this adds up. Betcha didn’t know that “13% of global disease is due to disorders of the brain, surpassing both cardiovascular diseases and cancer.”
It’s still worse again, because the authors conclude, “In every year over a third of the total EU population suffers from mental disorders. The true size of ‘disorders of the brain’ including neurological disorders is even considerably larger.”
Also, “less than one third of all cases receive any treatment, suggesting a considerable level of unmet needs.” Needs must be met, musn’t they? “Concerted priority action is needed at all levels, including substantially increased funding for…” well, for people like our authors.
Look closer at the 2005 study. This only included folks who were between 18 and 65 “for most diagnoses”, yet that study’s authors were able to conclude that over 1 in 4 were mentally ill. Of all European adults, 1 in 4 needed treatment.
And it wasn’t just 1 in 4, but at any point in time it was 1 in 4. This year you might be sane, a proud member of the untouched 3, but next year it’s tag-you’re-it and fit for the straightjacket. This means the fraction of people who are defined as mentally ill at some point in their lives creeps up to 1, meaning everybody slips a nut at least once, a nut that needs reaming out by a government bureaucracy.
How do the author’s discover that, for example, 2.3% or 10.1 million Europeans were inflicted with social phobia? They made the number up. Yes, but they called it an “expert based best guess.” To form this guess, they looked into what various journals reported on social phobia—a disorder diagnosable without error, I suppose—and saw that papers were reporting incidence rates from between 0.6 to 7.9%. From this range, they guessed 2.3%.
Hold on a moment: somebody out there is reporting that 7.9% of a population suffers from social phobia? Good grief!
Similarly shocking upper ranges were found for alcohol dependence (9.3%), major depression (10.1%), somatoform disorders (panic attacks, etc.; 11%), insomnia (12%), and post-traumatic stress disorder (6.7%). Taken separately, these indicate that Europe is one frightening place.
Except for drunks and druggies and ADHD-like things where the ratio reverses, the authors also concluded that women slip over the edge at nearly twice the rate of men. The biggest differences were in agoraphobia (fear of shopping on the Agora? women?; 3.1 times more women than men), PTSD (3.4 times), and anorexia and bulimia (up to 8 times more).
The authors didn’t track everything that can go wrong with the brain. The lists of disorders “evidently do not reflect the full range of mental disorders that should have been considered.” Thus they can claim.
The high prevalence of neurological disorders provides proof that our 38% estimate is at best a conservative, lower bound estimate for disorders of the brain.
They do not even bother to imply, they directly state, the true rate of mental illness “is almost certainly even considerably larger.”
The only possible solution the authors can imagine is for the government to take money from its citizens and to hand it over to them so that they can study the problem.
Update: See this post, too.
What is sanity but doing different things and expecting the same result?
There’s obviously a huge range of severity being combined in the report, presumably for effect, not just between “disorders” but also within a category. Perhaps in the next report the authors will evaluate the severity and produce a histogram of the population vs. the number of “eggs short of a dozen” — a colorful phrase which I hadn’t heard before.
I wonder what the average would be. I might be missing a yolk myself.
What an odd coincidence – I just jumped from the Last Psychiatrist’s post here:
http://thelastpsychiatrist.com/2011/09/how_to_be_mean_to_your_kids.html
I just turned 30, and when I try to foretell what kind of future I should expect from living in this world, well, let’s just say thinking about these posts is not helping *my* depression at all….
One of my grand-children has been recently diagnosed with “Oppositional Defiance Disorder” at his school. I suggested his classmates were suffering from “Passive Compliance Disorder”, ho ho, and then found that it’s an actual diagnosis. That’s everybody covered then.
To me, this highlights an underlying problem with “brain science”. All brains are not the same (obviously), and there’s a spectrum of values for just about anything you care to measure i.e. serotonin levels. Somewhere, someone sets an arbitrary value and says if you’re on this side of the line you’re normal, and if you’re on that side of the line you have a “mental disorder”. How much of that is just an attempt to sell yet another pill, I wonder?
I’m quite sure that I don’t agree with essentially equating all forms of mental disorder with each other. Yes, there are valid brain chemistry issues when you deviate too far from the norm and get into things like psychotic episodes or epilepsy. Equating that with “cannabis dependence”, though, seems like a stretch to me. There are some “mental disorders” that you can function with quite nicely, some that have a slight impairment of quality-of-life, and some that can cripple you.
(Furthermore, there’s fuzziness built into asking people questions about things like their happiness or quality of sleep, which would seem to be the preferred way to detect things like depression and insomnia. But that’s a different problem.)
Finally, don’t get me started on “mental illness” as a term – I think it’s part of the stigmatization of the issue, because, hey, illnesses are contagious, right? So maybe you can “catch the crazies” from that guy! (Or girl, no reason to be sexist about this.)
This was covered by Tim Black at Spiked yesterday as well:
http://www.spiked-online.com/index.php/site/article/11060/
He points out that the Diagnostic and Statistical Manual of Mental Disorders (DSM) (the “book” of classifiable mental disorders) has grown from 60 disorders in 1952 to 384 in 1994. With a new edition due in 2015, should we have bets on how many it will include?
And – sadly – don’t take too much comfort in bashing Europeans on this: the DSM is a globally-used resource so I would imagine that a goodly portion of your medical insurance dollars are going on these “diseases’ as well.
I thought his fist name was “Nicolas”? Silly me.
In a few short years, we will have to redefine the illness and say that a minority have a super-functional pysyco-emo ballance, while the rest of us are cursed with ordinary troubled brains.
If someone has unmet psychological needs, but it doesn’t keep them from working, or affec them so severly that they seek treatment, is there really a problem. It is like saying that someone who wakes up with an occaisional stiff neck suffers from an untreated muscu-skelital injury. While it may be technically true, it is irrelevant.
” three eggs short of a dozen.” – This was a new one for me.
I am comfortable with the idea that everybody’s behavior can be said to be under the “Normal” curve, and that makes us all normal.
I say those without psychological problems have a disorder (a Non-fluctuating Psyche Disorder). Somebody could probably come up with a pill of this terrible disease.
I was going to say something like, “Well they’re just talking about Europeans, so how can one tell if they’re suffering a mental disease,” but thought that too snarky so changed my mind. Hmmmmm. Passive decisional ambivalence: Is that one, too? Is it infectious?
Hmm, soon enough (2014 for Europe if the resent trend continues) those who are not suffering from some psychological disorder will be in the minority. When that happens failure to have a psychological disorder will become itself a psychological disorder and require treatment to create a psychological disorder. I guess I’m safe from needing treatment because this line of thinking is just plain crazy.
There is “free money” to be had. Free health care pays doctors to care for patients. Free mental health care pays psychiatrists to care for mentally ill people. If you want more of something just hand out money to those who create it or define it. I bet if the federal government started paying schools that take care of autistic students that the numbers of students defined with autisim would increase. Oh wait! That’s already happened so I can’t use that example. Ok! I got it! Lets say the federal government paid schools more for more students needing free lunches then the number of students needing free lunches would increase dramatically. Ooops! That already happened as well. Oh well, you get the picture. Pay bureaucrats more for whatever you want more of and like magic they will create it.
I’ve concluded for a while now that believers in Catastrophic Anthropogenic Climate Change (CACC) suffer from atephobia, a mental disorder defined as:
1. A morbid fear of catastrophe.
2. An excessive fear of ruins, either historical or those after a recent disaster, such as a fire or flood.
With polls indicating that about 31% of the population is apoplectic over climate change driven by society’s CO2 emissions, perhaps it is time for psychiatrists and psychologists to confront this unseen mental virus and start ladling big-time from the climate change research grant honeypot.
Will Obamacare cover this malady?
Is it a self-fulfilling prophecy, wherein the theory of CACC terrifies mentally balanced people who subsequently develop a CACC-created mental disorder?
Is it even necessary for climate to change, in order to identify millions of victims of CACC ingestion?
Will discussion of CACC-induced mental disorders be included in the AR5 Impacts chapter?
When will the CACC hit the fan?
Precariously balanced minds desire answers.
I suspect there is a very strong lagged relationship between the number of careers dependent on the treatment of those with various mental afflictions and the number identiofied as suffering from those same afflictions. Therefore one solution is to reduce the number of those whose careers depend on those with mental afflictions. I would argue this would reduce the incidence of mental afflictions to an equivalent degree. It is a bit like the number of lawyers and lawsuits.
Wittchen et al. were unkind to publish the results of their studies. I’ll bet most Europeans were coping fairly well, until the unhappy news was broadcast. I predict that newly aware Europeans will now, upon the least feeling of disquiet, however vague, dash off to see a mental health professional. Naturally, the increased demand will exert upward price pressures on psychotherapy services, pricing some head cases out of the market, or, even worse, causing them to resort to discount psychotherapists. No sane person would hire a psychoplumber or psychoelectrician, and only an insane person would hire a psychotherapist.
My biggest concern is the discount sector of the psychomarket, and one practitioner in particular. I refer, of course, to Heinrich W. (don’t call him Heinie) Bunz, founder of the arcane fields of psychoproctology (at bottom, it’s merely aversion therapy with implements), and chiro-proctology. (Slogan over clinic door: We’ll crack your bones and vice-versa). Okay, okay, I admit it. I am Heinrich.
The Europeans could take a lesson from us conservative Americans — We’ve quietly embraced a wee bit of crazy, as a homeopathic immunization against a whole truckload of insane.
“We’ve quietly embraced a wee bit of crazy, as a homeopathic immunization against a whole truckload of insane” Wasn’t that a Willie Nelson song?
It was! Good eye!
How many of the researchers are Europeans? One third of them shoud be barking mad, according to their own research. But who trusts a mad man?
I’m european and definitely insane, so there.