By Hristo Valev

Affective disorders are psychiatric disorders, also called mood disorders, which are characterized by sudden mood swings, which can last from a few weeks to months. People affected will usually experience at least one episode in their lifetime. Currently there is no cure for affective disorders, with patients having to rely on medication and different management therapies.

Roughly 9,5% of the population in the US has been diagnosed with a mood disorder.[6] Those include depression, bipolar disorder and anxiety disorder. Slightly more than 4% of the world population is diagnosed with depression.[5] Statistics state that 30%-40% of adults will experience at least one major depressive episode in their lifetimes, whether they are diagnosed with it or not.[2]

The tendency is for an increase of affective disorders in the population over the next years. It is of utmost importance for progress to be made in effective treatment and management in order to combat this rising challenge to health institutions. However, little is known to the wide public of the direct and indirect social and economic costs associated with those disorders.

Economic costs

According to the World Health Organization (WHO) the cost of mental illnesses is $2.5 trillion and projected to rise to $6 trillion in 2030.[1] This cost can be broken down in medication, medical staff costs and hospital care, where two thirds of those are attributed to productivity loss due to disability. Productivity is also affected even when people suffer from a mild depression, but still go about their day. Studies show that up to 5.6 hours are lost per week by people suffering from depression.[12] The biggest health-care related costs are attributed to hospitalizations.

During a depressive episode the usual length stay of inpatients with a primary diagnosis of depression is 6.6 days compared to 5 days for those hospitalized for other reasons.[3] People suffering from the bipolar disorder, when hospitalized, stay on average 32.4 days in hospitals when experiencing an episode.[4] In comparison the costs for providing medication for managing affective disorders are negligible.

Social costs

The social costs of suffering from a mental disorder are often unseen and are a by-product of the cultural and social environment.
Statistics from WHO state that up to 90% of people suffering from depression as well as 76% to 85%of people diagnosed with a mood disorder in low and middle-income countries receive no proper care.[11, 10] The Disability-Adjusted Life Year (DALY) Index[7] measures how debilitating a disease or disability is and tries to quantify those with a numerical value between 0 and 1. Minor, moderate and severe depressive episodes for example are rated as 0.14, 0.35 and 0.76 respectively.

To put things in perspective having an amputated arm or leg below the knee are weighted with 0.308 and 0.3. The bipolar disorder for example is categorized in the same weight group as mental retardation and rated in the range of 0.36-0.50. Affective disorders are also regarded as a factor in developing other health conditions such as heart diseases, obesity and others.[9, 8]

Outlook

Clearly affective disorders are part of our societies and play directly or indirectly an important role in our lives. The worrying trend, which projects that the proportion of people affected by affective disorders will increase, compels us to put more effort into understanding them and finding out a way to manage them better.

About AffecTech

The AffecTech project launched in 2017 has the ambitious aim to research the processes related to affective disorders and develop methods and technologies, which can help people manage their afflictions better. AffecTech is established with support from the Marie Skłodowska-Curie Innovative Training Network funded by European Commission H2020. AffecTech is also committed to raising awareness about mental health issues, and is supporting WHO’s World Mental Health Day this year.

About the author

AffecTech Early Stage Researcher (ESR) Hristo Valev (pictured) is a computer science graduate from the Karlsruhe Institute of Technology in Germany. He specialised in Antropomatics and Cognitive Systems. His research interests are in human-machine interactions, medical informatics and machine learning. He has been awarded the Marie-Curie Fellowship and is currently a PhD candidate at Lancaster University, while working at Philips Research in Eindhoven.

References

[1] David Bloom, Elizabeth Cafiero, Eva Jané-Llopis, Shafika Abrahams-Gessel, Lakshmi Bloom, Sana Fathima, An-drea Feigl, Tom Gaziano, Ali Hamandi, Mona Mowafi, et al. The global economic burden of noncommunicable diseases. Technical report, Program on the Global Demography of Aging, 2012.
[2] Garota Bonita. Major depressive disorder: A psychological disorder. Academon, 2004.
[3] Organization Center for Delivery, Healthcare Cost Markets, Utilization Project, and Population Division U.S. Census Bureau. Nationwide inpatient sample, census 2005. Technical report, AHRQ, 2005.
[4] Marie de Zelicourt, Roland Dardennes, Helene Verdoux, Gian Gandhi, Babak Khoshnood, Eric Chomette, Marie-Laure Papatheodorou, Eric T Edgell, Christian Even, and Francis Fagnani. Frequency of hospitalisations and inpatient care costs of manic episodes. Pharmacoeconomics, 21(15):1081–1090, 2003.
[5] Alize J Ferrari, Fiona J Charlson, Rosana E Norman, Scott B Patten, Greg Freedman, Christopher JL Murray, Theo Vos, and Harvey A Whiteford. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS medicine, 10(11):e1001547, 2013.
[6] Ronald C Kessler, Patricia Berglund, Olga Demler, Robert Jin, Kathleen R Merikangas, and Ellen E Walters. Lifetime prevalence and age-of-onset distributions of dsm-iv disorders in the national comorbidity survey repli-cation. Archives of general psychiatry, 62(6):617–27, 2005.
[7] Colin Mathers. The global burden of disease: 2004 update. World Health Organization, 2008.
[8] Susan L McElroy, Renu Kotwal, Shishuka Malhotra, Erik B Nelson, Paul E Keck, and Charles B Nemeroff. Are mood disorders and obesity related? a review for the mental health professional. J Clin Psychiatry, 65(5):634–651, 2004.
[9] Evans DL. Nemeroff CB, Musselman DL. Depression and cardiac disease. Depression and Anxiety, 8(Suppl 1):
71- 9., 1998.
[10] World Health Organization et al. Mental health action plan 2013-2020. 2013.
[11] Rahul Shidhaye, Crick Lund, and Dan Chisholm. Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions. International journal of mental health systems, 9(1):40, 2015.
[12] Walter F Stewart, Judith A Ricci, Elsbeth Chee, Steven R Hahn, and David Morganstein. Cost of lost productive work time among us workers with depression. Jama, 289(23):3135–3144, 2003.