The study examined six types of disorders individually, assessing the current state of medical care as well as the ramifications of each condition and the prospects for improved policies.
Epilepsy affects an estimated 40 million people in developing countries, accounting for approximately 85% of people with the disease worldwide. But because of the social stigma associated with the disease, it frequently goes untreated in these areas.
Developmental disabilities that can result from genetic and nutritional factors, infectious diseases, and traumatic events are virtually unrecognized in many third-world countries. But as many as 80% of the world's children are born in those countries, where nutritional deficiencies, environmental toxins and perinatal complications are prevalent.
Although the report noted that bipolar disorder accounts for about 11% of the neuropsychiatric disease burden in developing countries, and preliminary population-based studies have shown suicide rates may be as high as 24%, the authors conceded that little is known about its incidence both in developed and developing countries.
"Despite the identification of bipolar disorder early in the 20th century and prevalence rates in developed countries that are higher than those for nonaffective psychoses, less research has been conducted in these countries on this disorder in comparison to other psychiatric conditions [including those discussed elsewhere in this report]," the authors wrote. "In developing countries, an even smaller and similarly inconclusive body of research exists."
Depression is estimated to be the leading cause of disability worldwide, but because it is not even acknowledged as a major disease in many countries, there is little in the way of accurate statistical data on its prevalence in developing countries. The study reported that countries like Sri Lanka and China have the highest rates of suicide in the world, but added, "In non-Western countries...completed suicides may be less likely to have received a psychiatric diagnosis because of the paucity of mental health services."
Schizophrenia affects an estimated 33 million people in developing countries, with an average lifetime risk of about 1%. But, the study noted, "The social and economic costs of schizophrenia are disproportionately high relative to its incidence and prevalence...In terms of DALYs [disability adjusted life years], predicted demographic trends include more than a 50 percent increase in the disease burden attributable to schizophrenia in developing countries, a burden approaching that of malaria and nutritional deficiency."
In both developed and developing countries, the burden of schizophrenia includes a high degree of stigmatization and social rejection. "Many schizophrenic patients end up on the streets or in the criminal justice system and are exposed to abuse, even in psychiatric hospitals."