Summary of Findings: The Magnitude of the Problem

  • Brain disorders—neurological, psychiatric, and developmental—are a leading cause of death and disability worldwide and are responsible for a large proportion of the burden of disease in developing countries.

  • Brain disorders are projected to increase in the coming decades as a result of large-scale demographic and epidemiological shifts. By 2020, for example, depression is projected to be the second and stroke the leading cause of disability-adjusted life years (DALYs) lost worldwide.

  • The stigma associated with epilepsy, schizophrenia, and mental retardation often prevents people with these disorders from seeking and getting medical attention. It also results in the denial of social, educational, and employment opportunities to affected individuals and their families.

  • The relationship between poverty and illness is complex and circular; poverty can be both a cause and a result of ill health.

  • Poverty is associated with specific risk factors for brain disorders, including poor nutrition, unhygienic living conditions, inadequate access to health care, lack of educational and employment opportunities, and debt.

  • These disorders can substantially worsen people's economic circumstances because of the cost of medical or traditional treatments; the limits they impose on educational opportunities; and interference with effective functioning at home, work, and school.

  • Considerable research in developing countries indicates that poverty and several psychiatric disorders, such as depression, exacerbate each other.

  • Poverty is more common and more severe for women than for men. Women also have a more severe health burden from psychiatric disorders. Depression affects women disproportionately.

  • Specialist and physician care for brain disorders is extremely limited in most developing countries. Health care services in many countries lack the capacity, in terms of physicians, nurses, and trained health care workers, to provide care for these disorders to the majority of their populations.

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