title: Early-life mental disorders and adult household income in the World Mental Health Surveys.
abstract: BACKGROUND
  Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy makers to the value of expanding initiatives for early detection and treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income.
  
  
  METHODS
  Data come from the World Health Organization (WHO) World Mental Health Surveys in 11 high-income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents aged 18 to 64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income.
  
  
  RESULTS
  Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16% to 33% of median within-country household income, and population-level effect sizes are in the range 1.0% to 1.4% of gross household income.
  
  
  CONCLUSIONS
  Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy makers should take these associations into consideration in making health care research and treatment resource allocation decisions.
authors.affiliation: Department of Mental Health, School of Public Health, the University of Tokyo, Tokyo, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.forename: Emad Abdulrazaq
authors.initials: EA
authors.lastname: Abdulghani
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.forename: Wai Tat
authors.initials: WT
authors.lastname: Chiu
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: John
authors.initials: J
authors.lastname: Fayyad
authors.forename: Finola
authors.initials: F
authors.lastname: Ferry
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Lakoma
authors.forename: William
authors.initials: W
authors.lastname: Leblanc
authors.forename: Sing
authors.initials: S
authors.lastname: Lee
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.forename: Savita
authors.initials: S
authors.lastname: Malhotra
authors.forename: Herbert
authors.initials: H
authors.lastname: Matschinger
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Medina-Mora
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oakley Browne
authors.forename: Michail
authors.initials: M
authors.lastname: Okoliyski
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D003906:Developing Countries; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health; D008875:Middle Aged; D008960:Models, Psychological; D011153:Population; D000297:Psychology, Adolescent; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014478:Unemployment; D014944:World Health Organization; D055815:Young Adult