Damian Santomauro

Purpose: First Nations people in Australia, New Zealand, Canada and the United States of America (USA) experience high rates of mental and substance-use disorders (MSDs) and face socially determined health inequalities, but this is not always well quantified. This systematic review sought to summarise best-estimates of MSD prevalence and describe related sociodemographic correlates among First Nations adults in these countries. Methods: Relevant studies published between 1980 and 2026 were searched using PubMed, Embase, and PsycINFO following PRISMA guidelines. Epidemiological population surveys producing prevalence estimates and/or sociodemographic correlates of MSDs for representative populations of First Nations peoples were identified. Prevalence data and sociodemographic correlates were extracted and described. Meta-analyses were conducted for MSDs with at least three available estimates. Results: A total of 50 studies from 24 unique population-level representative surveys met inclusion criteria. Surveys from the USA provided the most data (35 studies). Generally, MSD prevalence was lowest in the USA and highest in Australia, with twelve-month rates ranging between 20.9% (18.8–23.1%) and 51.7% (47.3–55.9%) respectively. Mood disorders and anxiety disorders were most prevalent. Sociodemographic variables including sex, socioeconomic factors, and regionality were associated with higher risk of certain MSDs. Conclusion: The prevalence and related sociodemographic correlates of MSDs identified across countries are varied and have implications for risk profiles and treatment needs. Low numbers of studies and heterogeneous data-collection methodologies highlight the need for better quality, representative population level data on MSDs for First Nations peoples.

Objective: To describe the prevalence, incidence, and years lived with disability due to autism spectrum disorder in Brazil, as well as the variation of these metrics between 1990 and 2023. Methods: A time-series analysis using data for Brazil from the 2023 Global Burden of Disease study. Estimates of incidence, prevalence, and years lived with disability attributable to autism spectrum disorder were generated for Brazil and its regions. The study reports absolute frequencies, crude rates, and age-standardized rates per 100,000 inhabitants, all with 95% uncertainty intervals (95% UI), stratified by sex and age group. Results: In 2023, more than 1.1 million (95% UI: 0.58; 1.97) individuals on the autism spectrum were living in Brazil, representing 0.53% of the population (95% UI: 0.27; 0.93). The number of cases increased since 1990, while age-standardized prevalence remained stable over time. In 2023, more than 23,000 new autism spectrum disorder cases were estimated, with a rate of 11.19 per 100,000 individuals (95% UI: 2.47-31.39). Autism spectrum disorder was ranked within the top ten causes of years lived with disability for people younger than 20 years, being a non-fatal health burden. Conclusion: In 2023, 0.53% of Brazilians were autistic, corresponding to more than 207,000 years lived with disability. Prevalence was higher in males and children under five years of age. The permanent and complex nature of autism spectrum disorder imposes a significant burden, requiring healthcare and education services to be adequately prepared. Further research is needed to deepen the understanding of autism spectrum disorder and validate screening tools in the Brazilian context.

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) collects and calculates risk-outcome data for modifiable lifestyle exposures (eg, dietary intake) and physical health outcomes (eg, cancers). These estimates form a critical digital resource tool, the GBD VizHub data visualization tool, for governments and policy makers to guide local, regional, and global health decisions. Despite evidence showing the contributions of lifestyle exposures to common mental disorders (CMDs), such as depression and anxiety, GBD does not currently generate these lifestyle exposure-mental disorder outcome pairings. This gap is due to a lack of uniformly collected and analyzed data about these exposures as they relate to CMDs. Such data are required to quantify whether, and to what degree, the global burden of CMDs could be reduced by targeting lifestyle factors at regional and global levels. We have established the Global burden of disease Lifestyle And mental Disorder (GLAD) Taskforce to address this gap. Objective: This study aims to generate the necessary estimates to afford the inclusion of lifestyle exposures as risk factors for CMDs in the GBD study and the GBD digital visualization tools, initially focusing on the relationship between dietary intake and CMDs. Methods: The GLAD project is a multicenter, collaborative effort to integrate lifestyle exposures as risk factors for CMDs in the GBD study. To achieve this aim, global epidemiological studies will be recruited to conduct harmonized data analyses estimating the risk, odds, or hazards of lifestyle exposures with CMD outcomes. Initially, these models will focus on the relationship between dietary intake, as defined by the GBD, and anxiety and depression. Results: As of August 2024, 18 longitudinal cohort studies from 9 countries (Australia: n=4; Brazil: n=1; France: n=1; Italy: n=3; The Netherlands: n=3; New Zealand: n=1; South Africa: n=1; Spain: n=1; and United Kingdom: n=3) have agreed to participate in the GLAD project. Conclusions: Our comprehensive, collaborative approach allows for the concurrent execution of a harmonized statistical analysis protocol across multiple, internationally renowned epidemiological cohorts. These results will be used to inform the GBD study and incorporate lifestyle risk factors for CMD in the GBD digital platform. Consequently, given the worldwide influence of the GBD study, findings from the GLAD project can offer valuable insights to policy makers worldwide around lifestyle-based mental health care. International Registered Report Identifier (IRRID): DERR1-10.2196/65576

Objective: Mental and substance use disorders are the leading causes of disability worldwide. Contemporary estimates of prevalence, severity and impairment are essential for service planning. The current study provides estimates of prevalence, severity, impairment and demographic correlates of mental and substance use disorders in 2020-22, and changes in prevalence since 2007.Methods: Data were from the two Australian National Surveys of Mental Health and Wellbeing conducted in 2020-22 (N=15,893) and 2007 (N=8,841). Descriptive statistics report prevalence of lifetime and 12-month mental and substance use disorder by sex and age, proportion of people with each mental disorder by levels of severity (mild, moderate and severe) and mean days out of role by mental disorder class (mood, anxiety, substance use). Logistic regression analyses examined demographic correlates of mental disorder class and assessed changes over time.Results: The lifetime prevalence of any mental or substance use disorder in 2020-22 was 40.2%. The 12-month prevalence was 20.2% (mood disorder - 7.4%, anxiety disorder - 15.7% and substance use disorder - 3.1%). Mood disorders, were associated with significant impairment. The prevalence of mental disorders has changed over time, with mood and anxiety disorders increasing and substance use disorders decreasing. These changes were most evident among young adults.Conclusions: Mental disorders are common in Australia. Impairment associated with mental disorders remains significant. Particular focus should be paid to young adults aged 16-24 years who have shown the largest increases in anxiety and mood disorder prevalence over the past 13 years.

BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) collects and calculates risk-outcome data for modifiable lifestyle exposures (eg, dietary intake) and physical health outcomes (eg, cancers). These estimates form a critical digital resource tool, the GBD VizHub data visualization tool, for governments and policy makers to guide local, regional, and global health decisions. Despite evidence showing the contributions of lifestyle exposures to common mental disorders (CMDs), such as depression and anxiety, GBD does not currently generate these lifestyle exposure-mental disorder outcome pairings. This gap is due to a lack of uniformly collected and analyzed data about these exposures as they relate to CMDs. Such data are required to quantify whether, and to what degree, the global burden of CMDs could be reduced by targeting lifestyle factors at regional and global levels. We have established the Global burden of disease Lifestyle And mental Disorder (GLAD) Taskforce to address this gap. OBJECTIVE This study aims to generate the necessary estimates to afford the inclusion of lifestyle exposures as risk factors for CMDs in the GBD study and the GBD digital visualization tools, initially focusing on the relationship between dietary intake and CMDs. METHODS The GLAD project is a multicenter, collaborative effort to integrate lifestyle exposures as risk factors for CMDs in the GBD study. To achieve this aim, global epidemiological studies will be recruited to conduct harmonized data analyses estimating the risk, odds, or hazards of lifestyle exposures with CMD outcomes. Initially, these models will focus on the relationship between dietary intake, as defined by the GBD, and anxiety and depression. RESULTS As of August 2024, 18 longitudinal cohort studies from 9 countries (Australia: n=4; Brazil: n=1; France: n=1; Italy: n=3; The Netherlands: n=3; New Zealand: n=1; South Africa: n=1; Spain: n=1; and United Kingdom: n=3) have agreed to participate in the GLAD project. CONCLUSIONS Our comprehensive, collaborative approach allows for the concurrent execution of a harmonized statistical analysis protocol across multiple, internationally renowned epidemiological cohorts. These results will be used to inform the GBD study and incorporate lifestyle risk factors for CMD in the GBD digital platform. Consequently, given the worldwide influence of the GBD study, findings from the GLAD project can offer valuable insights to policy makers worldwide around lifestyle-based mental health care. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/65576

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