精神疾患對台灣、日本、法國及全球疾病負擔與經濟影響之研究

Abstract

背景 精神疾患已成為嚴重的全球公共衛生議題，在發展中國家與已開發國家中，其對失能調整生命年的貢獻日益增加。本研究透過對臺灣、日本͏、法國及全球趨勢進行為期十一年的跨國比較，探討經濟發展與精神疾病負擔之間的關係，並分析文化和健康政策的差異如何影響疾病統計數據的解讀。

方法 本研究採用健康指標和評估研究所所提供之2021年全球疾病負͏擔研究資料集，涵蓋2011年至2021年間有關精神疾患與物質使用障礙之失能調整生命年及盛行率之估計值。國內͏生產毛͏額與人均國內生產毛額之相關數據則取自世界銀͏行。鑒於世界銀行資料庫未涵蓋臺灣地區之數據，故本研究輔以中國經濟信息͏中心所提供之資料進行補充。研究中採用絕對指標與相對指標，衡量三個目標國家以及全球範圍內精神疾患所造成之健康負擔，並透過相關分析，探討經濟͏發展與精神疾患負擔在時間及空間層面上的關聯性。

結果͏ 2021年，全球͏因精神疾患所致之失能調整生命年達1.55億；若將物質使用͏障礙納入計算，則總量上升至1.88億。在本研究所涵蓋之台灣、日本與法國三國中，以法國的承受之精神疾患負擔最為嚴重。依據健康指標和評估研究所之定義，全球精神疾患所造成之經濟負擔估計約為1.92兆美元；若計入物質使用障礙，則增加至2.3͏2兆美元。儘管高收入國家承受最高之經濟損失，低收入地區則面臨更沉重的之健康負擔。人均國內生產毛額與精神疾患所造成之經濟負擔之間呈現正相關（r = 0.38），當將物質使用障礙納入模型後，該相關性顯著提升（r = 0.63）。整體而言，失能調整生命年與經濟負擔皆呈逐年上升趨勢，且各收入群體與地區間之差距亦日益擴大。

結論 精神疾患對全球健康與經濟造成日益加劇且分布不均之負擔。將物質使用障礙納入分析後，對疾病估算產生顯著影響；而經濟發展程度愈高，所觀察到的精神疾患負擔亦愈顯著，此反映了檢測能力與通報系統之差異，而非實際盛行率之下降。本研究結果突顯出建立標準化精神疾患定義的必要性，並呼籲針對不同國家與地區之結構性差異，進行更具精準性的投資。

Introduction Mental disorders have emerged as a serious global public health issue, increasingly contributing to disability-adjusted life years (DALYs) in both developing and developed countries. This study provides an eleven-year, cross-national comparison of Taiwan, Japan, France, and global trends to investigate the relationship between economic development and the burden of mental disorders while examining how cultural and health policy differences influence the interpretation of disease statistics.

Methods This study utilized data from the Global Burden of Disease Study (GBD) 2021 dataset provided by the Institute for Health Metrics and Evaluation, including DALYs and prevalence estimates of mental disorders and substance use disorders from 2011 to 2021. Gross Domestic Product (GDP) and GDP per capita were obtained from the World Bank. At the same time, Taiwan's data were supplemented using China Economic Information Center Data since it was not covered by World Bank records. Absolute and relative measures were used to evaluate the burden of mental disorders in the three target countries and globally. Correlation analysis was applied to explore the relationships between economic development and the burden of mental disorders with time and geography.

Results In 2021, mental disorders accounted for 155 million DALYs globally, rising to 188 million when substance use disorders were included. France showed the highest national burden among Taiwan, Japan, and France. The global economic burden was estimated at USD 1.92 trillion using the IHME definition and increased to USD 2.32 trillion when substance use disorders were included. High-income countries had the greatest monetary losses, whereas lower-income regions experienced greater health burdens. A positive correlation between GDP per capita and economic burden (r = 0.38) was significantly improved (r = 0.63) when substance use disorders were added to the model. DALYs and economic burden increased over time, with widening differences by income group and region.

Conclusion Mental disorders generate a growing and uneven burden on global health and economies. The inclusion of substance use disorders significantly alters disease estimation, while economic development is associated with a higher mental disorder burden, reflecting detection capacity and reporting differences rather than reduced prevalence. These findings highlight the need for a standardized mental health definition and targeted investment to address structural variations across diverse national and regional contexts.