Just to add to this. Acute schizophrenia is one of the worst health conditions on GBD13 DALY weightings (c.0.8). Severe depression is also one of the worst (c.0.65).
So Michael—I agree it’s very possible that mental health disorders are underweighted by DALY weightings because of the focusing illusion. But they are actually weighted quite highly at the moment. 10 years with severe depression is worth approximately 3.5 years of healthy life.
yes, it’s interesting that schizophrenia tops the list anyway, although this could be the case in virtue of the face it stops you from leading a normal life part of the disability (this being based on the EQ-5D), rather than because severe schiozophrenics are less happy than severely depressed people.
although they are weighted highly, that doesn’t stop them from being underweighted. Given the way DALYs are constructed—measuring health, not happiness; using preferences, not adaptation—it’s conceptually very hard to see how mental health conditions can’t be underweighted in terms of happiness. Unless and until we measure people’s experiences of various diseases we really won’t know.
My guess is that depression could be the most comparatively underweighted health state: if you can function normally, but you’re just really sad, you might do pretty well on an EQ-5D metric because you’re only doing badly in 1 of 5 criteria, and that’s the criteria most linked to happiness.
As an aside, do you know how the GBD project takes episode duration into account? Or is it just a measure of intensity?
Just to add to this. Acute schizophrenia is one of the worst health conditions on GBD13 DALY weightings (c.0.8). Severe depression is also one of the worst (c.0.65).
See http://www.thelancet.com/action/showFullTableImage?tableId=tbl2&pii=S2214109X15000698
So Michael—I agree it’s very possible that mental health disorders are underweighted by DALY weightings because of the focusing illusion. But they are actually weighted quite highly at the moment. 10 years with severe depression is worth approximately 3.5 years of healthy life.
yes, it’s interesting that schizophrenia tops the list anyway, although this could be the case in virtue of the face it stops you from leading a normal life part of the disability (this being based on the EQ-5D), rather than because severe schiozophrenics are less happy than severely depressed people.
although they are weighted highly, that doesn’t stop them from being underweighted. Given the way DALYs are constructed—measuring health, not happiness; using preferences, not adaptation—it’s conceptually very hard to see how mental health conditions can’t be underweighted in terms of happiness. Unless and until we measure people’s experiences of various diseases we really won’t know.
My guess is that depression could be the most comparatively underweighted health state: if you can function normally, but you’re just really sad, you might do pretty well on an EQ-5D metric because you’re only doing badly in 1 of 5 criteria, and that’s the criteria most linked to happiness.
As an aside, do you know how the GBD project takes episode duration into account? Or is it just a measure of intensity?