Evidence map›Paper›PMID 31200992›Full record

SynthesisLancet (London, England)2019

New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis.

Fiona Charlson, Mark van Ommeren, Abraham Flaxman, Joseph Cornett, Harvey Whiteford, Shekhar Saxena

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06587841 (Noninvasive Spinal Cord Neuromodulation to Improve Lower Urinary Tract Function After Spinal Cord Injury in Ukrainian War Veterans), which is not on this map. Cited by 732 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
732citing papers in PubMed, 15 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06587841 narecruitingnot on this mapstarted 2024, after this paper: background citation

Noninvasive Spinal Cord Neuromodulation to Improve Lower Urinary Tract Function After Spinal Cord Injury in Ukrainian War Veterans

TypeinterventionalSponsorUniversity of British ColumbiaRan2024 to 2027Enrolled60ConditionsSpinal Cord Injuries, Bowel Dysfunction, Sexual Dysfunction, Autonomic DysfunctionArmsSpinal COrd NEuromodulation™ (SCONE™) for transcutaneous spinal cord stimulation (TSCS)
3 · Its place in the literature

Who cites it

732 citing papers in PubMed, 15 syntheses or guidelines pooled it.

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  13. [Meta analysis of the prevalence of depressive symptoms among children and adolescents in China from 2015 to 2024].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025
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672 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Fiona CharlsonPolicy and Epidemiology Group, Queensland Centre for Mental Health Research, QLD, Australia; School of Public Health, University of Queensland, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Mark van OmmerenDepartment of Mental Health and Substance Abuse, WHO, Geneva, Switzerland. Electronic address: vanommerenm@who.int.
Abraham FlaxmanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Joseph CornettPolicy and Epidemiology Group, Queensland Centre for Mental Health Research, QLD, Australia.
Harvey WhitefordPolicy and Epidemiology Group, Queensland Centre for Mental Health Research, QLD, Australia; School of Public Health, University of Queensland, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Shekhar SaxenaT H Chan School of Public Health, Harvard University, Boston, MA, USA.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundExisting WHO estimates of the prevalence of mental disorders in emergency settings are more than a decade old and do not reflect modern methods to gather existing data and derive estimates. We sought to update WHO estimates for the prevalence of mental disorders in conflict-affected settings and calculate the burden per 1000 population.

methodsIn this systematic review and meta-analysis, we updated a previous systematic review by searching MEDLINE (PubMed), PsycINFO, and Embase for studies published between Jan 1, 2000, and Aug 9, 2017, on the prevalence of depression, anxiety disorder, post-traumatic stress disorder, bipolar disorder, and schizophrenia. We also searched the grey literature, such as government reports, conference proceedings, and dissertations, to source additional data, and we searched datasets from existing literature reviews of the global prevalence of depression and anxiety and reference lists from the studies that were identified. We applied the Guidelines for Accurate and Transparent Health Estimates Reporting and used Bayesian meta-regression techniques that adjust for predictors of mental disorders to calculate new point prevalence estimates with 95% uncertainty intervals (UIs) in settings that had experienced conflict less than 10 years previously.

findingsWe estimated that the prevalence of mental disorders (depression, anxiety, post-traumatic stress disorder, bipolar disorder, and schizophrenia) was 22·1% (95% UI 18·8-25·7) at any point in time in the conflict-affected populations assessed. The mean comorbidity-adjusted, age-standardised point prevalence was 13·0% (95% UI 10·3-16·2) for mild forms of depression, anxiety, and post-traumatic stress disorder and 4·0% (95% UI 2·9-5·5) for moderate forms. The mean comorbidity-adjusted, age-standardised point prevalence for severe disorders (schizophrenia, bipolar disorder, severe depression, severe anxiety, and severe post-traumatic stress disorder) was 5·1% (95% UI 4·0-6·5). As only two studies provided epidemiological data for psychosis in conflict-affected populations, existing Global Burden of Disease Study estimates for schizophrenia and bipolar disorder were applied in these estimates for conflict-affected populations.

interpretationThe burden of mental disorders is high in conflict-affected populations. Given the large numbers of people in need and the humanitarian imperative to reduce suffering, there is an urgent need to implement scalable mental health interventions to address this burden.

fundingWHO; Queensland Department of Health, Australia; and Bill & Melinda Gates Foundation.

Indexed as

WarfareAnxiety DisordersBipolar DisorderDepressionHumansMental DisordersPrevalenceSchizophreniaStress Disorders, Post-TraumaticWorld Health Organization

Identifiers

PMID31200992
PMCPMC6657025

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.