In high-income countries, what category of disease accounts for the greatest percentage of disability-adjusted life years lost?

In high-income countries, what category of disease accounts for the greatest percentage of disability-adjusted life years lost?
A. Alcohol abuse
B. Chronic obstructive pulmonary disease
C. Diabetes mellitus
D. Ischemic heart disease
E. Unipolar depressive disorders

Answer:
E. Unipolar depressive disorders

Discussion: The causes of morbidity and burden of disease in a population differ from the absolute causes of mortality in a population.

Unipolar depressive disorder accounts for 10.0 million disability-adjusted life years lost (DALYs) in high-income countries. Depression is quite common in the general population of developed countries.
However, the death rate from depression is low and is mainly reflected in suicides. Thus, depression creates disability and lost productivity without a significant impact on years of life lost. Depression often presents at young ages and persists or recurs throughout a lifetime, leading to significant morbidity over time.

After unipolar depressive disorder, the leading causes of DALYs lost in high-income countries are ischemic heart disease, cerebrovascular disease, Alzheimer’s disease and other dementia, and alcohol use disorders.

However, worldwide, the leading cause of DALYs is lower respiratory infections caused by the high burden of disease in low-income countries with an estimated 76.9 million DALYs lost because of lower respiratory infections in low-income countries. Additionally, in low income countries, the top five causes of DALYs are related to infectious diseases (diarrheal diseases, HIV, malaria) and prematurity.