Kaleidoscope

The Global Burden of Disease (GBD) is the most comprehensive global epidemiological study, and the analyses of the 2015 data have recently been published (thelancet.com/gbd). This is a rich data-set including observation on the general increase in global life expectancy, with the gains due to significant improvement in HIV outcomes balanced against the significant war-related decreases in male life expectancy in Syria. Interestingly, the age-standardised mortality rate for mental and substance use disorders dropped by over 12% between 2005 and 2015, though with considerable variations between conditions and countries, and the authors further note the difficulty in accurately attributing and coding excess deaths – for example, the years of life known to be indirectly lost to schizophrenia. Total deaths due to self-harm and interpersonal violence did not change much during this period.