Design, setting and participants: We analysed data from the 2003 Australian Burden of Disease and Injury Study, which estimated the prevalent disability burden attributable to 170 diseases and injuries, for younger adolescents (10–14 years), older adolescents (15–19 years) and young adults (20–24 years).
Main outcome measures: The broad categories of disease and injury that are the main contributors to prevalent disability and the 10 leading disease and injury causes of prevalent disability, according to sex and age group.
Results: Total prevalent disability rates are lowest in younger adolescents and highest in young adults. Mental disorders are the largest “contributor” to disability in young Australians, and anxiety and depressive disorders are the leading single cause. In young males, autism and attention deficit hyperactivity disorder cause similar levels of disability as do anxiety and depression. In young females, eating disorders are the second leading cause of mental disorder disability. Alcohol use disorders and schizophrenia make important contributions to disability in young adult males. Asthma is the most prominent cause of physical disability in all three age groups.
Conclusions: There are substantial changes in both the pattern and level of disability burden across the three age groups that we studied. The increase in total prevalent disability that occurs from early adolescence to young adulthood should focus attention on the delivery of accessible and youth friendly health care as well as the effectiveness of transitions from child health services to adult health services.
- 1. Patton GC, Viner R. Pubertal transitions in health. Lancet 2007; 369: 1130-1139.
- 2. Begg S, Vos T, Barker B, et al. The burden of disease and injury in Australia 2003. Canberra: Australian Institute of Health and Welfare, 2007. (AIHW Cat. No. PHE 82.) http://www.aihw.gov.au/publications/index.cfm/title/10317 (accessed Oct 2009).
- 3. Australian Institute of Health and Welfare. Young Australians: their health and wellbeing 2007. Canberra: AIHW, 2007. (AIHW Cat. No. PHE 87.) http://www.aihw.gov.au/publications/index.cfm/title/10451 (accessed Oct 2009).
- 4. Murray C, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, Mass: Harvard School of Public Health on behalf of the World Health Organization and the World Bank, 1996.
- 5. Stouthard MEA, Essink-Bot ML, Bonsel GJ, et al. Disability weights for diseases in the Netherlands. Rotterdam: Department of Public Health, Erasmus University, 1997. http://dare.uva.nl/record/30262 (accessed Jul 2010).
- 6. Suris JC, Michaud PA, Akre C, Sawyer SM. Health risk behaviors in adolescents with chronic conditions. Pediatrics 2008; 122: e1113-e1118.
- 7. Suris JC, Akre C, Rutishauser C. How adult specialists deal with the principles of a successful transition. J Adolesc Health 2009; 45: 551-555.
- 8. Sawyer SM, Drew S, Yeo MS, Britto MT. Adolescents with a chronic condition: challenges living, challenges treating. Lancet 2007; 369: 1481-1489.
- 9. Australian Bureau of Statistics. Mental health and wellbeing: profile of adults, Australia, 1997. Canberra: ABS, 1998. (ABS Cat. No. 4326.0.)
- 10. Shah S, Roydhouse JK, Sawyer SM. Asthma education in primary healthcare settings. Curr Opin Pediatr 2008; 20: 705-710.
- 11. Kogan MD, Strickland BB, Blumberg SJ, et al. A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005–2006. Pediatrics 2008; 122: e1149-e1158.
- 12. Sanci L, Lewis D, Patton G. Detecting emotional disorder in young people in primary care. Curr Opin Psychiatry 2010; 23: 318-323.
- 13. Tylee A, Haller DM, Graham T, et al. Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet 2007; 369: 1565-1573.
- 14. le Grange D, Crosby RD, Rathouz PJ, Leventhal BL. A randomized controlled comparison of family-based treatment and supportive psychotherapy for adolescent bulimia nervosa. Arch Gen Psychiatry 2007; 64: 1049-1056.
- 15. McGorry PD, Nelson B, Amminger GP, et al. Intervention in individuals at ultra-high risk for psychosis: a review and future directions. J Clin Psychiatry 2009; 70: 1206-1212.
- 16. Mihalopoulos C, Harris M, Henry L, et al. Is early intervention in psychosis cost-effective over the long term? Schizophr Bull 2009; 35: 909-918.
- 17. Correll CU, Hauser M, Auther AM, Cornblatt BA. Research in people with psychosis risk syndrome: a review of the current evidence and future directions. J Child Psychol Psychiatry 2010; 51: 390-431.
- 18. Ricciardi A, McAllister V, Dazzan P. Is early intervention in psychosis effective? Epidemiol Psichiatr Soc 2008; 17: 227-235.
- 19. Chisholm D. Choosing cost-effective interventions in psychiatry: results from the CHOICE programme of the World Health Organization. World Psychiatry 2005; 4: 37-44.
- 20. Carter R. The ACE (Assessing Cost Effectiveness) approach to priority setting. 6th World Congress: Explorations in Health Economics; 2007 Jul 8-11; Copenhagen, Denmark. Denmark: International Health Economics Association, 2007.
- 21. Carter R, Vos T, Moodie M, et al. Priority setting in health: origins, description and application of the Australian Assessing Cost Effectiveness initiative. Expert Rev Pharmacoecon Outcomes Res 2008; 8: 593-617.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.