Mental health

1. Key messages

2. Background

Mental health is the capacity of each of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections, and personal dignity [1]. Due to the high frequency of mental problems in western societies and the significance of their costs in human, social, and economic terms, mental health is now regarded as a public health priority. In Belgium, the Health Interview Survey is one of the main sources of systematic data on mental health parameters in the general population.

Among the various dimensions of mental health that are monitored in this survey, we focus on the following three indicators:

• Prevalence of anxiety disorders and depressive disorders, based on the self-report psychometric instruments GAD-7 and PHQ-9 respectively.
• Indicators concerning the use of psychotropic medicines.

However, it should be noted that the evaluation of mental health problems in the population through a health survey has a number of limitations. These are mainly related to the fact that the estimates are based on screening instruments for psychological problems and thus are not obtained by clinical diagnostic tools, which may be more nuanced. Nevertheless, the results of general population health surveys are generally in line with the findings of specific mental health surveys.

More serious mental health disorders like schizophrenia and bipolar disorders are not presented here. Indeed, health interview surveys are not a valid instrument to capture such complex conditions. Moreover, information about suicidal thoughts and attempts can be found on a specific page (in preparation).

3. Mental health disorders

Situation in 2018

Belgium

Based on the assessment of the psychometric instruments, in 2018, 11.2% of the total Belgian population had an anxiety disorder and 9.4% had a depressive disorder. For both disorders, women had a higher prevalence (14.2% for anxiety and 10.7% for depression) than men (7.9% for anxiety and 8% for depression).

Regional specificities

Wallonia had a higher prevalence of anxiety and depressive disorders than Brussels and Flanders and Brussels had a higher prevalence than Flanders.

Trends

Belgium

Between 2008 and 2013, the prevalence of anxiety disorders increased in Belgium in both genders and has stayed more or less stable since then.

Between 2008 and 2013, the prevalence of depressive disorders increased in both genders. It slightly decreased in men and more clearly decreased in women in 2018.

However, since the questionnaires used were changed between the 2013 and 2018 surveys, trends should be interpreted with caution.

Regional specificities

Between 2008 and 2013, the prevalence of anxiety disorders increased in all regions. Between 2013 and 2018, it continued to sharply increase in Wallonia in both genders, but not in the other regions.

The prevalence of depressive disorders was lower in Flanders than in Brussels and Wallonia in all years in women and since 2004 in men.

Socio-economic disparities

There is a strong socio-economic gradient in the prevalence of mental health disorders. After age-adjustment, anxiety disorders were 2.3 times more frequent in people from the lowest educational group compared to the highest educational group. Depressive disorders were 3 times more frequent in people from the lowest educational group compared to the highest educational group.

4. Consumption of psychotropic medicines

Situation in 2018

Belgium

In 2018, 12.3% of the population used sedatives (sleeping pills or tranquilizers) and 7.6% used antidepressants in the past 2 weeks. More women than men consumed sedatives (15% in women vs 9.5% in men) and antidepressants (9.8% vs 5.3%).

The consumption of sedatives increased with age, particularly after 45 years in women and after 65 years in men.

The consumption of antidepressants is particularly high in women after 45 years of age.

Regional specificities

In 2018, the consumption of sedatives is slightly higher in Wallonia and in Flanders than in Brussels, but the regional differences are narrow and not significant.

The consumption of antidepressants is slightly lower in Flanders than in the other regions, but the differences are only significant in women.

Trends

Belgium

From 1997 to 2008, the consumption of sedatives in the population increased, then it decreased in 2013 and in 2018 when considering both genders together. In men the consumption remained stable round 10%, while it decreased from 19% in 2008 to 15% in 2018 in women.

Since 1997, the consumption of antidepressants has doubled in both genders.

Regional specificities

The consumption of sedatives used to be significantly lower in Flanders than in the 2 other regions until 2008 in both genders. After 2008, as the use of sedatives continued to increase in Flanders while slightly decreasing in the other regions, the regional differences narrowed and quasi disappeared by 2018.

The consumption of antidepressants followed a same evolution in both genders and in all regions, that is, it has significantly increased since 1997.

Socio-economic disparities

There was a socio-economic gradient in the consumption of sedatives and antidepressants. A higher proportion of people from the lowest educational group consumed sedatives (17.7% vs 12.3%) and antidepressants (10.3% vs 6%) than from the highest educational group.

5. Read more

View the metadata for this indicator

HISIA: Interactive Analysis of the Belgian Health Interview Survey

Definitions

GAD-7: General Anxiety Disorder 7-item

The GAD-7 is a screening tool for general anxiety disorder. Participants are asked to evaluate the frequency, if ever, of experiencing 7 core symptoms in the last 2 weeks. The scores obtained allow to evaluate the symptom severity.

Anxiety disorders

Participants with a score of 10 or over out of 21 in the GAD-7 tool were considered to have an anxiety disorder.

PHQ-9: Patient Health Questionnaire 9-item depression scale

The PHQ-9 is a screening tool for major depressive disorder and other depressive disorders. Participants are asked to evaluate the frequency in which they have been bothered by 9 problems in the last 2 weeks.

Depressive disorders

Participants with a combination of answers meeting the criteria specific for major depressive disorder and other depressive disorders for the PHQ-9 were considered to have a depressive disorder.

References

1. https://www.canada.ca/en/public-health/services/health-promotion/mental-health/mental-health-promotion.html
2. Health Interview Survey, Sciensano, 1997-2018. https://his.wiv-isp.be/