Li Sangzi, Xu Yufeng, Zheng Leilei, Pang Hu, Zhang Qianni, Lou Lixia, Huang Xingru
School of Marxism, Zhejiang University, Hangzhou, China.
School of Design and Fashion, Zhejiang University of Science and Technology, Hangzhou, China.
Front Psychiatry. 2022 Feb 21;13:789305. doi: 10.3389/fpsyt.2022.789305. eCollection 2022.
Globally, major depressive disorder (MDD) is considered to be a leading cause of disability. In this article, we aim to investigate the sex difference in global burden of MDD by year, age, and socioeconomic development, utilizing disability-adjusted life-years (DALYs).
Global and national sex-specific DALY estimates caused by MDD from 1990 to 2019 and in different age groups were obtained from the Global Burden of Disease (GBD) Study 2019. Human development index (HDI) was used as an indicator of national socioeconomic development. Spearman correlation and linear regression analyses were performed to explore the relationship between national socioeconomic development and sex difference in MDD burden.
Sex difference in global burden of MDD persisted between 1990 and 2019, with age-standardized DALY rates being 352 among males vs. 593 among females in 1990 and 354 vs. 564 in 2019. Females had higher burden of MDD than males at the same age. Disability-adjusted life-years numbers and rates among both sexes rapidly increased with age for those aged 10-24 years, along with gradually enlarging sex difference. Age-standardized DALY rates among females were higher than that among males for each HDI-based country group ( < 0.001). National age-standardized DALY rates among both sexes were negatively related to HDI. However, female-to-male age-standardized DALY rate ratios were positively associated with HDI (Spearman = 0.383, < 0.001; standardized β = 0.300, < 0.001).
Although some improvement in sex difference in global burden of MDD has been achieved, it still persists in the past three decades, with females bearing more burden than males. To reduce sex difference in global MDD burden, more attention should be paid to young people and people in developed countries. The findings highlight the importance of making sex-specific health policy to manage mental impairment caused by MDD.
在全球范围内，重度抑郁症（MDD）被认为是导致残疾的主要原因。在本文中，我们旨在利用伤残调整生命年（DALYs），按年份、年龄和社会经济发展情况，调查MDD全球负担中的性别差异。
1990年至2019年不同年龄组由MDD导致的全球及各国特定性别的DALY估计值，取自《2019年全球疾病负担（GBD）研究》。人类发展指数（HDI）用作国家社会经济发展的指标。进行Spearman相关性分析和线性回归分析，以探讨国家社会经济发展与MDD负担性别差异之间的关系。
1990年至2019年期间，MDD全球负担中的性别差异持续存在，年龄标准化DALY率在1990年男性为352，女性为593；在2019年男性为354，女性为564。在相同年龄下，女性的MDD负担高于男性。10至24岁人群中，两性的伤残调整生命年数和率随年龄迅速增加，同时性别差异逐渐扩大。每个基于HDI的国家组中，女性的年龄标准化DALY率均高于男性（P<0.001）。各国两性的年龄标准化DALY率与HDI呈负相关。然而，女性与男性年龄标准化DALY率之比与HDI呈正相关（Spearman ρ=0.383，P<0.001；标准化β=0.300，P<0.001）。
尽管MDD全球负担中的性别差异已有所改善，但在过去三十年中仍然存在，女性负担比男性更重。为减少全球MDD负担中的性别差异，应更加关注年轻人和发达国家的人群。研究结果凸显了制定针对性别的健康政策以管理由MDD引起的精神损伤的重要性。
