Institute of Preventive Medicine, China Medical University, Shenyang, People's Republic of China.
Institute of Chronic Diseases Liaoning Provincial Center for Disease Control and Prevention, Shenyang, People's Republic of China.
BMC Public Health. 2024 May 20;24(1):1359. doi: 10.1186/s12889-024-18721-5.
Few studies have assessed the burden of mental disorders among children and adolescents considering the impact of co-morbidities and suicide on disability adjusted life years (DALYs).
This was a multicenter cross-sectional study. Our survey data in Liaoning Province (LN) were used to estimate the burden of six mental disorders, supplemented with data from other investigative studies conducted in China to assess four other disorders. DALYs were derived from the sum of years lived with a disability (YLDs) adjusted for co-morbidities, and the years of life lost (YLLs) adjusted for suicide. The changes in DALYs, YLDs, and YLLs were compared with and without adjustment for co-morbidities and suicide.
The DALYs rate of mental disorders among children and adolescents in LN decreased from 1579.6/10 to 1391.4/10, after adjusting for both co-morbidities and suicide (-11.9%). The DALYs rate for major depression, anxiety disorder, and conduct disorder (-80.8/10, -75.0/10 and -30.2/10, respectively) were the top three contributors to the DALYs reduction (-188.2/10). The YLDs decreased from 72724.8 to 62478.5 after co-morbidity adjustment (-17.8%), mainly due to the reduction by major depression (-35.3%) and attention deficit/hyperactivity disorder [ADHD] (-34.2%). The YLLs increased from 130 to 1697.8 after adjusting for suicides (+ 56.9% of all suicide YLLs), mainly due to the contribution of major depression (+ 32.4%) and anxiety disorder (+ 10.4%). Compared to GBD 2010, the estimated DALY rate for mental disorders in LN was to be about 80%, with the proportion of DALYs and DALY rates explained by major depressive disorder accounted for only approximately one-third (14.6% vs. 41.9% and 202.6 vs. 759.9, respectively). But the proportion and absolute level of DALY rates explained by anxiety disorders were approximately 2-fold higher (39.7% vs. 19.6% and 552.2 vs. 323.3, respectively).
The DALYs of mental disorders among Chinese children and adolescents were approximately 80% of the global level, with anxiety disorders imposing about 2 times the global level. Co-morbidity and suicide must be adjusted when calculating DALYs.
很少有研究评估儿童和青少年精神障碍的负担，同时考虑到共病和自杀对残疾调整生命年（DALYs）的影响。
这是一项多中心横断面研究。我们的调查数据来自辽宁省（LN），用于估计六种精神障碍的负担，同时结合来自中国其他调查研究的数据来评估其他四种障碍。DALYs 是通过对共病进行调整后的残疾生命年（YLDs）和对自杀进行调整后的生命损失年（YLLs）之和得出的。比较了不考虑和考虑共病及自杀情况下 DALYs、YLDs 和 YLLs 的变化。
LN 地区儿童和青少年的精神障碍 DALYs 率从调整共病和自杀前的 1579.6/10 降至 1391.4/10（下降 11.9%）。重度抑郁症、焦虑症和品行障碍的 DALYs 率（分别为-80.8/10、-75.0/10 和-30.2/10）是导致 DALYs 减少的前三大原因（-188.2/10）。YLDs 在调整共病后从 72724.8 降至 62478.5（下降 17.8%），主要是由于重度抑郁症（-35.3%）和注意缺陷/多动障碍（ADHD）[ADHD]（-34.2%）的减少。YLLs 在调整自杀后从 130 增加到 1697.8（增加 56.9%），主要是由于重度抑郁症（+32.4%）和焦虑症（+10.4%）的贡献。与 GBD 2010 相比，LN 地区精神障碍的估计 DALY 率约为 80%，其中重度抑郁症和焦虑症的 DALY 率和 DALY 率解释比例仅占约三分之一（分别为 14.6%和 41.9%，202.6 和 759.9）。但是，焦虑症的 DALY 率和绝对水平约为全球水平的两倍（分别为 39.7%和 19.6%，552.2 和 323.3）。
中国儿童和青少年的精神障碍 DALYs 约为全球水平的 80%，其中焦虑症的影响约为全球水平的两倍。计算 DALYs 时必须调整共病和自杀。
