Yan Na, Zhang Caochen, Wang Yihan, Wang Yuhao, Luo Yunjiao, Wang Yingxue, Shiferaw Blen Dereje, Mackay Louisa Esi, Wang Jingjing, Tang Jie, Wang Qingzhi, Gao Xiuyin, Wang Wei
School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu, 221004, China.
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, China.
BMC Psychol. 2025 Jan 10;13(1):30. doi: 10.1186/s40359-025-02349-0.
This study aims to examine the temporal changes in the incidence, prevalence, and disability-adjusted life years (DALYs) of depressive disorders as well as its association with age, period, and birth cohort among Chinese from 1990 to 2021, and forecast the future trends of incidence rates and numbers from 2022 to 2030.
Data for analysis were obtained from the Global Burden of Disease (GBD) 2021. Joinpoint analysis was used to calculate the annual percentage change (APC) and average annual percent change (AAPC) to describe the rates of depressive disorders. Age, period, and cohort model was utilized to disentangle age, period, and birth cohort effects on rates of depressive disorders. Bayesian age-period-cohort (BAPC) analysis was capitalized to forecast the incidence rates and numbers for different sexes and age groups from 2022 to 2030.
The age-standardized incidence (ASIR, AAPC: -0.35 [95%CI: -0.65, -0.04]), prevalence (ASPR, AAPC: -0.20 [95%CI: -0.24, -0.16]), and DAYLs (AAPC: -0.28 [95%CI: -0.51, -0.05]) rates of both sexes showed a downward trend from 1990 to 2021, despite a volatility growth in recent years (APC in 2019-2021 of ASPR: 0.96 [95%CI: 0.70, 1.23]). Females exhibited a higher burden of depressive disorders compared to males but experienced a more rapid rate of reduction changes. The burden of depressive disorders was most owing to the age effect and period effect in recent years. The ASIR was predicted to decrease in the whole population (males in 2030: 1,546.3 per 100,000 people; females in 2030: 2,465.8 per 100,000 people), but in children, adolescents, and the elderly demonstrate unfavorable trends in the future.
The burden of depressive disorders decreased in China from 1990 to 2021 in terms of age-standardized rates, but increased in recent years. Children, adolescents, and the elderly are the risk groups for future depressive disorders. Considering the large population, the increasing fewer children, and the aging trend, as well as the possible long-term effects of COVID-19 on human psychological burden, more sex-age-sensitive social healthcare programs should be considered in the future to minimize the burden of depressive disorders in China.
本研究旨在探讨1990年至2021年期间中国抑郁症的发病率、患病率和伤残调整生命年（DALYs）的时间变化，及其与年龄、时期和出生队列的关联，并预测2022年至2030年发病率和病例数的未来趋势。
分析数据来自《2021年全球疾病负担》（GBD 2021）。采用Joinpoint分析计算年度百分比变化（APC）和平均年度百分比变化（AAPC），以描述抑郁症的发病率。利用年龄、时期和队列模型来区分年龄、时期和出生队列对抑郁症发病率的影响。运用贝叶斯年龄-时期-队列（BAPC）分析预测2022年至2030年不同性别和年龄组的发病率和病例数。
1990年至2021年，两性的年龄标准化发病率（ASIR，AAPC：-0.35 [95%CI：-0.65，-0.04]）、患病率（ASPR，AAPC：-0.20 [95%CI：-0.24，-0.16]）和伤残调整生命年（AAPC：-0.28 [95%CI：-0.51，-0.05]）率呈下降趋势，尽管近年来有波动增长（2019 - 2021年ASPR的APC：0.96 [95%CI：0.70，1.23]）。与男性相比，女性抑郁症负担更高，但下降变化速度更快。近年来，抑郁症负担主要归因于年龄效应和时期效应。预计整个人口的ASIR将下降（2030年男性：每10万人中1546.3例；2030年女性：每10万人中2465.8例），但儿童、青少年和老年人未来呈现不利趋势。
从年龄标准化率来看，1990年至2021年中国抑郁症负担下降，但近年来有所上升。儿童、青少年和老年人是未来抑郁症的风险群体。考虑到人口众多、儿童数量减少和老龄化趋势，以及新冠疫情对人类心理负担可能产生的长期影响，未来应考虑更多对性别和年龄敏感的社会医疗保健项目，以减轻中国抑郁症的负担。
