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1990年至2021年抑郁症的全球、区域和国家负担及归因风险因素:2021年全球疾病负担研究结果

Global, regional and national burden of depressive disorders and attributable risk factors, from 1990 to 2021: results from the 2021 Global Burden of Disease study.

作者信息

Rong Jian, Wang Xueqin, Cheng Pan, Li Dan, Zhao Dahai

机构信息

Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.

Department of Materials and Equipment, The First Affiliated Hospital of Anhui Medical University, Anhui, China.

出版信息

Br J Psychiatry. 2025 Jan 15:1-10. doi: 10.1192/bjp.2024.266.

DOI:10.1192/bjp.2024.266
PMID:39809717
Abstract

BACKGROUND

Depressive disorders pose a significant global public health challenge, yet evidence on their burden remains insufficient.

AIMS

To report the global, regional and national burden of depressive disorders and their attributable risk factors from 1990 to 2021.

METHODS

Data from the Global Burden of Disease 2021 were analyzed for 204 countries and territories from 1990 to 2021. We explored the age-standardised incidence, prevalence and disability-adjusted life years (DALYs) of depressive disorders by age, gender and sociodemographic index.

RESULTS

In 2021, there were 357.44 million incident cases, 332.41 million prevalent cases and 56.33 million DALYs. Age-standardised rates for incidence, prevalence and DALYs were 4333.62, 4006.82 and 681.14 per 100 000 persons, with annual declines of 0.06%, 0.03% and 0.04%. Uganda, Greenland and Lesotho had the highest prevalence, while Spain, Mexico and Uruguay showed the largest increases. Greenland and Brunei Darussalam had the highest and lowest age-standardised DALYs rates, respectively. DALYs peaked in the 55-59 age group for men and 60-64 for women, with higher rates in women. Regionally, a U-shaped association was found between the sociodemographic index and DALYs rates. Population growth was the main driver for the increase in DALYs cases. Childhood maltreatment was the leading risk factor, with intimate partner violence affecting more females and childhood sexual abuse more males.

CONCLUSIONS

Despite decreasing trends in incidence, prevalence and DALYs rates, absolute case numbers and age-standardised rates continue to increase for depressive disorders. Tackling childhood abuse and improving depressive disorder management are crucial to reducing future burdens.

摘要

背景

抑郁症构成了重大的全球公共卫生挑战,但其负担方面的证据仍然不足。

目的

报告1990年至2021年抑郁症的全球、区域和国家负担及其可归因风险因素。

方法

分析了1990年至2021年来自204个国家和地区的全球疾病负担研究2021的数据。我们按年龄、性别和社会人口学指数探讨了抑郁症的年龄标准化发病率、患病率和伤残调整生命年(DALYs)。

结果

2021年,有3.5744亿例新发病例、3.3241亿例现患病例和5633万伤残调整生命年。发病率、患病率和伤残调整生命年的年龄标准化率分别为每10万人4333.62、4006.82和681.14,年下降率分别为0.06%、0.03%和0.04%。乌干达、格陵兰和莱索托患病率最高,而西班牙、墨西哥和乌拉圭增幅最大。格陵兰和文莱达鲁萨兰国的年龄标准化伤残调整生命年率分别最高和最低。男性伤残调整生命年在55 - 59岁年龄组达到峰值,女性在60 - 64岁年龄组达到峰值,女性的比率更高。在区域层面,社会人口学指数与伤残调整生命年率之间呈U形关联。人口增长是伤残调整生命年病例增加的主要驱动因素。童年期虐待是主要风险因素,亲密伴侣暴力对女性影响更大,童年期性虐待对男性影响更大。

结论

尽管抑郁症的发病率、患病率和伤残调整生命年率呈下降趋势,但绝对病例数和年龄标准化率仍在上升。应对童年期虐待和改善抑郁症管理对于减轻未来负担至关重要。

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