Errazuriz Antonia, Avello-Vega Dalia, Passi-Solar Alvaro, Torres Rafael, Bacigalupo Felix, Crossley Nicolas A, Undurraga Eduardo A, Jones Peter B
Department of Psychiatry, School of Medicine, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
School of Social and Political Science, University of Edinburgh, United Kingdom.
Lancet Reg Health Am. 2025 Mar 25;45:101057. doi: 10.1016/j.lana.2025.101057. eCollection 2025 May.
The prevalence of anxiety disorders among the adult population in Latin America (LATAM) and its association with development indicators is insufficiently characterised. We estimated pooled regional, country, and sex-specific prevalence rates of anxiety disorders in LATAM based on International Classification of Diseases (ICD) or Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. Additionally, we examined the association between its prevalence and four country-level development indicators: Human Development Index (HDI), income inequality (Gini coefficient), Gender Inequality Index (GII), and Intentional Homicide Rate (IHR).
We conducted a systematic review and meta-analysis of population-based studies on the prevalence of ICD/DSM anxiety disorders in LATAM from 1990 to 2024, irrespective of language. We searched PubMed, PsycINFO, Cochrane Library, SciELO, LILACS, and grey literature. Study quality was assessed using JBI's critical appraisal tools. Pooled estimates were generated using random-effects meta-analysis, and heterogeneity was evaluated using the I-squared ( ) statistic. Meta-regression analyses were performed to examine the ecological association between anxiety disorders prevalence and four development indicators. The study was registered with PROSPERO (CRD42020190238).
Using data from 36 studies in LATAM, we calculated the lifetime, 12-month, and current prevalence of ICD/DSM anxiety disorders at 14.55% (95% Confidence Interval 12.32%-17.11%; = 97.9%); 6.61% (5.20-8.37; = 98.1%), and 3.27% (2.34-4.56; = 97.5%), respectively. Heterogeneity was high across prevalence periods, sexes, and countries (all ≥ 91.4%), warranting caution in interpreting pooled estimates. Elevated 12-month and current prevalence rates of anxiety disorders were associated with higher Gini coefficients ( ≤ 0.0013). Additionally, higher current prevalence was associated with lower HDI ( = 0.0103) and higher GII ( = 0.0023), while elevated 12-month prevalence was associated with higher IHR ( = 0.011).
This study shows that approximately one in seven people in LATAM experience anxiety disorders at some point in their lives. These findings highlight the need to strengthen mental health systems in the region, and evidence the association between prevalence of anxiety disorders and development indicators. Our results can serve as a baseline for tracking anxiety disorders and for informed decision-making at the national and regional levels. The substantial heterogeneity between studies and the underrepresentation of some countries underscore the imperative for enhancing regional mental health capacities.
Pfizer Independent Medical Education Grant (69879319).
拉丁美洲成年人口中焦虑症的患病率及其与发展指标的关联尚未得到充分描述。我们根据国际疾病分类(ICD)或精神疾病诊断与统计手册(DSM)标准,估计了拉丁美洲焦虑症的区域、国家和特定性别合并患病率。此外,我们还研究了其患病率与四个国家层面发展指标之间的关联:人类发展指数(HDI)、收入不平等(基尼系数)、性别不平等指数(GII)和故意杀人率(IHR)。
我们对1990年至2024年拉丁美洲基于人群的ICD/DSM焦虑症患病率研究进行了系统综述和荟萃分析,不限语言。我们检索了PubMed、PsycINFO、Cochrane图书馆、SciELO、LILACS和灰色文献。使用JBI的批判性评价工具评估研究质量。采用随机效应荟萃分析生成合并估计值,并使用I²统计量评估异质性。进行荟萃回归分析以检验焦虑症患病率与四个发展指标之间的生态关联。该研究已在PROSPERO注册(CRD42020190238)。
利用拉丁美洲36项研究的数据,我们计算出ICD/DSM焦虑症的终生患病率、12个月患病率和当前患病率分别为14.55%(95%置信区间12.32%-17.11%;I² = 97.9%);6.61%(5.20-8.37;I² = 98.1%)和3.27%(2.34-4.56;I² = 97.5%)。不同患病率时期、性别和国家之间的异质性都很高(所有I²≥91.4%),因此在解释合并估计值时需谨慎。焦虑症12个月患病率和当前患病率升高与较高的基尼系数相关(P≤0.0013)。此外,当前患病率较高与较低的人类发展指数相关(P = 0.0103),与较高的性别不平等指数相关(P = 0.0023),而12个月患病率升高与较高的故意杀人率相关(P = 0.011)。
本研究表明,拉丁美洲约七分之一人口在生命中的某个时刻经历过焦虑症。这些发现凸显了加强该地区心理健康系统的必要性,并证明了焦虑症患病率与发展指标之间的关联。我们的结果可作为追踪焦虑症以及在国家和地区层面进行明智决策的基线。研究之间的巨大异质性以及一些国家代表性不足凸显了加强区域心理健康能力的紧迫性。
辉瑞独立医学教育基金(69879319)。