An Jia, Wang Qiang, Bai Zihao, Du Xueying, Yu Di, Mo Xuming
Nanjing Children's Hospital, Clinical Teaching Hospital of Medical school, Nanjing University, 22 Hankou Road, Nanjing, 210008, China.
Department of Cardio-thoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
BMC Public Health. 2025 May 2;25(1):1632. doi: 10.1186/s12889-025-22814-0.
Alcohol use disorders (AUD), drug use disorders (DUD), interpersonal violence, and self-harm are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with this. This study aims to estimate the disease burden, trends, projections, and disparities of AUD, DUD, interpersonal violence, and self-harm among all ages and sexes from 1990 to 2021.
This study is a secondary analysis utilizing data from the Global Burden of Disease (GBD) 2021 in 204 countries and territories. The incidence, deaths, and disability-adjusted life years (DALYs), projection, and the inequality were estimated for AUD, DUD, interpersonal violence, and self-harm among all age and sex.
In 2021, there were 55.78 (46.56-64.31) million new cases of AUD, 13.61 (11.63-15.67) million new cases of DUD, 29.40 (26.17-32.65) million new cases of interpersonal violence, 5.49 (4.6-6.5) million new cases of self-harm globally. By 2040, AUD is forecasted to be 51.98 (29-74.97) million, DUD will be 13.81 (9.23-18.39) million, 36.01 (15.25-56.78) million for interpersonal violence, and 10.55 (3.16-17.94) million for self-harm. In terms of gender and age distribution, males had higher incidence, mortality, and DALYs for AUD, DUD, and interpersonal violence compared to females. Females had higher incidence of self-harm, while males had higher mortality. By age group, individuals aged 15-49 bore the highest burden of DUD, interpersonal violence, and self-harm, while those aged 50-74 had the highest burden of AUD. The burden of these conditions is closely related to the socio-demographic index (SDI). High- and middle-high SDI regions had a heavier burden of AUD, DUD, and self-harm, while low- and middle-low SDI regions had a heavier burden of interpersonal violence. Additionally, from 1990 to 2021, health inequalities for AUD and self-harm decreased, while those for DUD and interpersonal violence increased.
From 1990 to 2021, the disease burden of AUD, DUD, interpersonal violence, and self-harm exhibited specific patterns across different genders, age groups, and regions. Multilevel interventions should be initiated, with a focus on reducing inequalities through resource allocation and policy support.
酒精使用障碍（AUD）、药物使用障碍（DUD）、人际暴力和自我伤害是全球主要的公共卫生问题，与之相关的残疾、发病率和死亡率很高。本研究旨在估计1990年至2021年所有年龄和性别的AUD、DUD、人际暴力和自我伤害的疾病负担、趋势、预测以及差异。
本研究是一项利用来自204个国家和地区的《2021年全球疾病负担》（GBD）数据进行的二次分析。估计了所有年龄和性别的AUD、DUD、人际暴力和自我伤害的发病率、死亡人数和伤残调整生命年（DALYs）、预测情况以及不平等状况。
2021年，全球有5578万（4656万 - 6431万）新的AUD病例、1361万（1163万 - 1567万）新的DUD病例、2940万（2617万 - 3265万）新的人际暴力病例、549万（460万 - 650万）新的自我伤害病例。到2040年，预计AUD病例将达5198万（2900万 - 7497万），DUD病例将达1381万（923万 - 1839万），人际暴力病例将达3601万（1525万 - 5678万），自我伤害病例将达1055万（316万 - 1794万）。在性别和年龄分布方面，与女性相比，男性在AUD、DUD和人际暴力方面的发病率、死亡率和DALYs更高。女性自我伤害的发病率较高，而男性的死亡率较高。按年龄组划分，15 - 49岁的个体承受DUD、人际暴力和自我伤害的负担最高，而50 - 74岁的个体承受AUD的负担最高。这些疾病的负担与社会人口指数（SDI）密切相关。高SDI和高中高SDI地区的AUD、DUD和自我伤害负担较重，而低SDI和低中低SDI地区的人际暴力负担较重。此外，从1990年到2021年，AUD和自我伤害的健康不平等有所下降，而DUD和人际暴力的不平等有所增加。
1990年至2021年，AUD、DUD、人际暴力和自我伤害的疾病负担在不同性别、年龄组和地区呈现出特定模式。应启动多层次干预措施，重点通过资源分配和政策支持来减少不平等。
