Global burden of mental disorders in 204 countries and territories, 1990-2021: results from the global burden of disease study 2021.

BACKGROUND

Mental disorders, one of the leading causes of the global health-related burden, which has been exacerbated by the emergence of the COVID-19 pandemic (2019-2021). In this study, we aim to provide global, regional, and national estimates of the mental disorders burden from 1990 to 2021, including during the COVID-19.

METHODS

We collected data from the Global Burden of Disease Study 2021 (GBD 2021) on the incidence, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), and age-standardized DALY rate (ASR) of 12 mental disorders from 204 countries and regions. The socio-demographic index (SDI) was used to evaluate the correlation between mental disorders burden and different regions. We utilized joinpoint regression analysis to estimate the average annual percentage change (AAPC).

RESULTS

In 2021, there were 444,397,716 incident cases and 155,418,119 DALYs globally from mental disorders. From 1990 to 2021, there was an upward trend in both ASIR [15.23% (12.97-17.60%)] and ASR [17.28% (15.06-19.44%)]. In 2021, the highest ASIR was observed in Central Sub-Saharan Africa (8706.11), while the lowest was in East Asia (3340.99). Australia (2787.87) had the highest ASR. Nationally, Greenland, Greece, the United States, and Australia had the highest ASRs. During the COVID-19 pandemic, aside from East Asia, both the ASIR showed an upward trend in the five SDI and other GBD regions. In 2021, the ASR for females was higher than that for males. Among the 12 subtypes, major depressive disorder (557.87) and anxiety disorders (524.33) had the highest ASR. Major depressive disorder ranked first in ASR in 13 of the 21 regions worldwide. Despite the overall upward trend in DALYs for mental disorders [AAPC: 5.96; 95%CI: (4.99, 6.92)], the ASR exhibited varying trends among different subtypes, with anxiety disorders experiencing the most significant increase.

CONCLUSIONS

GBD 2021 showed that the burden of mental disorders has increased over the past three decades, with notable regional disparities. High SDI regions and females should be paid more attention. To alleviate future burdens, providing comprehensive mental health support, establishing effective mental health knowledge dissemination and tailored interventions are in great need.

CLINICAL TRIAL NUMBER

Not applicable.