Xie Li, Tang Liangchen, Liu Yixin, Dong Zhenchao, Zhang Xiaojun
Emergency Department, The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, China.
Front Public Health. 2025 May 14;13:1571579. doi: 10.3389/fpubh.2025.1571579. eCollection 2025.
Self-harm has become a major public health problem globally. Data on the burden of self-harm in this study were taken from the GBD 2021. This study aimed to quantify historical trends (1990-2021) in the global burden of self-harm across genders, age groups, and regions, and project future changes (2022-2050) through Bayesian forecasting models.
Based on the seven GBD super-regions, the burden of self-harm was analyzed by region, age, and gender from 1990 to 2021. Hierarchical statistical approach was used to predict trends in global and regional changes in the burden of self-harm, 2022-2050.
In 2021, the global DALYs and death counts from self-harm were 33.5 million (95% UI: 31.3-35.8) and 746.4 thousand (95% UI: 691.8-799.8). The region with the highest number of DALYs and deaths is South Asia and the highest age-standardized rates of DALYs and mortality were in central Europe, eastern Europe, and central Asia. Globally, the burden of self-harm was higher for males than for females. DALYs rates were highest among adolescents and young adults (20-29 years), whereas mortality rates showed a predominantly age-progressive pattern with the highest burden observed in middle-aged and older populations, albeit with a modest decline in the oldest age groups. Forecasting models showed a sustained decline in the global burden of self-harm from 2022-2050.
The results highlight the need for policymakers to allocate resources to high-burden regions (e.g., South Asia and Eastern Europe), to implement gender- and age-specific prevention programs, and to strengthen cross-sectoral collaboration to address the underlying social determinants of self-harm. The findings call for strengthened mental health services and targeted interventions to effectively respond to and reduce the devastating impact of self-harm on individuals and the global community.
自我伤害已成为全球主要的公共卫生问题。本研究中自我伤害负担的数据取自《2021年全球疾病负担研究》。本研究旨在量化1990年至2021年期间全球不同性别、年龄组和地区的自我伤害负担的历史趋势,并通过贝叶斯预测模型预测未来变化(2022年至2050年)。
基于全球疾病负担研究的七个超级区域,分析了1990年至2021年期间不同地区、年龄和性别的自我伤害负担。采用分层统计方法预测2022年至2050年全球和区域自我伤害负担的变化趋势。
2021年,全球自我伤害导致的伤残调整生命年(DALYs)和死亡人数分别为3350万(95%不确定区间:3130万 - 3580万)和74.64万(95%不确定区间:69.18万 - 79.98万)。伤残调整生命年和死亡人数最多的地区是南亚,伤残调整生命年和死亡率的年龄标准化率最高的地区是中欧、东欧和中亚。在全球范围内,男性的自我伤害负担高于女性。伤残调整生命年率在青少年和青年(20 - 29岁)中最高,而死亡率呈现出主要随年龄增长的模式,中年和老年人群的负担最高,尽管在最年长的年龄组中略有下降。预测模型显示,2022年至2050年全球自我伤害负担将持续下降。
研究结果凸显政策制定者需要向高负担地区(如南亚和东欧)分配资源,实施针对性别和年龄的预防项目,并加强跨部门合作以解决自我伤害的潜在社会决定因素。研究结果呼吁加强心理健康服务和有针对性的干预措施,以有效应对并减少自我伤害对个人和全球社会的毁灭性影响。