Lancet Public Health. 2025 Jun;10(6):e480-e491. doi: 10.1016/S2468-2667(25)00098-2.
The Association of Southeast Asian Nations (ASEAN), a geopolitical and economic network of ten member states, recognises mental disorders as a health priority; however, sparse epidemiological data hinder the development of effective strategies to reduce their prevalence and burden. We aimed to examine the prevalence, morbidity, and disease burden associated with ten mental disorders from 1990 to 2021 in the ASEAN.
As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2021), we analysed estimates for depressive disorders, anxiety disorders, bipolar disorders, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder (ADHD), eating disorders, idiopathic developmental intellectual disability, and other mental disorders in ten ASEAN member states (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam). Case definitions were based on Diagnostic and Statistical Manual of Mental Disorders or ICD criteria. Prevalence estimates by age, sex, year, and location were derived using DisMod-MR 2.1, a Bayesian meta-regression modelling tool. Disease burden was quantified by estimating years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs).
In 2021, 80·4 million (95% UI 73·8-87·2) cases of mental disorders were reported across ASEAN countries, representing a 70·0% (63·5-77·2) increase since 1990. The age-standardised prevalence of mental disorders was 11·9% (10·9-12·9) in 2021, ranging from 10·1% (9·1-11·3) in Viet Nam to 13·2% (11·6-15·3) in Malaysia, with anxiety and depressive disorders being the most common. The age-standardised prevalence of mental disorders increased by 6·5% (3·7-9·8) between 1990 and 2021. Mental disorders accounted for 11·2 million (8·5-14·3) DALYs in 2021, representing an 87·4% (81·1-94·0) increase since 1990. The 10-14 years age group had the highest disease burden attributable to mental disorders, which accounted for 16·3% (12·7-20·5) of total DALYs in this age group. The largest relative increases in the number of cases of mental disorders between 1990 and 2021 were seen in older adults (182·8% [174·9-192·1] among those aged ≥70 years), despite small relative changes in prevalence in these age groups.
The increase in mental disorder prevalence and burden found in this study might partly reflect recent improvements in detection. However, mental disorders now rank among the top ten causes of disease burden in all ASEAN countries except Myanmar, underscoring the urgent need for a comprehensive intersectoral approach to address prevention and treatment gaps across entire populations.
Gates Foundation.
东南亚国家联盟（东盟）是一个由十个成员国组成的地缘政治和经济网络，将精神障碍视为卫生工作重点；然而，流行病学数据匮乏阻碍了制定有效策略以降低其患病率和负担。我们旨在研究1990年至2021年期间东盟地区十种精神障碍的患病率、发病率和疾病负担。
作为全球疾病、伤害及风险因素负担研究（GBD 2021）的一部分，我们分析了东盟十个成员国（文莱、柬埔寨、印度尼西亚、老挝、马来西亚、缅甸、菲律宾、新加坡、泰国和越南）中抑郁症、焦虑症、双相情感障碍、精神分裂症、自闭症谱系障碍、品行障碍、注意力缺陷多动障碍（ADHD）、进食障碍、特发性发育性智力残疾和其他精神障碍的估计数据。病例定义基于《精神障碍诊断与统计手册》或国际疾病分类标准。使用贝叶斯元回归建模工具DisMod-MR 2.1得出按年龄、性别、年份和地点划分的患病率估计值。通过估计残疾失能生命年（YLDs）、寿命损失年（YLLs）和残疾调整生命年（DALYs）来量化疾病负担。估计值以95%的不确定性区间（UIs）呈现。
2021年，东盟国家报告了8040万例（95% UI 7380 - 8720万）精神障碍病例，自1990年以来增加了70.0%（63.5 - 77.2）。2021年精神障碍的年龄标准化患病率为11.9%（10.9 - 12.9），从越南的10.1%（9.1 - 11.3）到马来西亚的13.2%（11.6 - 15.3）不等，焦虑症和抑郁症最为常见。1990年至2021年期间，精神障碍的年龄标准化患病率增加了6.5%（3.7 - 9.8）。2021年，精神障碍导致1120万（850 - 1430万）DALYs，自1990年以来增加了87.4%（81.1 - 94.0）。10 - 14岁年龄组因精神障碍导致的疾病负担最高，占该年龄组总DALYs的16.3%（12.7 - 20.5）。1990年至2021年期间，精神障碍病例数相对增加最大的是老年人（≥70岁人群中为182.8% [174.9 - 192.1]），尽管这些年龄组的患病率相对变化较小。
本研究中发现的精神障碍患病率和负担增加可能部分反映了近期检测方面的改善。然而，除缅甸外，精神障碍现在在所有东盟国家的疾病负担原因中位列前十，这凸显了迫切需要采取全面的跨部门方法来解决整个人口中的预防和治疗差距。
盖茨基金会。
