Epidemiological trends of depression and anxiety at global, regional, and national level: A population-based observational study from 1990 to 2021 based on Global Burden of Disease 2021

全球、区域和国家层面抑郁症和焦虑症的流行病学趋势:一项基于1990年至2021年全球疾病负担数据的基于人群的观察性研究

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Abstract

Mental disorders are significant contributors to the global disease burden, of which depression and anxiety are the most common mental disorders diseases. We aimed to achieve a more accurate representation of the health burden of depression and anxiety using the standardized Global Burden of Disease methodologies. To measure temporal patterns and evaluate trends in age-standardized rates of anxiety and depression, age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized disability-adjusted life years rate (ASDR) are calculated from 1990 to 2021. Temporal trends from 1990 to 2021 were strictly examined by using Joinpoint regression analysis to identify significant changes in trends over time. This methodological approach enabled the calculation of the annual percentage change, the average annual percentage change, and their respective 95% confidence intervals (CIs). The analyses were broken down by gender, 20 age groups, 21 Global Burden of Disease regions, 204 countries/territories, and 5 sociodemographic index (SDI) quintiles. Globally, from 1990 to 2021, ASPR, ASIR, and ASDR for anxiety in 2021 have increased by 0.63 (95% CI: 0.55-0.74), 0.69 (95% CI: 0.61-0.81), and 0.64 (95% CI: 0.55-0.74), respectively. For depression, corresponding increases were 0.36 (95% CI: 0.3-0.45), 0.49 (95% CI: 0.4-0.63), and 0.43 (95% CI: 0.35-0.54), respectively. Gender comparisons and geographical and demographic distribution showed notable differences in the 2 diseases burden. The specific manifestation is that females consistently showed higher burden than males for both disorders. High-SDI regions had the highest age-standardized rates for anxiety, whereas for depression, the highest rates were observed in low-SDI regions. From 1990 to 2021, ASPR, ASIR, and ASDR for anxiety and depression exhibited significant annual increases, particularly pronounced during the COVID-19 pandemic. Epidemiological trends during the period emphasize significant disparities in the burden of anxiety and depressive disorders across geographic, demographic, and socioeconomic dimensions. These findings underscore the urgent need for targeted mental health interventions, particularly in high-burden regions like Tropical Latin America and among females and younger populations, to address the rising burden of anxiety and depression.

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