Abstract
Over the past three decades, China's rapid economic development, social transformation, and the COVID-19 pandemic, have reshaped the landscape of mental disorders and self-harm burden. The raw data were sourced from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Our study presented the burden by disability-adjusted life-years (DALY) of mental disorders and self-harm at both national and provincial levels in China from 1990 to 2021, by age and sex. We also analysed the association between economic situation and disease burden by Pearson's correlation. While the overall age-standardised DALY rates of mental disorders exhibited minimal change (-0.3%) over this period, that of self-harm declined dramatically (-69.8%). From 1990 to 2019, both depressive and anxiety disorders saw significant reductions, particularly among working-age adults. However, depression disorders increased significantly among the elderly. The pandemic reversed the gains in anxiety disorders burden, especially in young adults, but only transiently increased depressive disorders burden. With increasing economic development, eating disorders burden rose substantially (+70.4%). These findings underscore the necessity for tailored interventions targeting high-risk groups, including addressing depression among the elderly, anxiety in young adults following the pandemic, and eating disorders in economically prosperous regions.