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Global, regional and national burden of depressive disorders and attributable risk factors, from 1990 to 2021: results from the 2021 Global Burden of Disease study

Published online by Cambridge University Press:  15 January 2025

Jian Rong ,
Xueqin Wang ,
Pan Cheng ,
Dan Li  and
Dahai Zhao Open the ORCID record for Dahai Zhao [Opens in a new window]
Jian Rong
Affiliation:
Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
Xueqin Wang
Affiliation:
Department of Materials and Equipment, The First Affiliated Hospital of Anhui Medical University, Anhui, China
Pan Cheng
Affiliation:
Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
Dan Li
Affiliation:
Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
Dahai Zhao*
Affiliation:
Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; and Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
*
Correspondence: Dahai Zhao. Email: 596058582@qq.com
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Abstract

Background

Depressive disorders pose a significant global public health challenge, yet evidence on their burden remains insufficient.

Aims

To report the global, regional and national burden of depressive disorders and their attributable risk factors from 1990 to 2021.

Methods

Data from the Global Burden of Disease 2021 were analyzed for 204 countries and territories from 1990 to 2021. We explored the age-standardised incidence, prevalence and disability-adjusted life years (DALYs) of depressive disorders by age, gender and sociodemographic index.

Results

In 2021, there were 357.44 million incident cases, 332.41 million prevalent cases and 56.33 million DALYs. Age-standardised rates for incidence, prevalence and DALYs were 4333.62, 4006.82 and 681.14 per 100 000 persons, with annual declines of 0.06%, 0.03% and 0.04%. Uganda, Greenland and Lesotho had the highest prevalence, while Spain, Mexico and Uruguay showed the largest increases. Greenland and Brunei Darussalam had the highest and lowest age-standardised DALYs rates, respectively. DALYs peaked in the 55–59 age group for men and 60–64 for women, with higher rates in women. Regionally, a U-shaped association was found between the sociodemographic index and DALYs rates. Population growth was the main driver for the increase in DALYs cases. Childhood maltreatment was the leading risk factor, with intimate partner violence affecting more females and childhood sexual abuse more males.

Conclusions

Despite decreasing trends in incidence, prevalence and DALYs rates, absolute case numbers and age-standardised rates continue to increase for depressive disorders. Tackling childhood abuse and improving depressive disorder management are crucial to reducing future burdens.

Keywords

Depressive disordersepidemiologyburden of diseasesystematic reviewrisk factor
Type
Original Article
Information
The British Journal of Psychiatry , First View , pp. 1 - 10
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Copyright
Copyright © The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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Footnotes

*

Joint first authors.

References

World Health Organization (WHO). Depressive Disorder (Depression). WHO, 2023 (https://www.who.int/news-room/fact-sheets/detail/depression).Google Scholar
Institute of Health Metrics and Evaluation (IHME). Global Health Data Exchange (GHDx). IHME, 2024 (https://vizhub.healthdata.org/gbd-results/).Google Scholar
Ferrari, AJ, Charlson, FJ, Norman, RE, Patten, SB, Freedman, G, Murray, CJ, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med 2013; 10(11): e1001547.CrossRefGoogle ScholarPubMed
Bonadiman, CSC, Malta, DC, de Azeredo Passos, VM, Naghavi, M, Melo, APS. Depressive disorders in Brazil: results from the global burden of disease study 2017. Popul Health Metr 2020; 18(Suppl 1): 6.CrossRefGoogle ScholarPubMed
Gao, P, Cao, G, Liu, J, Yang, F, Liu, M. Global, regional, and national trends in incidence of depression among women, 1990–2019: an analysis of the global burden of disease study. Psychiatry Res 2024; 331: 115668.CrossRefGoogle ScholarPubMed
Institute for Health Metrics and Evaluation (IHME). GBD Cause and Risk Summaries: Depressive Disorders-Level 3 Cause. IHME, 2024 (https://www.healthdata.org/research-analysis/diseases-injuries-risks/factsheets/2021-depressive-disorders-level-3-disease).Google Scholar
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet 2020; 396(10258): 1204–22.CrossRefGoogle Scholar
GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the global burden of disease study 2021. Lancet 2024; 403(10440): 2133–61.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition, Text Revision(DSM-IV-TR). American Psychiatric Association, 2000.Google Scholar
World Health Organization (WHO). ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. World Health Organization, 1992.Google Scholar
Hong, C, Liu, Z, Gao, L, Jin, Y, Shi, J, Liang, R, et al. Global trends and regional differences in the burden of anxiety disorders and major depressive disorder attributed to bullying victimisation in 204 countries and territories, 1999–2019: an analysis of the global burden of disease study. Epidemiol Psychiatr Sci 2022; 31: e85.CrossRefGoogle ScholarPubMed
Fu, L, Tian, T, Wang, B, Lu, Z, Bian, J, Zhang, W, et al. Global, regional, and national burden of HIV and other sexually transmitted infections in older adults aged 60–89 years from 1990 to 2019: results from the global burden of disease study 2019. Lancet Healthy Longev 2024; 5(1): e17–e30.CrossRefGoogle ScholarPubMed
Yang, F, Lodder, P, Huang, N, Liu, X, Fu, M, Guo, J. Thirty-year trends of depressive disorders in 204 countries and territories from 1990 to 2019: an age-period-cohort analysis. Psychiatry Res 2023; 328: 115433.CrossRefGoogle ScholarPubMed
Das Gupta, P. A general method of decomposing a difference between two rates into several components. Demography 1978; 15(1): 99–112.CrossRefGoogle ScholarPubMed
Ribeiro, WS, Bauer, A, Andrade, MCR, York-Smith, M, Pan, PM, Pingani, L, et al. Income inequality and mental illness-related morbidity and resilience: a systematic review and meta-analysis. Lancet Psychiatry 2017; 4: 554–62.CrossRefGoogle ScholarPubMed
Ventriglio, A, Sancassiani, F, Contu, MP, Bhugra, D. Urbanization and emerging mental health issues. CNS Spectrums 2021; 26: 43–50.CrossRefGoogle ScholarPubMed
Obradovich, N, Migliorini, R, Paulus, MP, Rahwan, I. Empirical evidence of mental health risks posed by climate change. Proc Natl Acad Sci U S A 2018; 115: 10953–8.CrossRefGoogle ScholarPubMed
Liu, Q, He, H, Yang, J, Feng, X, Zhao, F, Lyu, J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res 2020; 126: 134–40.CrossRefGoogle ScholarPubMed
Smith, MV, Mazure, CM. Mental health and wealth: depression, gender, poverty, and parenting. Annu Rev Clin Psychol 2021; 17: 181–205.CrossRefGoogle ScholarPubMed
Rathod, S, Pinninti, N, Irfan, M, Gorczynski, P, Rathod, P, Gega, L, et al. Mental health service provision in Low- and middle-income countries. Health Serv Insights 2017; 10: 1178632917694350.CrossRefGoogle ScholarPubMed
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018; 392(10159): 1789–858.CrossRefGoogle Scholar
Finnsson PT. Greenland: Large Decline in Greenland's Working age Population Projected, But Increase in Bioeconomy Jobs. Nordregio, 2020 (https://nordregio.org/nordregio-magazine/issues/state-of-the-nordic-region-2020/greenland-large-decline-in-greenlands-working-age-population-projected-but-increase-in-bioeconomy-jobs/).Google Scholar
Christiansen, J, Qualter, P, Friis, K, Pedersen, SS, Lund, R, Andersen, CM, et al. Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Public Health 2021; 141(4): 226–36.CrossRefGoogle ScholarPubMed
Poppel, B, Kruse, J. Living conditions and quality of life in the Arctic. In The Economy of the North 2015 (eds Glomsrød, S, Duhaime, G, Aslaksen, I): 135–53. Statistics Norway, 2015.Google Scholar
Chen, P, Feng, Y, Li, XH, Li, JX, Wang, YY, Zheng, WY, et al. Systematic reviews and meta-analyses on major depressive disorder: a bibliometric perspective. Front Psychiatry 2023; 14: 1136125.CrossRefGoogle ScholarPubMed
Li, S, Zhang, X, Cai, Y, Zheng, L, Pang, H, Lou, L. Sex difference in incidence of major depressive disorder: an analysis from the global burden of disease study 2019. Ann Gen Psychiatry 2023; 22(1): 53.CrossRefGoogle ScholarPubMed
Qian, J, Li, N, Ren, X. Obesity and depressive symptoms among Chinese people aged 45 and over. Sci Rep 2017; 7: 45637.CrossRefGoogle ScholarPubMed
Kuehner, C. Why is depression more common among women than among men? Lancet Psychiatry 2017; 4: 146–58.CrossRefGoogle ScholarPubMed
Xu, Y, Li, R, Hu, C, He, Y, Zhang, X, Jin, L. Global, regional, and national incidence trends of depressive disorder, 1990–2019: an age-period-cohort analysis based on the global burden of disease 2019 study. Gen Hosp Psychiatry 2024; 88: 51–60.CrossRefGoogle ScholarPubMed
Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet 2013; 382(9904): 1575–86.CrossRefGoogle ScholarPubMed
Cacioppo, JT, Cacioppo, S. Social relationships and health: the toxic effects of perceived social isolation. Soc Personal Psychol Compass 2014; 8(2): 58–72.CrossRefGoogle ScholarPubMed
Khan, S. Urbanization and mental health: exploring the relationship in developing cities. Soc Sci Rev Arch 2023; 1: 1–15.Google Scholar
Sultan-Taïeb, H, Villeneuve, T, Chastang, JF, Niedhammer, I. Burden of cardiovascular diseases and depression attributable to psychosocial work exposures in 28 European countries. Eur J Public Health 2023; 33: 149.Google Scholar
Kim, AJH, Servino, L, Bircher, S, Feist, C, Rdesinski, RE, Dukhovny, S, et al. Depression and socioeconomic stressors in expectant parents with fetal congenital anomalies. J Matern Fetal Neonatal Med 2022; 35(25): 8645–51.CrossRefGoogle ScholarPubMed
United Nations. World Population Prospects 2019: Highlights. United Nations, 2019 (https://population.un.org/wpp/Publications/Files/WPP2019_Highlights.pdf).Google Scholar
World Health Organization (WHO). Depression and Other Common Mental Disorders: Global Health Estimates. WHO, 2017 (https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf).Google Scholar
Yang, CH, Lv, JJ, Kong, XM, Chu, F, Li, ZB, Lu, W, et al. Global, regional and national burdens of depression in adolescents and young adults aged 10–24 years, from 1990 to 2019: findings from the 2019 global burden of disease study. Br J Psychiatry 2024; 225: 311–20.CrossRefGoogle Scholar
Lippard, ETC, Nemeroff, CB. The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders. Am J Psychiatry 2023; 180(8): 548–64.CrossRefGoogle ScholarPubMed
Chandan, JS, Thomas, T, Bradbury-Jones, C, Russell, R, Bandyopadhyay, S, Nirantharakumar, K, et al. Female survivors of intimate partner violence and risk of depression, anxiety and serious mental illness. Br J Psychiatry 2020; 217(4): 562–7.CrossRefGoogle ScholarPubMed
Schramm, E, Klein, DN, Elsaesser, M, Furukawa, TA, Domschke, K. Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications. Lancet Psychiatry 2020; 7: 801–12.CrossRefGoogle ScholarPubMed
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