Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.
Level 1 - systematic review of randomized trials
Systematic review and Bayesian meta-regression analysis of global epidemiological data (graded by design analogy for burden/prevalence)
PubMed 35026139 · doi:10.1016/S2215-0366(21)00395-3
What was done
As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, researchers systematically reviewed PsycINFO, Embase, PubMed, and the Global Health Data Exchange for data on 12 mental disorders across 23 age groups, both sexes, and 204 countries and territories from 1990 to 2019. Bayesian meta-regression was used to estimate prevalence, which was combined with disability weights to estimate years lived with disability (YLDs). Cause of Death Ensemble modelling and mortality databases were used to calculate years of life lost (YLLs), which were combined with YLDs to determine disability-adjusted life-years (DALYs).
What was found
Global DALYs from mental disorders increased from 80.8 million (95% UI 59.5–105.9) in 1990 to 125.3 million (95% UI 93.0–163.2) in 2019, rising from 3.1% (95% UI 2.4–3.9) to 4.9% (95% UI 3.9–6.1) of all global DALYs. Age-standardised DALY rates per 100,000 remained largely unchanged between 1990 (1581.2 [95% UI 1170.9–2061.4]) and 2019 (1566.2 [95% UI 1160.1–2042.8]). YLDs drove nearly all burden (125.3 million YLDs in 2019; 14.6% [95% UI 12.2–16.8] of all global YLDs). Only eating disorders were coded as underlying causes of death, accounting for 17,361.5 YLLs (95% UI 15,518.5–21,459.8). Age-standardised DALY rates per 100,000 were higher in females (1703.3 [95% UI 1261.5–2237.8]) than males (1426.5 [95% UI 1056.4–1869.5]), with highest rates in Australasia, Tropical Latin America, and high-income North America.
Why it matters
Mental disorders remain a top contributor to worldwide disability with no observed global reduction in age-standardized burden over three decades.
Limits
YLLs were restricted to anorexia nervosa and bulimia nervosa, failing to capture premature mortality linked indirectly to other mental disorders. The abstract does not report the total number of primary studies synthesized, and estimates for regions with limited direct epidemiological surveillance rely on model imputation.
Cited by
- context Depression is the leading cause of disability, loss of quality-adjusted life years, and societal cost.