Global, regional, and national burdens of anxiety and depression in adolescents and young adults aged 10-24 years from 1990 to 2021: a trend analysis based on the Global Burden of Disease Study 2021 (Preprint)
Authors: Lv Jiaxuan , Guo Guolin , Zhao Huangxin , Liu Zijian , Rong Hongguo , Lu Fan 
Published: February 2025

BACKGROUND

Depressive and anxiety disorders pose a significant public health concern, yet data on its burden and trends among adolescents and young adults are scarce. This study aimed to comprehensively analyze the trends of prevalence, incidence and disability adjusted life year (DALYs) for anxiety and depression among adolescents and young adults between 1990 and 2021 at the global, regional, and national levels.

OBJECTIVE

Our findings aim to elucidate evolving trends and disparities in the burden of these mental health conditions, thereby informing evidence-based policy-making and targeted intervention strategies.

METHODS

Data and methodologies publicly accessible from the 2021 Global Burden of Diseases (GBD) study were utilized to conduct a systematic analysis aimed at assessing the worldwide burden of anxiety and depression.

RESULTS

In 2021, there were 57.49 million prevalent cases, 73.81 million incidence, and 10.72 million DALYs of depression among individuals aged 10-24 years. And there were 93.95 million prevalent cases, 16.67 million incidence, and 11.52 million DALYs of anxiety. Between 1990 and 2021, we observed increases in the prevalence of depression globally (AAPC, 0. 74 [95% CI, 0. 63, 0. 84]), incidence (AAPC, 0. 87 [95% CI, 0. 78, 0. 97]), the DALY rate (AAPC, 0.82 [95% CI, 0.72, 0.92]), and the prevalence of anxiety (AAPC, 0. 69 [95% CI, 0. 52, 0. 86]), incidence (AAPC, 0. 81 [95% CI, 0. 69, 0. 92]) and the DALY rate (AAPC, 0.69 [95% CI, 0.52, 0.86]). Notably, females had higher prevalence, incidence and DALYs rate than males. Globally, the age-standardized DALY rate for mental disorders was 1426·5 (95% UI 1056·4-1869·5) per 100000 population among males and 1703·3 (1261·5-2237·8) per 100 000 population among females. Age-standardized DALY rates of depression were highest in high-income North America, Western Europe, and Australasia, that of anxiety were Western Europe, Tropical Latin America and Andean Latin America. At the national revel, for depression, Greenland, the United States of America, and Palestine had the highest levels of incidence and China, Taiwan (Province of China), Democratic People's Republic of Korea the lowest, while Zambia, Zimbabwe and Canada showed the highest increase in the age-standardized prevalence during 1990-2021.for anxiety, Portugal, Lebanon and Iran had the highest levels of incidence and Uzbekistan, Kyrgyzstan and Kazakhstan the lowest. Overall, a negative association between the DALY rate and SDI was observed over the past thirty-two years.

CONCLUSIONS

On a global scale, the burden of anxiety and depression among adolescents did not change significantly from 1990 to 2019, but it significantly increased from 2020 to 2021 due to the impact of the COVID-19 pandemic. Therefore, it is necessary to raise awareness of the risk factors, consequences, and evidence-based treatment strategies for anxiety and depression among the population, strengthen effective intervention measures and cooperation among countries to improve adolescents' mental health care, and should focus on the adolescent population in high and low Socio-demographic Index (SDI) countries.