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. 2025 Dec 23;38(6):e102278. doi: 10.1136/gpsych-2025-102278

Global burden of mental disorders among adolescents and young adults, 1990–2021: a systematic analysis of the Global Burden of Diseases Study 2021

Jiayi Tian 1,0, Na Yan 1,0, Xinyi Hu 1, Susu Tian 1, Yuhao Wang 1, Louisa Esi Mackay 1, Yunjiao Luo 1, Yingxue Wang 1, Yihan Wang 1, Yuxuan Liu 1, Blen Dereje Shiferaw 1, Huihang Lan 2, Wenjun Yan 1, Qingzhi Wang 1, Xiuyin Gao 1, Caiyi Zhang 3, Haibo Xu 4,5,6,*, Wei Wang 1,6,7,✉
PMCID: PMC12730781  PMID: 41451038

Abstract

Background

Mental disorders pose a significant global health burden, especially after the coronavirus disease 2019 pandemic.

Aims

This study aimed to characterise trends in the burden of mental disorders among adolescents and young adults by sex, age, sociodemographic index (SDI) quintile, region and country from 1990 to 2021.

Methods

Estimates and 95% uncertainty intervals (UIs) for disability-adjusted life years (DALYs) were extracted from the Global Burden of Diseases Study 2021. The number and rate of DALYs, as well as the percentage change from 1990 to 2021, were estimated by sex, age, SDI quintile, region and country.

Results

The number of DALYs for mental disorders increased from 26.1 (95% UI 19.3 to 34.4) million to 36.3 (26.6 to 48.1) million. The DALY rate increased from 1687.8 (1245.3 to 2225.4) per 100 000 population in 1990 to 1923.7 (1408.7 to 2548.4) per 100 000 population in 2021, representing a 14% (12% to 16%) increase. Females (16% (13% to 18%)) and individuals aged 15–19 years (16% (13% to 18%)) showed the greatest increase in DALY rates. Between 1990 and 2021, DALY rates rose significantly across all SDI quintiles and regions, except East Asia (−5% (−9% to −1%)). The most rapid increases were observed in parts of Latin America, particularly for anxiety and depressive disorders.

Conclusions

The global burden of mental disorders among adolescents increased significantly from 1990 to 2021, necessitating attention to policies targeting high-risk populations and specific regions.

Keywords: Mental Disorders, Adolescent Psychiatry, Anxiety, Autism Spectrum Disorder, Depressive Disorder

WHAT IS ALREADY KNOWN ON THIS TOPIC.

WHAT THIS STUDY ADDS

  • Using data from the Global Burden of Disease Study 2021, we extracted the number, rate and percentage change of disability-adjusted life years (DALYs) for 10 mental disorders by sex, three age groups (10–14 years, 15–19 years and 20–24 years), five sociodemographic index regions, 21 regions and 204 countries.

  • We analysed geographical disparities, differences by sex and age group and DALYs.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

  • This study tracked DALYs and disease burden of 10 mental disorders among adolescents and young adults globally, focusing on dynamic change and providing recommendations for prevention and treatment.

  • In the postpandemic era, more effective strategies are needed to prioritise the prevention, treatment and management of mental disorders, particularly among high-risk populations.

Introduction

Mental disorders, also known as psychiatric or psychological disorders, are a broad category of conditions that affect an individual’s thoughts, feelings, behaviour and daily functioning.1 2 These disorders can profoundly impact quality of life, impairing a person’s ability to work, maintain relationships and perform daily activities.3 4 Mental disorders may be chronic or temporary, and their severity and impact vary widely between individuals. Between 1990 and 2019, the number of reported disability-adjusted life years (DALYs) attributable to mental disorders increased from 80.8 million to 125.3 million, while their share of total DALYs increased from 3.1% to 4.9%.5 Globally, according to the World Health Organization (WHO), approximately 10%–20% of adolescents experience at least one type of mental disorder, and about half of all cases first emerge before the age of 14.6 Mental disorders in the younger population can cause serious harm to both individuals and society. Understanding their patterns and burden is essential for developing effective public policies, organising services and providing necessary support to address this public health challenge.7

During the transition from childhood through puberty to early adulthood, individuals undergo rapid psychological and physiological development, making them particularly susceptible to mental disorders.8 9 These conditions may contribute to unhealthy lifestyles, such as sleep deprivation and physical inactivity, which in turn negatively affect physical health. Furthermore, adolescents with mental disorders are at significantly higher risk of self-harm and suicide, underscoring the urgent need for attention and intervention.10,12 In the long term, untreated mental disorders in adolescence may persist into adulthood, increasing the risk of future mental health problems. These disorders can also impair adolescents’ educational and occupational achievements, ultimately affecting their future socioeconomic status and quality of life.13 Moreover, the coronavirus disease 2019 (COVID-19) pandemic has placed an enormous psychological burden on adolescents worldwide. School closures, social isolation and activity restrictions have severely disrupted the lives of young people, further worsening their mental health.14 15 During the pandemic, adolescents and young adults across different regions reported varying levels of anxiety, depression, post-traumatic stress disorder and other forms of emotional distress,16,18 suggesting that the burden of mental disorders in this population has likely increased in recent years.

The Global Burden of Disease (GBD) study is the largest and most comprehensive scientific effort to quantify health levels and trends. GBD 2021 provides the most up-to-date global data, offering detailed and comprehensive information for a nuanced understanding of the current status of mental disorders among adolescents and young adults. Over the past three decades, changes in the global landscape, including wars, economic fluctuations, under-reporting, rapid social development and advances in healthcare, have had a substantial impact on the mental health of this population. Although existing studies have examined the global burden of mental disorders and specific subtypes (eg, depressive and anxiety disorders) among adolescents and young adults, most analyses have covered the period from 1990 to 2019.519,22 To date, no study has systematically described the burden of mental disorders among individuals aged 10–24 years since the COVID-19 pandemic, leaving the postpandemic situation unclear. Therefore, the current study aimed to use the latest GBD 2021 data to analyse and estimate the burden of mental disorders in adolescents and young adults aged 10–24 years. We examined the trends in the number and rate of DALYs by sex, age, sociodemographic index (SDI) quintile, region and country from 1990 to 2021 to provide up-to-date evidence to support informed healthcare decision-making and strategy implementation.

Methods

Case categorisation and data source

GBD 2021, formulated by GBD collaborators, provides a comprehensive assessment of the burden of 371 diseases and injuries across 204 countries, territories and 811 subnational areas.23 The data in the GBD were derived from a variety of sources, including national and regional census data, medical records, national health survey data, hospital records, disease surveillance registries and other public health data. The GBD 2021 dataset enables the exploration of a wide range of variables, such as risks, causes, impairments and injuries, which were analysed according to their characteristics and included metrics such as deaths, DALYs, years lived with disability (YLDs) and years of life lost (YLLs) from 1990 to 2021. Data were further disaggregated by sex, age, region and country, providing rates, percentages and absolute values for detailed analyses.23

In this study, DALY estimates for mental disorders were obtained from the Global Health Data Exchange query tool.24 The GBD study categorised mental disorders into 10 major groups: schizophrenia, depressive disorders, bipolar disorders, anxiety disorders, eating disorders, autism spectrum disorders, attention-deficit/hyperactivity disorders (ADHD), conduct disorder, idiopathic intellectual disability and other mental disorders. Definitions of these disorders in GBD 2021 were based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)25 or the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic criteria,26 as detailed in online supplemental methods S1–S2.

Statistical analysis

Adolescents and young adults are in a critical period of rapid psychological and physiological development, making them particularly susceptible to mental disorders. Therefore, we selected adolescents and young adults aged 10–24 as the study population.27 We extracted the number, rate and percentage change of DALYs for mental disorders by sex, three age groups (10–14 years, 15–19 years and 20–24 years), five SDI regions, 21 regions and 204 countries (figure 1). DALYs represent the total number of healthy YLL due to disease or premature death, calculated as the sum of YLDs and YLLs. YLLs are the number of YLL due to premature mortality from a disease or injury, calculated from the number of deaths and standard life expectancy. YLDs are the number of YLD, reflecting the reduced quality of life while living with the condition. We report 95% uncertainty intervals (UI) for all estimates, defined as the 2.5th and 97.5th percentiles of 1000 ordered estimates generated using the GBD algorithm. The SDI is a composite measure incorporating per capita income, average years of schooling and fertility rates for females under 25 years of age. SDI values range from 0 to 1, with higher values indicating higher socioeconomic levels. Based on the 2021 SDI values, all countries were classified into five SDI quintiles.

Figure 1. Study flowchart. DALYs, disability-adjusted life years; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; GBD, Global Burden of Disease; ICD-10, International Classification of Diseases, Tenth Revision; SDI, sociodemographic index.

Figure 1

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First, DALYs for 10 mental disorders were analysed for adolescents and young adults aged 10–24 years from 1990 to 2021. The disease burden of these mental disorders was further examined by developmental age, sex, SDI quintile, region and country. We also analysed the correlation between SDI and DALY rates for mental disorders in each country across the seven global super-regions defined by GBD 2021.28 Based on SDI and the observed DALY rates across countries, expected DALY rates were estimated and assessed using Spearman rank order correlation tests.

The University of Washington Institutional Review Board committee approved the 2021 GBD study, and Xuzhou Medical University approved the current project. Informed consent was waived because only deidentified data were used. All analyses adhered to the Guidelines for Accurate and Transparent Health Estimate Reporting.

Results

Global trends

A significant increase in the number and rate of DALYs for mental disorders was observed among adolescents and young adults aged 10–24 years from 1990 to 2021. The number of DALYs for mental disorders increased from 26.1 (95% UI 19.2 to 34.4) million in 1990 to 36.3 (26.6 to 48.1) million in 2021. DALY rates increased from 1687.7 (1245.3 to 2225.4) per 100 000 population in 1990 to 1923.7 (1408.7 to 2548.4) per 100 000 population in 2021, representing a 14% (12% to 16%) increase (online supplemental table 1). Notably, between 2020 and 2021, the age-standardised DALY rates attributable to mental disorders among adolescents and young adults worldwide rose sharply by approximately 11.8% (figure 2).

Figure 2. Number of DALYs for ten mental disorders and trends in DALY rates in males and females aged 10–24 years, 1990–2021. DALYs, disability-adjusted life years.

Figure 2

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From 1990 to 2021, the number of DALYs increased across all subtypes of mental disorders. Significant rises were observed for depressive disorders (25% (20% to 29%)), anxiety disorders (21% (18% to 24%)) and eating disorders (17% (14% to 20%)). A particularly sharp increase in DALY rates of anxiety (18.9%) and depressive disorders (23.7%) occurred between 2019 and 2020, likely due to the COVID-19 pandemic. In contrast, ADHD (−12% (−15% to −10%)), idiopathic developmental intellectual disability (−5% (−10% to 3%)) and schizophrenia (−4% (−8% to −1%)) showed decreasing trends in DALY rates. No significant change was observed in autism spectrum disorders (3% (1% to 5%)) or other mental disorders (−0% (−2% to 9%)) (online supplemental table S2).

Anxiety disorders, depressive disorders and conduct disorders consistently accounted for the highest number and rate of DALYs from 1990 to 2021. In 2021, among the 175 grade 3 causes, anxiety disorders (610.4 (385.3 to 895.9) per 100 000 population) had the third highest DALY rates, followed by depressive disorders, which ranked fourth (567.8 (359.5 to 828.1) per 100 000 population), and conduct disorder, which ranked 18th (217.4 (115.7 to 348.6) per 100 000 population) (online supplemental figure S2).

Sex trends

As shown in online supplemental table 1, from 1990 to 2021, the number and rate of DALYs for mental disorders increased in both sexes, with a greater rise observed among females (16% (13% to 18%)) than males (12% (9% to 15%)). In 2021, the DALY rate for mental disorders was 1759.9 (1295.5 to 2313.3) per 100 000 population in males and 2095.9 (1520.6 to 2788.5) per 100 000 population in females. Compared with 1990, the gap in disease burden between sexes widened over time. Globally, in 2021, DALY rates for depressive disorders rose by 23.1% for males and 24.2% for females, while anxiety disorder rates increased by 18.6% and 19.1%, respectively, was widening, compared with 1990. Depressive disorders and eating disorders showed a greater increase in males than in females, while autism spectrum disorders and conduct disorders exhibited the opposite pattern. Idiopathic developmental intellectual disability showed a marked sex difference in the change of DALY rate, with a significant decrease in males (−9% (−15% to −3%)) but no significant change in females (0% (−6% to 9%)). Trends in other mental disorders did not differ significantly by sex. The greatest increase in DALY rates was observed for depressive disorders in both sexes (males: 30% (26% to 34%); females: 23% (17% to 28%)), while both sexes showed the greatest decrease for ADHD (−13% (−16% to −10%)). Additionally, notable changes were observed in sex disparities across different SDI regions: compared with low-SDI regions, sex disparities in disease burden were more pronounced in high-SDI regions, with females bearing a significantly higher burden than males (online supplemental table S2).

In 2021, anxiety disorders, depressive disorders and conduct disorders ranked as the top three mental disorders in both sexes, with DALY rates higher in females than in males. Additionally, idiopathic developmental intellectual disability, eating disorders and bipolar disorder also showed higher DALY rates in females, whereas other disorders showed the opposite trends. The three lowest-ranking mental disorders in males were ADHD, other mental disorders and eating disorders, respectively, while in females, they were ADHD, other mental disorders and schizophrenia. Between 2019 and 2020, DALY rates for depressive and anxiety disorders among male and female adolescents and young adults increased significantly, likely due to the COVID-19 pandemic (figure 3, online supplemental table S2).

Figure 3. Distribution of mental disorders categories by age groups in 2021. (A) Males. (B) Females. (C) Both sexes.

Figure 3

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Age trends

From 1990 to 2021, both the number and rate of DALYs for mental disorders increased across all age groups, with the greatest increase observed in the 15–19 age group (16% (13% to 18%)). In 2021, the 20–24 age group had the highest rate and number of DALYs for mental disorders (rate: 2310.5 (1664.9 to 3062.6) per 100 000 population; number: 13.8 (9.94 to 18.29) million) (online supplemental table 3). The burden of DALY rates for depressive disorders, eating disorders, bipolar disorder, schizophrenia and other mental disorders increased with age, whereas conduct disorder, autism spectrum disorders, idiopathic developmental intellectual disability and ADHD showed a decreasing trend with age (online supplemental table S3). Among all subtypes, anxiety disorders, depressive disorders and eating disorders showed the most significant increases. Specifically, the 20–24 age group had the greatest increase in anxiety disorders (23% (19% to 27%)) and eating disorders (20% (16% to 23%)), while the greatest increase in depressive disorders was observed in the 10–14 age group (41% (37% to 46%)).

In 2021, the leading subtypes of mental disorders by DALY rate in the 10–14 age group were, in order, anxiety disorders, conduct disorder and depressive disorders. Depressive disorders became the second most common mental disorder in the 15–19 age group, owing to the faster increase in DALY rates. With increasing age, depressive disorders surpassed anxiety disorders and had the highest rate of DALYs in mental disorders in the 20–24 age group, followed by anxiety disorders and schizophrenia (figure 3, online supplemental table S3). The subtypes of mental disorders with the lowest DALY rates in the 10–14 age group were, in order, other mental disorders, schizophrenia and bipolar disorder. In the 15–19 age group, subtypes of mental disorders with the lowest DALY rates were ADHD, other mental disorders and schizophrenia. With further increases in age, conduct disorder, ADHD and idiopathic developmental intellectual disability progressively declined to become the disorders with the lowest DALY rates.

SDI quintile trends

DALY rates for mental disorders increased significantly across all SDI regions in the past 32 years from 1990 to 2021 (online supplemental table 1, online supplemental figure S3). The greatest increase was observed in the high-SDI region (27% (23% to 31%)), while the smallest was in the low-SDI region (11% (8% to 14%)). In 2021, the high-SDI region had the highest DALY rate for mental disorders (2771.4 (2012.7 to 3640.6) per 100 000 population), whereas the low-SDI region had the lowest (1800.1 (1305.1 to 2377.4) per 100 000 population). Increases in DALY rates for anxiety disorders, eating disorders, depressive disorders and bipolar disorders were observed across all SDI regions, with most showing particularly rapid growth in anxiety disorders and depressive disorders between 2020 and 2021 (figure 4). The high-SDI region had the greatest increase in anxiety disorders (33% (27% to 39%)) and depressive disorders (57% (49% to 65%)), while the middle-SDI region had the greatest increases in bipolar disorders (11% (8% to 13%)) and eating disorders (42% (37% to 46%)). A slight decrease in idiopathic intellectual development disability was reported in almost all SDI regions, with the greatest decrease in the low–middle SDI region (−25% (−30% to −19%)). Other subtypes of mental disorders exhibited substantial regional variation. For example, ADHD increased in the high-SDI (10% (5% to 14%)) and high–middle SDI regions (4% (-1% to 11%)) but declined in the remaining regions (online supplemental figure S3–S13).

Figure 4. Trends in DALY rates for mental disorders from 1990 to 2021 among individuals aged 10–24 years, both sexes, by SDI quintile and region. DALYs, disability-adjusted life years; SDI, sociodemographic index.

Figure 4

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The burden of each mental disorder subtype varies markedly by SDI quintile. In 2021, anxiety disorders, depressive disorders and conduct disorders consistently ranked among the top three mental disorders in all SDI regions (figure 4). The high-SDI region had the highest DALY rates for depressive disorders (962.2 (627.8 to 1410.6) per 100 000 population) and anxiety disorders (853.7 (539.2 to 1241.1) per 100 000 population), which were also the two leading causes of mental disorder burden in this region (online supplemental figure 2). Eating disorders and bipolar disorders also showed higher DALY rates in the high-SDI region compared with other SDI regions. The low-SDI region had the highest DALY rate for conduct disorder (234.0 (125.7 to 378.9) per 100 000 population) and idiopathic developmental intellectual disability (106.3 (53.9 to 175.4) per 100 000 population). Across all SDI quintiles, the 20–24 age group consistently exhibited the highest burden of mental disorders (online supplemental figures S14–S25).

Regional trends

From 1990 to 2021, DALY rates for mental disorders increased significantly across all regions, except East Asia (−5% (−9% to −1%)) (online supplemental table 1), (online supplemental figure S3). The greatest increases were observed in high-income North America (36% (30% to 43%)), Andean Latin America (30% (20% to 42%)) and Tropical Latin America (28% (22% to 35%)). In contrast, Western Sub-Saharan Africa (5% (3% to 7%)), Central Sub-Saharan Africa (7% (0% to 17%)) and Oceania (8% (−2% to 17%)) showed the smallest increases. In 2021, Australasia (3403.3 (2490.2 to 4526.7) per 100 000 population), high-income North America (3233.9 (2347.5 to 4269.9) per 100 000 population) and Western Europe (3029.2 (2179.8 to 4057.4) per 100 000 population) had the highest DALY rates for mental disorders, while East Asia (1373.5 (999.8 to 1799.3) per 100 000 population), Central Asia (1596.2 (1155.3 to 2131.0) per 100 000 population) and Western Sub-Saharan Africa (1608.7 (1168.8 to 2107.0) per 100 000 population) had the lowest. Significant growth in anxiety disorders and depressive disorders was reported in almost all regions from 1990 to 2021, except for depressive disorders in East Asia (−37% (−42% to −32%)), with particularly sharp increases between 2020 and 2021 (online supplemental figures S3–S13). The fastest-growing regions were concentrated in Latin America. Eating disorders also showed a broad upward trend, with the top three regions for growth all located in Asia. For other mental disorder subtypes, changes in disease burden varied considerably across regions. For example, Australasia (103% (50% to 133%)) was the only region with a significant increase in idiopathic intellectual developmental disability, while high-income Asia Pacific (−70% (−97% to −55%)) had the greatest decrease. East Asia was notable for sharp rises in conduct disorder (19% (11% to 28%)) and ADHD (17% (8% to 27%)).

In 2021, anxiety disorders and depressive disorders were the leading contributors to the burden of mental disorders in all regions, with conduct disorder ranking third in most regions (figure 4). In general, DALY rates for depressive disorders and anxiety disorders were highest in economically developed regions, such as parts of Latin America, Western Europe and Australasia. Among these, Western Europe (1145.8 (716.9 to 1686.3) per 100 000 population) had the highest DALY rate of anxiety disorders, and high-income North America (1387.2 (936.8 to 2013.9) per 100 000 population) had the highest DALY rate for depressive disorders. The burden of conduct disorder was greatest in Eastern and Central Europe and Africa.

Regional disparities were also evident within the same disorder. For example, the DALY rate for idiopathic intellectual developmental disability in South Asia (166.0 (88.0 to 267.0) per 100 000 population) was 42.6 times higher than in the lowest region, high-income Asia Pacific (3.9 (0.1 to 12.5) per 100 000 population). The DALY rate for schizophrenia in Australasia (136.6 (94.7 to 175.8) per 100 000 population) was 2.8 times higher than in Central Sub-Saharan Africa (48.1 (26.0 to 80.0) per 100 000 population), and the DALY rate for bipolar disorders in Australasia (292.5 (179.5 to 456.0) per 100 000 population) was 8.9 times higher than in the lowest region, East Asia (32.8 (20.1 to 50.0) per 100 000 population) (online supplemental figures S15–S25).

National trends

Among 204 countries, 140 showed a significant increase in DALY rates for mental disorders in the last 32 years from 1990 to 2021 (online supplemental table S4). As shown in online supplemental table S4, the greatest increase was observed in Eswatini (42% (26% to 61%)), followed by the USA 38% (32% to 44%)) and Mexico (38% (31% to 45%)). A significant decrease was observed only in China (−5% (−9% to −1%)).

In 2021, the burden of mental disorders varied substantially between countries. Greenland recorded the highest DALY rates for mental disorders (3867.6 (2699.4 to 5393.3) per 100 000 population), followed by Portugal (3693.5 (2517.1 to 4982.7) per 100 000 population) and Lebanon (3449.0 (2369.3 to 4806.7) per 100 000 population). The lowest DALY rates were observed in China (1369.5 (995.8 to 1793.0) per 100 000 population), followed by Vietnam (1370.6 (974.2 to 1863.2) per 100 000 population) and Bhutan (1410.1 (1009.3 to 1897.3) per 100 000 population). Changes in DALY rates for 10 subtypes of mental disorders from 1990 to 2021, along with their 2021 estimates, are presented in online supplemental table S4.

Association with SDI

Figure 5 shows the observed versus expected DALY rates attributable to mental disorders based on SDI at the national level in 2021. In general, DALY rates for mental disorders were positively correlated with SDI (r=0.486, p<0.001), indicating that countries with higher SDI values tend to experience a greater burden of mental disorders. Notably, most countries in Asia, Central and Eastern Europe and Oceania regions showed lower-than-expected DALY rates for mental disorders, whereas most countries in North Africa and the Middle East showed higher-than-expected rates. Except for idiopathic developmental intellectual disability (r=−0.381, p<0.001) and conduct disorder (r=−0.046, p<0.001), DALY rates for other subtypes of mental disorders showed a significant positive correlation with SDI (online supplemental figures S26–S35).

Figure 5. Trend for DAYLs rate of mental disorders among 204 countries colored by GBD super-region by SDI for both sexes in 10-24 years population in 2021. The size of the data points indicates the number of DAYLs. The black line represents the expected DALYs rate based on SDI. DALY, disability-adjusted life year; GBD, Global Burden of Disease; SDI, sociodemographic Index.

Figure 5

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Discussion

Main findings

This is the first study to describe the global trends in DALYs for mental disorders among adolescents and young adults aged 10–24 years from 1990 to 2021, providing insights for the prevention and management of mental disorders in the post-COVID-19 era. Globally, both the number and rate of DALYs for mental disorders in this age group rose significantly, with depressive disorders and anxiety disorders contributing the most, especially after 2019. In 2021, anxiety disorders, depressive disorders and conduct disorders were the three leading subtypes contributing to the global burden of mental disorders. The burden was higher in females than in males, both in absolute DALY rates and in percentage change from 1990 to 2021. The greatest increase in DALY rates was observed in the 15–19 age group, while the 20–24 age group had the highest disease burden. All SDI quintiles and regions experienced significant growth in DALY rates for mental disorders, except East Asia. A total of 140 countries experienced a significant increase in DALY rates for mental disorders. In 2021, national DALY rates for mental disorders were positively correlated with SDI, although significant regional and cross-country differences were observed in both overall and subtype-specific burdens.

The global burden of mental disorders among adolescents and young adults has increased significantly in the last 32 years from 1990 to 2021, especially after 2019. The increase in the number of DALYs between 1990 and 2019 may reflect population growth, heightened awareness of mental disorders and advances in diagnostic methods. The COVID-19 pandemic, as a global health crisis, was a major contributor to the subsequent increase in the burden of mental disorders.29 Research suggests that COVID-19 not only directly precipitated mental disorders30 but also intensified psychological distress through indirect effects such as social isolation, excessive social media use and reduced social support.29 In 2020 and 2021, the burden of anxiety disorders and depressive disorders increased most significantly among individuals aged 10–24 years, accounting for most of the overall rise in the mental disorder burden. The WHO reported that the COVID-19 pandemic triggers a 25% increase in the global prevalence of anxiety and depression, consistent with our findings.31 The uncertainty surrounding the new coronavirus increased health concerns, causing widespread anxiety and depression. Furthermore, studies of mental health service utilisation during the pandemic confirmed that the pandemic was a major driver of the growing mental health burden.32,33 34 Alarmingly, the impact of the COVID-19 pandemic on mental health appears to be long-term.30 35 Continuous monitoring of mental health status and preventive interventions for young people are particularly important in the postpandemic era.

In 2021, the disparity in the disease burden of mental disorders between males and females widened, with females bearing a higher burden, particularly for anxiety, depressive and eating disorders. This finding is broadly consistent with previous research.36 Fluctuations in female physiological hormone levels37 and persistent gender inequality in many sociocultural contexts38 make females more vulnerable to depression and other mental health problems. In contrast, the burden of ADHD, conduct disorder and autism spectrum disorders was significantly higher in males than in females, likely reflecting gender bias in diagnostic practices. Studies have found that males are more likely than females to be diagnosed with autism spectrum disorder and ADHD, even when symptom severity is comparable.39 40 We also found that eating disorders and depressive disorders increased more rapidly in males than in females,41 a trend potentially linked to increasing body-image pressures faced by males in recent years, driven by the influence of social media, the rise of fitness culture and marketing that emphasises male body aesthetics.42

In 2021, conduct disorder accounted for the third highest burden of mental disorders, following anxiety and depressive disorders, and showed a slow upward trend over the last 32 years from 1990 to 2021. Childhood and adolescence constitute the peak period for the onset of conduct disorder,43 yet it remains one of the least recognised and studied mental illnesses.44 Half of children and adolescents with conduct disorders continue to experience chronic symptoms and antisocial behaviour into adulthood, underscoring the importance of early screening and intervention during childhood. Additionally, the burden of eating disorders increased significantly between 1990 and 2019, and they became the third most prevalent mental disorder after anxiety disorders and depressive disorders, particularly among females. This rise may be attributed to various factors, including decreased body satisfaction45 and the impacts of anxiety.46 47 However, many studies have overlooked the full spectrum of eating disorders, suggesting that their true prevalence may be higher than currently reported.48 Although previous studies reported a continued increase in eating disorders during the COVID-19 pandemic,48 our study did not reveal a clear pattern. Given the close relationship between eating disorders and anxiety disorders,49 continued attention to the management of eating disorders remains essential.

Another important finding is that the overall burden of mental disorders and that of most subtypes increased with higher SDI levels. One possible explanation is the greater exposure to risk factors such as alcohol and drug use50 51 in high-income regions, which increases vulnerability to mental disorders. Moreover, intense competition and individualistic values in developed societies may exacerbate psychological stress.52 Low data coverage in less developed regions should also be considered, as it could lead to underestimation of disease burden in those regions. Conversely, the burden of idiopathic developmental intellectual disability decreased with increasing SDI, a pattern strongly associated with lead exposure in low-development and low–medium-development countries, despite global improvements in exposure control.53 Besides, consanguineous marriage, prenatal injury and environmental contaminants are recognised risk factors for idiopathic developmental intellectual disability, highlighting the importance of prenatal and childhood screening and stricter regulation of heavy metals from drinking water and lead-acid batteries.54

Our analysis also revealed that the burden of mental disorders varies considerably across regions and countries. Latin American and Australian regions showed greater increases in anxiety disorders and depressive disorders,55 which are closely linked to socioeconomic inequalities and the impact of the COVID-19 pandemic.56 57 Notably, East Asia was the only region to show a decline in mental disorders, particularly depressive disorders, which decreased by 11% over the past three decades. This trend may be attributed to economic development, expansion of healthcare coverage and positive cultural and social evolution in East Asian countries.58 In addition, policy initiatives in countries such as China and South Korea have increasingly integrated child and adolescent mental health into national public health agendas, linking it with education and social welfare systems.59 Recent governmental efforts to ease academic pressure have also introduced measures aimed at reducing stress, which may have helped mitigate the negative psychological impact of educational stress. However, conduct disorder and ADHD have increased substantially in East Asia, potentially influenced by cultural factors.60 In the past, parents in many Asian societies tended to attribute children’s hyperactivity or disruptive behaviour to personality traits rather than as possible signs of ADHD and conduct disorder. As public awareness of mental disorders has increased and diagnostic methods have advanced, stigma surrounding mental disorders has gradually diminished, leading to higher detection and reporting rates. Another contributing factor may be the substantial academic workload and pressure associated with prolonged compulsory education.61

In summary, this study reported global trends in DALYs for 10 mental disorders in adolescents and young adults aged 10–24 years from 1990 to 2021, providing an updated overview of the postpandemic global burden of mental disorders. We found a substantial and continuing rise in the burden of mental disorders in adolescents and young adults. Global mental health resources have increased dramatically postpandemic, and governments should establish data-driven support systems guided by disease burden monitoring, integrating epidemiological surveys and multisource health data to dynamically track trends and regional disparities in adolescent mental disorders. Such systems would generate quantitative evidence to inform public health policy, optimise resource allocation policies for high-risk populations and regions and support the development of a sustainable adolescent mental health governance system.

Limitations

Several limitations of this study should be acknowledged. First, although the GBD integrates extensive data from multiple countries and regions, issues remain with data accuracy and coverage as well as incomplete reporting of many diseases and causes of death, especially in low-income and lower middle-income countries. These limitations may lead to potential inaccuracies in GBD estimates. Future research should aim to improve data collection methods and incorporate regional datasets to address these limitations in data quality. Second, this analysis focused on 10 third-level categories of mental disorders. Fourth-level mental disorders, such as dysthymia and major depressive disorder under depressive disorders, were not included and should be examined in more detail in future research. Third, the GBD 2021 estimates of the burden of mental disorders during the COVID-19 pandemic may not fully capture the direct psychological impact of the pandemic itself. Instead, factors such as changes in government public health policies or socioeconomic development may have significantly influenced the observed disease burden. Fourth, changes in diagnostic definitions over time between DSM-IV-TR and ICD-10 may have affected trend estimates, particularly for conditions such as autism spectrum disorders and ADHD. Future studies should account for these changes to improve methodological consistency. Finally, psychiatric comorbidities may have contributed to the underestimation or overestimation of the burden of specific disorders, leading to less rigorous conclusions. Also, relying solely on bibliometric methods may yield relatively narrow estimates of disease burden. Additional analytical approaches, such as trend analysis using nodal regression, may provide more comprehensive insights in future research.

Implications

In conclusion, an alarming escalation in the disease burden of mental disorders among adolescents and young adults aged 10–24 years was observed from 1990 to 2021, with anxiety and depressive disorders being the main contributors, particularly following the onset of the COVID-19 pandemic in 2019. Because of limited data availability in certain regions and countries, as well as the persistent stigma surrounding mental disorders, the true burden of mental disorders in this age group is likely underestimated. These findings indicate the urgent need for effective global strategies to prevent, treat and manage mental disorders in the postpandemic era to mitigate this growing public-health challenge.

Supplementary material

online supplemental file 1
gpsych-38-6-s001.docx (8MB, docx)
DOI: 10.1136/gpsych-2025-102278

Acknowledgements

We thank all GBD collaborators for preparing these publicly available data.

Biography

Jiayi Tian obtained his bachelor's degree from Xuzhou Medical University in China. He is currently pursuing a master's degree in Epidemiology and Health Statistics under the guidance of Professor Wei Wang at the School of Public Health, Xuzhou Medical University in China. His main research interests include public health and psychological health behaviour studies among children and adolescents.

graphic file with name gpsych-38-6-g001.gif

Footnotes

Funding: This work was supported by the Jiangsu Province Colleges ‘Qinglan’ Project, Scientific research project of Jiangsu Provincial Health Commission (MQ2024002) and Postgraduate Research & Practice Innovation Program of Jiangsu Province (KYCX25_3212).

Provenance and peer review: Not commissioned; externally peer-reviewed.

Patient consent for publication: Not applicable.

Ethics approval: The research was conducted according to the guidelines of the Declaration of Helsinki. Secondary survey data do not require ethical approval and informed consent.

Data availability statement

The data presented in this study are available on the IHME website (https://vizhub.healthdata.org/gbd-results/).

References

  • 1.Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015;72:334–41. doi: 10.1001/jamapsychiatry.2014.2502. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Clark LA, Cuthbert B, Lewis-Fernández R, et al. Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC) Psychol Sci Public Interest. 2017;18:72–145. doi: 10.1177/1529100617727266. [DOI] [PubMed] [Google Scholar]
  • 3.GBD 2017 Child and Adolescent Health Collaborators. Reiner RC, Jr, Olsen HE, et al. Diseases, injuries, and risk factors in child and adolescent health, 1990 to 2017: findings from the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study. JAMA Pediatr. 2019;173:e190337. doi: 10.1001/jamapediatrics.2019.0337. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Mokdad AH, Forouzanfar MH, Daoud F, et al. Global burden of diseases, injuries, and risk factors for young people’s health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387:2383–401. doi: 10.1016/S0140-6736(16)00648-6. [DOI] [PubMed] [Google Scholar]
  • 5.GBD 2019 Mental Disorders Collaborators 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. Lancet Psychiatry. 2022;9:137–50. doi: 10.1016/S2215-0366(21)00395-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Ullrich R, Becker M, Scharf J. The development of gender role attitudes during adolescence: effects of sex, socioeconomic background, and cognitive abilities. J Youth Adolesc. 2022;51:2114–29. doi: 10.1007/s10964-022-01651-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Liu X, Yang F, Huang N, et al. Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study. Gen Psychiatr . 2024;37:e101288. doi: 10.1136/gpsych-2023-101288. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Solmi M, Radua J, Olivola M, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27:281–95. doi: 10.1038/s41380-021-01161-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Paus T, Keshavan M, Giedd JN. Why do many psychiatric disorders emerge during adolescence? Nat Rev Neurosci. 2008;9:947–57. doi: 10.1038/nrn2513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Hawton K, Saunders KEA, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379:2373–82. doi: 10.1016/S0140-6736(12)60322-5. [DOI] [PubMed] [Google Scholar]
  • 11.Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry. 2013;70:300–10. doi: 10.1001/2013.jamapsychiatry.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Thapar A, Collishaw S, Pine DS, et al. Depression in adolescence. Lancet. 2012;379:1056–67. doi: 10.1016/S0140-6736(11)60871-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Baranne ML, Falissard B. Global burden of mental disorders among children aged 5-14 years. Child Adolesc Psychiatry Ment Health. 2018;12:19. doi: 10.1186/s13034-018-0225-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Montero-Marin J, Hinze V, Mansfield K, et al. Young people’s mental health changes, risk, and resilience during the COVID-19 pandemic. JAMA Netw Open. 2023;6:e2335016. doi: 10.1001/jamanetworkopen.2023.35016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.El Omrani O, Carmen VA, Bionat JF, et al. COVID-19, mental health, and young people’s engagement. J Adolesc Health. 2023;72:S18–9. doi: 10.1016/j.jadohealth.2021.03.020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Freizinger M, Jhe GB, Dahlberg SE, et al. Binge-eating behaviors in adolescents and young adults during the COVID-19 pandemic. J Eat Disord. 2022;10:125. doi: 10.1186/s40337-022-00650-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Gill PK, Du C, Khan F, et al. The psychological effects of COVID-19 spread in young Canadian adults. Int J Soc Psychiatry. 2022;68:216–22. doi: 10.1177/0020764020988878. [DOI] [PubMed] [Google Scholar]
  • 18.Marahwa P, Makota P, Chikomo DT, et al. The psychological impact of COVID-19 on university students in China and Africa. PLoS One. 2022;17:e0270824. doi: 10.1371/journal.pone.0270824. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Ferrari AJ, Charlson FJ, Norman RE, 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:e1001547. doi: 10.1371/journal.pmed.1001547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Santomauro DF, Mantilla Herrera AM, Shadid J, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet. 2021;398:1700–12. doi: 10.1016/S0140-6736(21)02143-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Kieling C, Buchweitz C, Caye A, et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the Global Burden of Disease Study. JAMA Psychiatry. 2024;81:347–56. doi: 10.1001/jamapsychiatry.2023.5051. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Yang C-H, Lv J-J, Kong X-M, 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. doi: 10.1192/bjp.2024.69. [DOI] [PubMed] [Google Scholar]
  • 23.Yang W, Wu H, Cai X, et al. Weight reduction and the risk of gallbladder and biliary disease: a systematic review and meta-analysis of randomized clinical trials. Obes Rev. 2024;25:e13725. doi: 10.1111/obr.13725. [DOI] [PubMed] [Google Scholar]
  • 24.Institute for Health Metrics and Evaluation VizHub-GBD results. 2024. [11-Oct-2024]. https://vizhub.healthdata.org/gbd-results/ Available. Accessed.
  • 25.American Psychiatric Association . Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) American Psychiatric Association; 2009. p. 42. [Google Scholar]
  • 26.World Health Organization . Clinical Descriptions & Diagnostic Guidelines Geneva; 1993. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. [Google Scholar]
  • 27.Sawyer SM, Azzopardi PS, Wickremarathne D, et al. The age of adolescence. Lancet Child Adolesc Health. 2018;2:223–8. doi: 10.1016/S2352-4642(18)30022-1. [DOI] [PubMed] [Google Scholar]
  • 28.Chen Q, Huang S, Xu H, et al. The burden of mental disorders in Asian countries, 1990-2019: an analysis for the global burden of disease study 2019. Transl Psychiatry. 2024;14:167. doi: 10.1038/s41398-024-02864-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Chawla N, Tom A, Sen MS, et al. Psychological impact of COVID-19 on children and adolescents: a systematic review. Indian J Psychol Med. 2021;43:294–9. doi: 10.1177/02537176211021789. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020;7:611–27. doi: 10.1016/S2215-0366(20)30203-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.World Health Organization COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. 2022. [2-Mar-2022]. https://www.who.int/zh/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide Available. Accessed.
  • 32.Jensen P, Engdahl B, Gustavson K, et al. Incidence rates of treated mental disorders before and during the COVID-19 pandemic-a nationwide study comparing trends in the period 2015 to 2021. BMC Psychiatry. 2023;23:668. doi: 10.1186/s12888-023-05157-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Breaux R, Naragon-Gainey K, Katz BA, et al. Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic. J Anxiety Disord. 2024;106:102910. doi: 10.1016/j.janxdis.2024.102910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.López-Morales H, Trudo RG, García MJ, et al. Depression and anxiety in the context of the COVID-19 pandemic: a 6-waves longitudinal study in the Argentine population. Soc Psychiatry Psychiatr Epidemiol. 2025;60:631–44. doi: 10.1007/s00127-024-02746-7. [DOI] [PubMed] [Google Scholar]
  • 35.Zeng N, Zhao Y-M, Yan W, et al. A systematic review and meta-analysis of long term physical and mental sequelae of COVID-19 pandemic: call for research priority and action. Mol Psychiatry. 2023;28:423–33. doi: 10.1038/s41380-022-01614-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Piao J, Huang Y, Han C, et al. Alarming changes in the global burden of mental disorders in children and adolescents from 1990 to 2019: a systematic analysis for the Global Burden of Disease study. Eur Child Adolesc Psychiatry . 2022;31:1827–45. doi: 10.1007/s00787-022-02040-4. [DOI] [PubMed] [Google Scholar]
  • 37.Park HY.Sex/gender differences in depression and anxiety disordersKim N.Sex/gender-specific medicine in clinical areas .Singapore: Springer Nature Singapore; 2024369–79. [Google Scholar]
  • 38.Rajkumar RP. Cultural collectivism, intimate partner violence, and women’s mental health: an analysis of data from 151 countries. Front Sociol. 2023;8:1125771. doi: 10.3389/fsoc.2023.1125771. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.Dworzynski K, Ronald A, Bolton P, et al. How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? J Am Acad Child Adolesc Psychiatry. 2012;51:788–97. doi: 10.1016/j.jaac.2012.05.018. [DOI] [PubMed] [Google Scholar]
  • 40.Beheshti A, Chavanon ML, Schneider S, et al. ADHD overdiagnosis and the role of patient gender among Iranian psychiatrists. BMC Psychiatry. 2021;21:514. doi: 10.1186/s12888-021-03525-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.Coelho JS, Suen J, Marshall S, et al. Gender differences in symptom presentation and treatment outcome in children and youths with eating disorders. J Eat Disord. 2021;9:113. doi: 10.1186/s40337-021-00468-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Gültzow T, Guidry JPD, Schneider F, et al. Male body image portrayals on instagram. Cyberpsychol Behav Soc Netw. 2020;23:281–9. doi: 10.1089/cyber.2019.0368. [DOI] [PubMed] [Google Scholar]
  • 43.Wu J, Chen L, Li X, et al. Trends in the prevalence of conduct disorder from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Psychiatry Res. 2022;317:114907. doi: 10.1016/j.psychres.2022.114907. [DOI] [PubMed] [Google Scholar]
  • 44.Fairchild G, Hawes DJ, Frick PJ, et al. Conduct disorder. Nat Rev Dis Primers. 2019;5:43. doi: 10.1038/s41572-019-0095-y. [DOI] [PubMed] [Google Scholar]
  • 45.Melisse B, Blankers M, de Beurs E, et al. Correlates of eating disorder pathology in Saudi Arabia: BMI and body dissatisfaction. J Eat Disord. 2022;10:126. doi: 10.1186/s40337-022-00652-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Sahlan RN, Keshishian AC, Christian C, et al. Eating disorder and social anxiety symptoms in Iranian preadolescents: a network analysis. Eat Weight Disord. 2022;27:1855–67. doi: 10.1007/s40519-021-01329-8. [DOI] [PubMed] [Google Scholar]
  • 47.Schaumberg K, Reilly EE, Gorrell S, et al. Conceptualizing eating disorder psychopathology using an anxiety disorders framework: evidence and implications for exposure-based clinical research. Clin Psychol Rev. 2021;83:101952. doi: 10.1016/j.cpr.2020.101952. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Silén Y, Keski-Rahkonen A. Worldwide prevalence of DSM-5 eating disorders among young people. Curr Opin Psychiatry. 2022;35:362–71. doi: 10.1097/YCO.0000000000000818. [DOI] [PubMed] [Google Scholar]
  • 49.Guerdjikova AI, Mori N, Casuto LS, et al. Update on binge eating disorder. Med Clin North Am. 2019;103:669–80. doi: 10.1016/j.mcna.2019.02.003. [DOI] [PubMed] [Google Scholar]
  • 50.Degenhardt L, Stockings E, Patton G, et al. The increasing global health priority of substance use in young people. Lancet Psychiatry. 2016;3:251–64. doi: 10.1016/S2215-0366(15)00508-8. [DOI] [PubMed] [Google Scholar]
  • 51.Shen J, Hua G, Li C, et al. Prevalence, incidence, deaths, and disability-adjusted life-years of drug use disorders for 204 countries and territories during the past 30 years. Asian J Psychiatr. 2023;86:103677. doi: 10.1016/j.ajp.2023.103677. [DOI] [PubMed] [Google Scholar]
  • 52.Barbalat G, Franck N. Ecological study of the association between mental illness with human development, income inequalities and unemployment across OECD countries. BMJ Open. 2020;10:e035055. doi: 10.1136/bmjopen-2019-035055. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 53.Zhou N, Huang Y, Li M, et al. Trends in global burden of diseases attributable to lead exposure in 204 countries and territories from 1990 to 2019. Front Public Health. 2022;10:1036398. doi: 10.3389/fpubh.2022.1036398. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 54.Ruíz-Patiño A, Rojas L, Zuluaga J, et al. Genomic ancestry and cancer among Latin Americans. Clin Transl Oncol. 2024;26:1856–71. doi: 10.1007/s12094-024-03415-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 55.Cheng Y, Fang Y, Zheng J, et al. The burden of depression, anxiety and schizophrenia among the older population in ageing and aged countries: an analysis of the Global Burden of Disease Study 2019. Gen Psychiatr . 2024;37:e101078. doi: 10.1136/gpsych-2023-101078. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Salas Quijada C, López-Contreras N, López-Jiménez T, et al. Social inequalities in mental health and self-perceived health in the first wave of COVID-19 lockdown in Latin America and Spain: results of an online observational study. Int J Environ Res Public Health. 2023;20:5722. doi: 10.3390/ijerph20095722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 57.Zhang SX, Batra K, Xu W, et al. Mental disorder symptoms during the COVID-19 pandemic in Latin America - a systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2022;31:e23. doi: 10.1017/S2045796021000767. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 58.Zhang J, Sun L, Liu Y, et al. The change in suicide rates between 2002 and 2011 in China. Suicide Life Threat Behav. 2014;44:560–8. doi: 10.1111/sltb.12090. [DOI] [PubMed] [Google Scholar]
  • 59.Hung Y-A, Choi M, Liao Y-A, et al. Child and adolescent mental health burden, policies, and services in high-income countries and areas in the Western Pacific Region. Lancet Reg Health West Pac . 2025;62:101678. doi: 10.1016/j.lanwpc.2025.101678. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 60.Xiang Y-T, Chiu HFK, Ungvari GS. Quality of life and mental health in Chinese culture. Curr Opin Psychiatry. 2010;23:43–7. doi: 10.1097/YCO.0b013e328333d60f. [DOI] [PubMed] [Google Scholar]
  • 61.Yu Y, Wang T, Liang J, et al. Behavioural problems amongst pre-school children in Chongqing, China: current situation and influencing factors. Risk Manag Healthc Policy. 2020;13:1149–60. doi: 10.2147/RMHP.S263155. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

online supplemental file 1
gpsych-38-6-s001.docx (8MB, docx)
DOI: 10.1136/gpsych-2025-102278

Data Availability Statement

The data presented in this study are available on the IHME website (https://vizhub.healthdata.org/gbd-results/).

Articles from General Psychiatry are provided here courtesy of Shanghai Mental Health Center

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