Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Burden of mental disorders and risk factors in the Western Pacific region from 1990 to 2021
Ya-Xin Xu, Xiao-Xuan Niu, Wen-Chang Jia, Jing Wen, Xue-Lin Cheng, Yan Han, Ming-Hui Peng, Jing Zhou, Yao Liu, Sun-Fang Jiang, Xiao-Pan Li
Ya-Xin Xu, Wen-Chang Jia, Jing Wen, Xue-Lin Cheng, Yan Han, Ming-Hui Peng, Jing Zhou, Sun-Fang Jiang, Xiao-Pan Li, Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai 200030, China
Ya-Xin Xu, Jing Wen, Xue-Lin Cheng, Yao Liu, Sun-Fang Jiang, Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai 200030, China
Xiao-Xuan Niu, Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Wen-Chang Jia, School of Public Health, Fudan University, Shanghai 200032, China
Co-first authors: Ya-Xin Xu and Xiao-Xuan Niu.
Co-corresponding authors: Xiao-Pan Li and Sun-Fang Jiang.
Author contributions: Xu YX and Niu XX contributed equally to this work as co-first authors. They were jointly responsible for the overall study design, including formulating the research question, developing the methodology, and coordinating the project execution. They also led the primary data analysis and interpretation, ensuring the robustness and accuracy of the results. Additionally, they played a key role in drafting substantial portions of the manuscript and integrating feedback from all authors. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. Jia WC made significant contributions to the data analysis and visualization, including creating detailed plots and figures that were crucial for illustrating the study's findings. Wen J, Chen XL, and Han Y were involved in the meticulous collection and organization of data, as well as drafting the initial sections of the manuscript. Peng MH, Zhou J and Liu Y provided crucial assistance with advanced data analysis techniques and contributed significantly to the discussion and interpretation of the findings. Li XP and Jiang SF are co-corresponding authors of this paper. They were responsible for supervising the research process, providing strategic guidance, and ensuring the scientific rigor of the study. They also made significant contributions to revising the manuscript, addressing critical feedback, and enhancing the overall clarity and impact of the paper. Their collaboration was essential in shaping the final version of the manuscript. All authors have read and approved the final manuscript.
Supported by National Key Research and Development Program of China, No. 2022YFC3600903; and Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System (2023-2025), No. GWVI-11.1-44.
Institutional review board statement: This study utilized secondary data from the Global Burden of Disease (GBD) database, involving no direct contact with participants. Therefore, approval from an Institutional Review Board was not required.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data utilized in this study are publicly accessible through the Global Health Data Exchange at the Global Burden of Disease 2021 portal. The specific datasets and results can be accessed
via the following link:
https://ghdx.healthdata.org/gbd-2021.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao-Pan Li, PhD, Associate Chief Doctor, Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 179 Fenglin Road, Xuhui District, Shanghai 200030, China.
zsjkglzx@163.com
Received: September 25, 2024
Revised: November 4, 2024
Accepted: December 3, 2024
Published online: January 19, 2025
Processing time: 84 Days and 2 Hours
BACKGROUND
The burden of mental disorders (MD) in the Western Pacific Region (WPR) remains a critical public health concern, with substantial variations across demographics and countries.
AIM
To analyze the burden of MD in the WPR from 1990 to 2021, along with associated risk factors, to reveal changing trends and emerging challenges.
METHODS
We used data from the Global Burden of Disease 2021, analyzing prevalence, incidence, and disability-adjusted life years (DALYs) of MD from 1990 to 2021. Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.
RESULTS
Between 1990 and 2021, the prevalence of MD rose from 174.40 million cases [95% uncertainty interval (UI): 160.17-189.84] to 234.90 million cases (95%UI: 219.04-252.50), with corresponding DALYs increasing from 22.8 million (95%UI: 17.22-28.79) to 32.07 million (95%UI: 24.50-40.68). During this period, the burden of MD shifted towards older age groups. Depressive and anxiety disorders were predominant, with females showing higher DALYs for depressive and anxiety disorders, and males more affected by conduct disorders, attention-deficit hyperactivity disorder, and autism spectrum disorders. Australia, New Zealand, and Malaysia reported the highest burdens, whereas Vietnam, China, and Brunei Darussalam reported the lowest. Additionally, childhood sexual abuse and bullying, and intimate partner violence emerged as significant risk factors.
CONCLUSION
This study highlights the significant burden of MD in the WPR, with variations by age, gender, and nation. The coronavirus disease 2019 pandemic has exacerbated the situation, emphasizing the need for a coordinated response.
Core Tip: This study is the first to use the Global Burden of Disease database to analyze mental disorder (MD) burden in the Western Pacific Region from 1990 to 2021, examining differences by country, age, and gender. Results reveal a disproportionate MD burden in Australia, New Zealand, and Malaysia, while other countries fall below global average burdens for similar Sociodemographic Index levels. Notably, MD burden surged during the coronavirus disease 2019 pandemic (2019-2021), emphasizing the urgent need for mental health support. Additionally, findings highlight childhood abuse and bullying as prevalent risk factors, offering insights for targeted prevention and resource allocation.
