Global burden of mental disorders in 204 countries and territories results from the Global Burden of Disease Study 2021

Table 1 Incidence of mental disorders, and percentage change of age-standardized rates by global burden of disease region

World region	Number of incidence cases in 1990	ASIR per 100000 in 1990	Number of incidence cases in 2019	ASIR per 100000 in 2019	Number of incidence cases in 2021	ASIR per 100000 in 2021	1990-20211	2019-20211
Global	241360893.59	4737.974 (4278.42, 5368.46)	374348204.98	4703.23 (4247.84, 5334.32)	444397716.12	5459.77 (4873.72, 6241.42)	15.23 (12.97, 17.60)	16.08 (14.22, 18.00)
Low SDI	23709008.99	6143.20 (5397.31, 7113.59)	50605025.34	5861.74 (5164.94, 6762.84)	60311400.61	6514.44 (5697.32, 7557.96)	6.04 (1.97, 9.92)	11.13 (6.80, 15.31)
Low-middle SDI	55310181.11	5665.99 (5054.42, 6486.09)	95238869.07	5330.20 (4759.97, 6080.08)	116086947.49	6216.11 (5495.21, 7144.06)	9.709 (5.377, 14.245)	16.62 (12.05, 20.87)
Middle SDI	68734613.80	4227.592 (3825.97, 4770.91)	107423073.71	4260.84 (3870.13, 4789.73)	126831832.25	4920.13 (4442.47, 5540.26)	16.38 (14.01, 18.91)	15.47 (12.91, 18.23)
High-middle SDI	48995901.86	4539.15 (4134.81, 5057.42)	61968786.98	4326.48 (3937.12, 4843.04)	70163004.56	4917.24 (4414.74, 5538.76)	8.32 (4.11, 12.48)	13.65 (10.03, 17.57)
High SDI	44390979.50	4835.38 (4415.93, 5367.04)	58825036.24	5270.11 (4760.83, 5950.82)	70659767.83	6423.82 (5760.36, 7244.81)	32.85 (28.39, 37.98)	21.89 (18.63, 25.34)
Andean Latin America	1464494.28	4243.82 (3782.93, 4830.68)	2604676.88	4070.36 (3639.89, 4687.07)	3583280.08	5347.37 (4595.75, 6241.11)	26.00 (13.96, 40.20)	31.37 (18.58, 45.39)
Australasia	1418294.61	6766.65 (6089.73, 7556.67)	2019342.19	6827.27 (6066.05, 7815.30)	2231887.29	7325.01 (6147.35, 8863.53)	8.25 (-7.22, 26.30)	7.29 (-7.81, 24.20)
Caribbean	1948481.12	5803.64 (5154.29, 6668.33)	2584766.49	5297.02 (4665.54, 6132.14)	3122929.251	6307.79 (5409.94, 7386.54)	8.68 (0.29, 18.08)	19.08 (10.54, 29.18)
Central Asia	2741842.19	4448.91 (3934.43, 5055.71)	3873032.28	4278.75 (3794.93, 4893.24)	4684860.78	4994.54 (4299.53, 5811.01)	12.26 (3.84, 22.01)	16.72 (7.27, 26.71)
Central Europe	5045588.24	3802.67 (3437.13, 4277.96)	4728493.55	3478.35 (3142.74, 3913.23)	5712469.56	4364.02 (3862.89, 4955.29)	14.762 (8.98, 20.94)	25.46 (19.97, 32.21)
Central Latin America	6437675.11	4458.02 (4017.97, 5047.77)	12460247.31	4854.37 (4375.38, 5478.64)	15343630.39	5849.19 (5223.78, 6692.60)	31.21 (25.97, 36.95)	20.49 (15.88, 25.13)
Central sub-Saharan Africa	3527045.57	8271.15 (7096.42, 9844.93)	8374613.58	8023.19 (6936.78, 9482.64)	9791078.54	8706.11 (7166.05, 10620.38)	5.25 (-6.92, 20.21)	8.51 (-4.18, 22.48)
East Asia	42832652.44	3537.32 (3214.57, 3939.56)	55224835.55	3342.22 (3058.38, 3686.25)	56340544.97	3340.99 (3025.52, 3712.33)	-5.55 (-9.83, -0.99)	-0.04 (-3.38, 3.83)
Eastern Europe	12459215.15	5103.58 (4537.33, 5713.92)	11408783.79	4720.44 (4200.09, 5309.38)	14023793.62	6014.06 (5286.17, 6838.01)	17.84 (12.25, 24.82)	27.40 (21.45, 34.99)
Eastern sub-Saharan Africa	9655720.56	7014.94 (6190.74, 8082.61)	20759152.74	6673.86 (5917.56, 7655.79)	25372933.20	7528.26 (6567.61, 8690.75)	7.31 (1.96, 13.44)	12.80 (6.73, 18.94)
High-income Asia Pacific	5924026.78	3276.75 (2999.91, 3622.88)	6465420.28	3377.09 (3095.76, 3745.76)	7350004.69	3950.35 (3551.76, 4462.44)	20.55 (14.32, 27.21)	16.97 (11.27, 23.02)
High-income North America	15096975.24	5205.05 (4701.26, 5826.75)	23451454.02	6417.86 (5818.29, 7228.01)	29528972.62	8145.60 (7295.06, 9182.34)	56.49 (50.04, 63.07)	26.92 (22.34, 32.28)
North Africa and Middle East	19331359.71	6334.31 (5557.62, 7364.13)	38717767.93	6400.93 (5545.95, 7463.87)	46242809.91	7336.22 (6303.06, 8574.72)	15.81 (10.24, 21.48)	14.61 (9.56, 20.12)
Oceania	228321.57	3774.89 (3318.00, 4378.00)	464450.15	3692.82 (3252.82, 4283.07)	527863.68	3981.68 (3330.94, 4801.24)	5.47 (-7.42, 20.21)	7.82 (-5.91, 23.24)
South Asia	52393026.91	5730.80 (5137.66, 6540.88)	91516789.32	5207.73 (4654.64, 5906.19)	112893184.39	6134.14 (5462.68, 7015.18)	7.03 (3.11, 11.72)	17.78 (13.41, 22.41)
Southeast Asia	14009335.03	3167.44 (2844.43, 3579.11)	21721271.57	3104.21 (2785.32, 3485.37)	26764622.17	3720.30 (3311.08, 4216.65)	17.45 (13.45, 22.26)	19.84 (15.48, 24.81)
Southern Latin America	2463407.05	4980.19 (4497.42, 5639.55)	3207725.50	4662.74 (4229.63, 5239.88)	4018236.66	5775.16 (4900.07, 6788.32)	15.96 (2.41, 29.82)	23.85 (10.52, 37.83)
Southern sub-Saharan Africa	2524562.52	5700.30 (5128.44, 6492.29)	4273340.97	5686.72 (5105.84, 6454.32)	5531244.66	7052.85 (6182.21, 8128.01)	23.72 (16.52, 32.01)	24.02 (16.69, 32.11)
Tropical Latin America	8655965.15	6083.62 (5503.83, 6856.24)	13484022.70	5692.05 (5193.08, 6297.35)	17191336.65	7097.75 (6342.27, 8053.77)	16.670 (10.49, 23.24)	24.69 (17.64, 32.02)
Western Europe	24941474.43	6120.52 (5603.73, 6762.26)	27848759.86	5984.89 (5352.55, 6812.56)	32649490.49	7218.40 (6356.58, 8319.83)	17.938 (11.02, 25.75)	20.61 (14.83, 26.97)
Western sub-Saharan Africa	8261429.89	5614.08 (4983.27, 6430.13)	19159258.26	5405.37 (4793.92, 6170.41)	21492542.48	5657.36 (4960.75, 6496.80)	0.771 (-3.21, 4.65)	4.66 (0.46, 8.60)

¹Percentage change of age-standardized incidence rate.

ASIR: Age-standardized incidence rate; SDI: Socio-demographic index.

Table 2 Disability-adjusted life-years of mental disorders in 2021, and percentage change of age-standardized rates by Global Burden of Disease region

World region	Number of DALYs in 1990	ASDR per 100000 in 1990	Number of DALYS in 2019	ASDR per 100000 in 2019	Number of DALYS in 2021	ASDR per 100000 in 2021	1990-20211	2019-20211
Global	89567098.53	1745.15 (1314.32, 2214.47)	138453210.63	1738.12 (1308.29, 2210.63)	155418118.96	1909.14 (1440.15, 2437.87)	73.52 (70.24, 76.71)	12.25 (10.88, 13.56)
Low SDI	7645111.92	1861.88 (1395.11, 2401.28)	16805738.54	1836.88 (1373.03, 2359.95)	19117471.85	1964.32 (1463.82, 2530.28)	150.06 (144.44, 155.66)	13.75 (11.25, 16.24)
Low-middle SDI	18719851.28	1838.15 (1375.03, 2356.10)	32748795.18	1791.40 (1342.03, 2288.04)	37352846.13	1968.25 (1480.56, 2533.15)	99.53 (93.01, 105.74)	14.05 (11.57, 16.58)
Middle SDI	26700052.22	1627.38 (1225.92, 2063.50)	41930137.62	1650.13 (1242.47, 2095.44)	47067856.90	1816.49 (1369.70, 2310.33)	76.28 (71.26, 80.68)	12.25 (10.52, 13.87)
High-middle SDI	18211388.79	1671.33 (1260.67, 2122.96)	23521925.81	1648.84 (1243.62, 2094.28)	25764094.81	1806.88 (1364.02, 2290.90)	41.47 (37.83, 45.76)	9.53 (7.29, 11.81)
High SDI	18207904.56	1956.55 (1480.64, 2473.36)	23336865.32	2027.55 (1534.76, 2566.03)	18207904.56	2276.02 (1710.69, 2886.64)	42.75 (39.46, 46.12)	11.38 (9.41, 13.46)
Andean Latin America	630276.18	1828.65 (1375.57, 2339.06)	1181926.22	1825.23 (1364.44, 2329.47)	1470467.74	2175.32 (1597.74, 2830.02)	133.31 (116.82, 152.38)	24.41 (16.09, 34.41)
Australasia	554993.60	2609.71 (1950.75, 3349.12)	821429.23	2681.89 (2016.93, 3442.45)	880845.84	2787.87 (2088.14, 3552.40)	58.71 (46.94, 72.04)	7.23 (-0.87, 16.22)
Caribbean	656305.57	1934.62 (1436.83, 2484.77)	910312.46	1866.16 (1394.07, 2396.41)	1029437.01	2082.12 (1548.02, 2715.62)	56.85 (49.28, 64.92)	13.08 (8.06, 18.66)
Central Asia	944337.44	1484.65 (1119.71, 1902.71)	1364943.75	1466.30 (1104.34, 1871.73)	1535701.79	1603.18 (1206.41, 2060.86)	62.62 (55.31, 70.73)	12.51 (7.54, 17.23)
Central Europe	2017814.13	1528.92 (1169.19, 1927.43)	1960653.20	1498.25 (1142.11, 1886.92)	2182318.13	1712.83 (1297.62, 2176.20)	8.15 (4.91, 11.74)	11.31 (8.06, 14.58)
Central Latin America	2480053.55	1673.34 (1263.96, 2140.13)	4586287.69	1774.05 (1330.82, 2273.49)	5247771.46	1993.08 (1480.80, 2558.59)	111.59 (103.28, 120.61)	14.42 (11.24, 17.98)
Central sub-Saharan Africa	942596.08	2118.47 (1564.97, 2752.91)	2308899.09	2110.82 (1586.14,2 739.58)	2616800.70	2233.63 (1647.69, 2950.03)	177.61 (159.16, 199.37)	13.33 (6.08, 21.79)
East Asia	17695221.64	1450.67 (1095.61, 1834.85)	22909872.70	1398.13 (1058.68, 1770.21)	24029128.42	1447.28 (1103.83, 1825.01)	35.79 (30.35, 41.71)	4.88 (2.76, 7.29)
Eastern Europe	4019810.84	1668.96 (1248.15, 2119.26)	3814347.83	1635.43 (1221.57, 2074.01)	4340593.41	1910.06 (1423.91, 2436.16)	7.98 (4.89, 11.88)	13.79 (10.43, 17.73)
Eastern sub-Saharan Africa	2962956.97	1990.29 (1482.98, 2575.21)	6612095.91	1960.51 (1459.54, 2525.98)	7679754.06	2126.41 (1586.72, 2744.99)	159.19 (151.63, 167.12)	16.14 (12.82, 19.41)
High-income Asia Pacific	2863618.83	1554.80 (1179.04, 1932.41)	3068965.68	1577.35 (1195.17, 1960.64)	3286395.26	1721.55 (1305.43, 2154.41)	14.76 (11.66, 18.46)	7.08 (4.55, 10.39)
High-income North America	6387812.05	2152.02 (1621.42, 2726.69)	8831876.25	2319.04 (1737.27, 2926.87)	10106540.71	2662.06 (1977.68, 3399.24)	58.21 (53.49,63.42)	14.43 (11.90, 17.34)
North Africa and Middle East	6564776.37	2131.18 (1595.27, 2757.58)	13138710.18	2151.24 (1610.31, 2784.08)	14960229.40	2359.65 (1745.61, 3049.99)	127.88 (119.60, 136.42)	13.86 (10.55, 17.32)
Oceania	89588.18	1522.16 (1149.14, 1956.12)	188766.03	1517.06 (1141.30, 1932.53)	208647.58	1591.91 (1175.71, 2085.55)	132.89 (114.45, 151.51)	10.53 (1.91, 19.29)
South Asia	17712064.43	1834.57 (1375.65, 2335.07)	31453176.96	1749.41 (1311.92, 2219.26)	35948513.77	1925.51 (1447.69, 2471.47)	102.96 (95.43, 110.67)	14.29 (11.64, 16.95)
Southeast Asia	6243886.07	1438.95 (1090.28, 1812.42)	10204058.52	1434.00 (1091.84, 1816.59)	6243886.07	1588.29 (1206.94, 2022.22)	85.73 (79.51, 92.35)	13.65 (11.06, 16.66)
Southern Latin America	993417.81	2018.97 (1526.97, 2568.90)	1372828.90	1968.57 (1490.93, 2510.91)	1591300.65	2249.71 (1653.51, 2928.35)	60.18 (48.05, 73.33)	15.91 (7.09, 26.69)
Southern sub-Saharan Africa	833002.08	1805.43 (1353.31, 2309.14)	1394612.85	1800.76 (1349.52, 2297.27)	1659943.92	2073.72 (1548.89, 2686.33)	99.27 (91.67, 107.60)	19.02 (14.68, 23.54)
Tropical Latin America	3088703.74	2145.85 (1602.80, 2762.53)	5399427.95	2256.85 (1665.95, 2895.97)	6336302.74	2601.75 (1916.60, 3349.09)	105.14 (95.88, 114.65)	17.35 (13.32, 21.59)
Western Europe	9197288.60	2243.61 (1676.13, 2871.42)	10401818.91	2240.86 (1676.53, 2874.71)	11520859.82	2522.52 (1872.21, 3250.66)	25.26 (20.91, 29.65)	10.75 (7.31, 14.25)
Western sub-Saharan Africa	2688574.39	1709.71 (1277.72, 2177.53)	6528200.33	1703.06 (1275.72, 2175.80)	7189409.23	1755.29 (1304.72, 2236.64)	167.41 (162.07, 172.36)	10.13 (7.97, 12.22)

¹Percentage change of age-standardized disability-adjusted life-year rate.

DALY: Disability-adjusted life-year; ASDR: Age-standardized disability-adjusted life-year rate; SDI: Socio-demographic index.

Table 3 The global age-standardized disability-adjusted life-years for 12 mental disorders in 2021, and percentage change from 1990 to 2021

World region	Number of DALYs in 2021	ASDR per 100000 in 2021	1990-20211	2019-20211
Anxiety disorders
Total	42509645.28	524.33 (363.05, 716.25)	18.16 (15.57, 20.95)	19.11 (16.59, 21.48)
Male	16113657.45	396.91 (272.28, 547.66)	18.17 (15.38, 20.95)	17.82 (15.18, 20.39)
Female	26395987.83	652.16 (453.44, 887.15)	18.42 (15.76, 21.32)	19.98 (17.45, 22.47)
Major depressive disorder
Total	46018844.07	557.87 (381.19, 760.70)	16.07 (13.19, 18.96)	18.08 (15.86, 20.45)
Male	17895582.75	436.59 (297.51, 595.74)	19.16 (16.46, 22.27)	17.82 (15.39, 20.42)
Female	28123261.33	678.54 (464.94, 923.36)	14.32 (11.21, 17.39)	18.36 (15.98, 20.75)
Schizophrenia
Total	14816611.18	177.75 (131.51, 228.79)	0.64 (-0.48, 1.71)	-0.14 (-0.86, 0.60)
Male	7870786.02	188.96 (139.92, 243.73)	0.89 (-0.43, 2.20)	-0.10 (-1.12, 0.89)
Female	6945825.16	166.40 (122.80, 213.92)	0.46 (-0.89, 1.81)	-0.19 (-1.25, 0.84)
Bipolar disorder
Total	8007783.13	166.40 (122.80, 213.92)	0.29 (-1.14, 1.65)	-0.16 (-0.73, 0.39)
Male	3869179.30	94.16 (60.91, 135.74)	2.07 (0.43, 3.66)	-0.02 (-0.79, 0.77)
Female	4138603.83	100.48 (65.15, 143.98)	-1.29 (-2.74, 0.10)	-0.29 (-1.12, 0.45)
Dysthymia
Total	10311517.07	123.27 (79.24, 174.71)	2.82 (1.16, 4.58)	1.81 (0.56, 2.98)
Male	4315356.20	103.91 (66.67, 147.42)	2.18 (-0.10, 4.21)	1.77 (0.19, 3.36)
Female	5996160.87	142.62 (91.89, 202.72)	3.22 (1.05, 5.45)	1.84 (0.10, 3.71)
Anorexia nervosa
Total	798443.32	10.31 (6.42, 16.25)	5.18 (3.05, 7.45)	-0.85 (-2.28, 0.80)
Male	219973.16	5.59 (3.35, 9.02)	9.03 (5.73, 12.45)	-0.24 (-3.02, 2.76)
Female	578470.16	15.18 (9.53, 23.90)	4.10 (1.47, 6.85)	-1.02 (-2.63, 0.71)
Bulimia nervosa
Total	2604702.47	33.05 (18.64, 55.29)	20.06 (18.37, 21.94)	0.18 (-0.85, 1.22)
Male	1040190.47	26.01 (14.68, 43.25)	24.62 (21.930, 27.48)	0.917 (-0.504, 2.41)
Female	1564512.00	40.297 (22.67, 66.23)	17.32 (15.07, 19.47)	-0.26 (-1.53, 1.04)
Autism spectrum disorders
Total	11544038.08	147.55 (100.21, 208.15)	2.11 (0.55, 3.41)	-0.02 (-0.75, 0.69)
Male	7896838.23	199.80 (136.29, 281.96)	1.97 (0.08, 3.54)	-0.09 (-1.02, 0.81)
Female	3647199.85	94.45 (64.55, 133.017)	2.23 (0.96, 3.69)	0.13 (-0.73, 1.09)
Attention-deficit/hyperactivity disorder
Total	1030941.35	13.49 (7.41, 21.89)	-9.68 (-11.90, -7.29)	-0.07 (-1.96, 1.99)
Male	742263.67	19.04 (10.44, 30.75)	-9.81 (-12.51, -6.80)	0.06 (-2.55, 2.68)
Female	288677.68	7.69 (4.18, 12.69)	-9.93 (-12.83, -6.63)	-0.44 (-2.87, 2.11)
Conduct disorder
Total	5002614.36	67.68 (36.75, 105.51)	3.03 (1.42, 4.86)	-0.11 (-0.75, 0.54)
Male	3257831.43	85.60 (47.16, 132.77)	1.79 (0.13, 3.94)	-0.08 (-0.92, 0.73)
Female	1744782.93	48.67 (26.08, 76.31)	4.74 (2.21, 6.96)	-0.14 (-1.19, 1.03)
Other mental disorders
Total	8962343.98	106.59 (68.18, 160.68)	-0.34 (-1.06, 0.33)	-0.22 (-0.72, 0.24)
Male	5287137.39	127.47 (81.99, 191.81)	-0.52 (-1.37, 0.23)	-0.19 (-0.81, 0.39)
Female	3675206.59	86.08 (55.86, 127.90)	-0.16 (-0.99, 0.72)	-0.28 (-1.04, 0.38)

¹Percentage change of age-standardized disability-adjusted life-years rate.

DALY: Disability-adjusted life-year; ASDR: Age-standardized disability-adjusted life-year rate.