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Burden and trends of mental disorders in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

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Abstract

Purpose

Mental disorders remain the leading causes of disability worldwide. We aimed to determine the burden and trends of mental disorders in China from 1990 to 2019.

Methods

The incidence, prevalence, and disability-adjusted life years (DALYs) of mental disorders at national level of China were examined by age, sex, and subcategories. Temporal trends in the age-standardized rates for incidence, prevalence, and DALYs were assessed by the average annual percentage change (AAPC). All estimates are presented as numbers and age-standardized rates, with 95% uncertainty intervals (UIs).

Results

The number of incident cases due to mental disorders increased from 42.90 million to 52.72 million, the number of prevalent cases increased from 132.63 million to 160.16 million, and the number of DALYs increased from 15.64 million to 20.29 million during 1990–2019. Decreasing trends were observed in the age-standardized rates for incidence, prevalence and DALYs. Anxiety and depressive disorders were more frequent in women, while ADHD, conduct disorder, and autism spectrum disorders were more common in men. Compared with 1990, the age-specific incidence rates were higher in individuals under 14 years and over 55 years, whereas rates were lower in those aged 15–49 years in 2019.

Conclusion

The number of incident cases, prevalent cases, and DALYs due to mental disorders gradually increased in China from 1990 to 2019. Anxiety and depressive disorders were the leading causes of burden due to mental disorders, which affected women more than men. Mental disorders deserve greater attention in health policy decision making.

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Data availability

To download the data used in these analyses, please visit the Global Health Data Exchange GBD 2019 website (https://ghdx.healthdata.org/gbd-2019).

References

  1. GBD 2019 Diseases and Injuries Collaborators (2020) Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9

    Article  Google Scholar 

  2. GBD 2019 Mental Disorders Collaborators (2022) 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 9(2):137–150. https://doi.org/10.1016/S2215-0366(21)00395-3

    Article  PubMed Central  Google Scholar 

  3. World Health Organization (2013) Comprehensive mental health action plan 2013–2020. https://www.afro.who.int/sites/default/files/2017-06/9789241506021_eng.pdf. Accessed 11 Mar 2023

  4. United Nations (2015) Resolution adopted by the General Assembly on 25 September 2015, transforming our world: the 2030 Agenda for Sustainable Development. https://documents-dds-ny.un.org/doc/UNDOC/GEN/N15/291/89/PDF/N1529189.pdf?OpenElement. Accessed 11 Mar 2023

  5. Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, Yu Y, Kou C, Xu X, Lu J, Wang Z, He S, Xu Y, He Y, Li T, Guo W, Tian H, Xu G, Xu X, Ma Y, Wang L, Wang L, Yan Y, Wang B, Xiao S, Zhou L, Li L, Tan L, Zhang T, Ma C, Li Q, Ding H, Geng H, Jia F, Shi J, Wang S, Zhang N, Du X, Du X, Wu Y (2019) Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry 6(3):211–224. https://doi.org/10.1016/S2215-0366(18)30511-X

    Article  PubMed  Google Scholar 

  6. Emerson SD, Carbert NS (2019) An apple a day: Protective associations between nutrition and the mental health of immigrants in Canada. Soc Psychiatry Psychiatr Epidemiol 54(5):567–578. https://doi.org/10.1007/s00127-018-1616-9

    Article  PubMed  Google Scholar 

  7. Patel V, Xiao S, Chen H, Hanna F, Jotheeswaran AT, Luo D, Parikh R, Sharma E, Usmani S, Yu Y, Druss BG, Saxena S (2016) The magnitude of and health system responses to the mental health treatment gap in adults in India and China. Lancet 388(10063):3074–3084. https://doi.org/10.1016/S0140-6736(16)00160-4

    Article  PubMed  Google Scholar 

  8. Ren X, Yu S, Dong W, Yin P, Xu X, Zhou M (2020) Burden of depression in China, 1990–2017: findings from the global burden of disease study 2017. J Affect Disord 268:95–101. https://doi.org/10.1016/j.jad.2020.03.011

    Article  PubMed  Google Scholar 

  9. Zhang J, Wang R, Wang C, Wang Y, Chen X, Mi G, Chen X, Cheng X, Wang L, Wu X, Xue F, Wang Q (2021) Prevalence of mental disorders in 21st century Shandong Province, China: a 10-year comparative study. J Affect Disord 283:344–353. https://doi.org/10.1016/j.jad.2021.01.068

    Article  PubMed  Google Scholar 

  10. Yin H, Xu G, Tian H, Yang G, Wardenaar KJ, Schoevers RA (2018) The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS). Psychol Med 48(3):473–487. https://doi.org/10.1017/S0033291717001878

    Article  CAS  PubMed  Google Scholar 

  11. Zhang YS, Rao WW, Cui LJ, Li JF, Li L, Ng CH, Ungvari GS, Li KQ, Xiang YT (2019) Prevalence of major depressive disorder and its socio-demographic correlates in the general adult population in Hebei province, China. J Affect Disord 252:92–98. https://doi.org/10.1016/j.jad.2019.01.049

    Article  PubMed  Google Scholar 

  12. Chen Y, Bennett D, Clarke R, Guo Y, Yu C, Bian Z, Ma L, Huang Y, Sun Q, Zhang N, Zheng X, Chen J, Peto R, Kendler KS, Li L, Chen Z (2017) Patterns and correlates of major depression in Chinese adults: a cross-sectional study of 0.5 million men and women. Psychol Med 47(5):958–970. https://doi.org/10.1017/S0033291716002889

    Article  CAS  PubMed  Google Scholar 

  13. Ma C, Yu S, Huang Y, Liu Z, Wang Q, Chen H, Zhang T, Zhou M (2020) Burden of mental and substance use disorders—China, 1990–2019. China CDC Wkly 2(41):804–809. https://doi.org/10.46234/ccdcw2020.219

    Article  PubMed  PubMed Central  Google Scholar 

  14. GBD 2019 Risk Factors Collaborators (2020) Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1223–1249. https://doi.org/10.1016/S0140-6736(20)30752-2

    Article  Google Scholar 

  15. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators (2017) Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390(10100):1211–1259. https://doi.org/10.1016/S0140-6736(17)32154-2

    Article  Google Scholar 

  16. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392(10159):1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7

    Article  Google Scholar 

  17. Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, Li X, Wang L, Wang L, Liu Y, Liu J, Zhang M, Qi J, Yu S, Afshin A, Gakidou E, Glenn S, Krish VS, Miller-Petrie MK, Mountjoy-Venning WC, Mullany EC, Redford SB, Liu H, Naghavi M, Hay SI, Wang L, Murray CJL, Liang X (2019) Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 394(10204):1145–1158. https://doi.org/10.1016/S0140-6736(19)30427-1

    Article  PubMed  PubMed Central  Google Scholar 

  18. Stevens GA, Alkema L, Black RE, Boerma JT, Collins GS, Ezzati M, Grove JT, Hogan DR, Hogan MC, Horton R, Lawn JE, Marušić A, Mathers CD, Murray CJ, Rudan I, Salomon JA, Simpson PJ, Vos T, Welch V, GATHER Working Group (2016) Guidelines for accurate and transparent health estimates reporting: the GATHER statement. PLoS Med 13(6):e1002056. https://doi.org/10.1371/journal.pmed.1002056

    Article  PubMed  PubMed Central  Google Scholar 

  19. Thapar A, Cooper M (2016) Attention deficit hyperactivity disorder. Lancet 387(10024):1240–1250. https://doi.org/10.1016/S0140-6736(15)00238-X

    Article  PubMed  Google Scholar 

  20. Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, Chisholm D, Collins PY, Cooper JL, Eaton J, Herrman H, Herzallah MM, Huang Y, Jordans MJD, Kleinman A, Medina-Mora ME, Morgan E, Niaz U, Omigbodun O, Prince M, Rahman A, Saraceno B, Sarkar BK, De Silva M, Singh I, Stein DJ, Sunkel C, UnÜtzer J (2018) The Lancet Commission on global mental health and sustainable development. Lancet 392(10157):1553–1598. https://doi.org/10.1016/S0140-6736(18)31612-X

    Article  PubMed  Google Scholar 

  21. Affleck W, Carmichael V, Whitley R (2018) Men’s mental health: social determinants and implications for services. Can J Psychiatry 63(9):581–589. https://doi.org/10.1177/0706743718762388

    Article  PubMed  PubMed Central  Google Scholar 

  22. Luo W, Xie Y (2020) Economic growth, income inequality and life expectancy in China. Soc Sci Med 256:113046. https://doi.org/10.1016/j.socscimed.2020.113046

    Article  PubMed  Google Scholar 

  23. Yu B, Chen X, Elliott AL, Wang Y, Li F, Gong J (2019) Social capital, migration stress, depression and sexual risk behaviors among rural-to-urban migrants in China: a moderated mediation modeling analysis. Anxiety Stress Coping 32(4):362–375. https://doi.org/10.1080/10615806.2019.1596673

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ventriglio A, Torales J, Castaldelli-Maia JM, De Berardis D, Bhugra D (2021) Urbanization and emerging mental health issues. CNS Spectr 26(1):43–50. https://doi.org/10.1017/S1092852920001236

    Article  PubMed  Google Scholar 

  25. Lin Y, Zhang Q, Chen W, Shi J, Han S, Song X, Xu Y, Ling L (2016) Association between social integration and health among internal migrants in ZhongShan, China. PLoS One 11(2):e0148397. https://doi.org/10.1371/journal.pone.0148397

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Zhang N, Nazroo J, Vanhoutte B (2021) The relationship between rural to urban migration in China and risk of depression in later life: an investigation of life course effects. Soc Sci Med 270:113637. https://doi.org/10.1016/j.socscimed.2020.113637

    Article  PubMed  Google Scholar 

  27. Peng X (2011) China’s demographic history and future challenges. Science 333(6042):581–587. https://doi.org/10.1126/science.1209396

    Article  CAS  PubMed  Google Scholar 

  28. Tang D, Gao X, Coyte PC (2021) The relationship between internal migration and the likelihood of high-risk pregnancy: Hukou system and high-risk pregnancies in China. BMC Pregnancy Childbirth 21(1):509. https://doi.org/10.1186/s12884-021-03958-4

    Article  PubMed  PubMed Central  Google Scholar 

  29. Yuan P, Wang L (2016) Migrant workers: China boom leaves children behind. Nature 529(7584):25. https://doi.org/10.1038/529025a

    Article  CAS  PubMed  Google Scholar 

  30. Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, Orcutt M, Ricci K, Mohamed-Ahmed O, Burns R, Knipe D, Hargreaves S, Hesketh T, Opondo C, Devakumar D (2018) Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet 392(10164):2567–2582. https://doi.org/10.1016/S0140-6736(18)32558-3

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kusi-Mensah K, Omigbodun O (2020) Children left behind by parental migration in sub-Saharan Africa. Lancet Child Adolesc Health 4(4):261–262. https://doi.org/10.1016/S2352-4642(19)30398-0

    Article  PubMed  Google Scholar 

  32. Viet Nguyen C (2016) Does parental migration really benefit left-behind children? Comparative evidence from Ethiopia, India, Peru and Vietnam. Soc Sci Med 153:230–239. https://doi.org/10.1016/j.socscimed.2016.02.021

    Article  PubMed  Google Scholar 

  33. Fang EF, Xie C, Schenkel JA, Wu C, Long Q, Cui H, Aman Y, Frank J, Liao J, Zou H, Wang NY, Wu J, Liu X, Li T, Fang Y, Niu Z, Yang G, Hong J, Wang Q, Chen G, Li J, Chen HZ, Kang L, Su H, Gilmour BC, Zhu X, Jiang H, He N, Tao J, Leng SX, Tong T, Woo J (2020) A research agenda for ageing in China in the 21st century (2nd edition): focusing on basic and translational research, long-term care, policy and social networks. Ageing Res Rev 64:101174. https://doi.org/10.1016/j.arr.2020.101174

    Article  PubMed  PubMed Central  Google Scholar 

  34. Curran E, Rosato M, Ferry F, Leavey G (2020) Prevalence and factors associated with anxiety and depression in older adults: gender differences in psychosocial indicators. J Affect Disord 267:114–122. https://doi.org/10.1016/j.jad.2020.02.018

    Article  PubMed  Google Scholar 

  35. Bangasser DA, Cuarenta A (2021) Sex differences in anxiety and depression: circuits and mechanisms. Nat Rev Neurosci 22(11):674–684. https://doi.org/10.1038/s41583-021-00513-0

    Article  CAS  PubMed  Google Scholar 

  36. Tronieri JS, Wurst CM, Pearl RL, Allison KC (2017) Sex differences in obesity and mental health. Curr Psychiatry Rep 19(6):29. https://doi.org/10.1007/s11920-017-0784-8

    Article  PubMed  Google Scholar 

  37. May T, Adesina I, McGillivray J, Rinehart NJ (2019) Sex differences in neurodevelopmental disorders. Curr Opin Neurol 32(4):622–626. https://doi.org/10.1097/WCO.0000000000000714

    Article  PubMed  Google Scholar 

  38. Young LJ, Pfaff DW (2014) Sex differences in neurological and psychiatric disorders. Front Neuroendocrinol 35(3):253–254. https://doi.org/10.1016/j.yfrne.2014.05.005

    Article  PubMed  Google Scholar 

  39. Ma H (2012) Integration of hospital and community services-the ’686 Project’-is a crucial component in the reform of China’s mental health services. Shanghai Arch Psychiatry 24(3):172–174. https://doi.org/10.3969/j.issn.1002-0829.2012.03.007

    Article  PubMed  PubMed Central  Google Scholar 

  40. Huang J, Shao Y, Ma H, Yang W, Li H (2019) Changing of Chinese psychiatrists’ attitudes toward consent process to treatment and its association with the China’s National Mental Health Law. Int J Psychiatry Med 54(1):11–21. https://doi.org/10.1177/0091217418791436

    Article  PubMed  Google Scholar 

  41. Liang D, Mays VM, Hwang WC (2018) Integrated mental health services in China: challenges and planning for the future. Health Policy Plan 33(1):107–122. https://doi.org/10.1093/heapol/czx137

    Article  PubMed  Google Scholar 

  42. He J, Ouyang F, Li L, Qiu D, Li Y, Xiao S (2021) Incidence trends of major depressive disorder in China: an age-period-cohort modeling study. J Affect Disord 288:10–16. https://doi.org/10.1016/j.jad.2021.03.075

    Article  PubMed  Google Scholar 

  43. Ebrahimi Meimand S, Amiri Z, Shobeiri P, Malekpour MR, Saeedi Moghaddam S, Ghanbari A, Tehrani YS, Shokri Varniab Z, Pourabhari Langroudi A, Sohrabi H, Foroutan Mehr E, Rezaei N, Moradi-Lakeh M, Mokdad H, Larijani B (2023) Burden of autism spectrum disorders in North Africa and Middle East from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Brain Behav 13(7):e3067. https://doi.org/10.1002/brb3.3067

    Article  PubMed  PubMed Central  Google Scholar 

  44. Bao Y, Sun Y, Meng S, Shi J, Lu L (2020) 2019-nCoV epidemic: address mental health care to empower society. Lancet 395(10224):e37–e38. https://doi.org/10.1016/S0140-6736(20)30309-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Shi L, Lu ZA, Que JY, Huang XL, Liu L, Ran MS, Gong YM, Yuan K, Yan W, Sun YK, Shi J, Bao YP, Lu L (2020) Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic. JAMA Netw Open 3(7):e2014053. https://doi.org/10.1001/jamanetworkopen.2020.14053

    Article  PubMed  PubMed Central  Google Scholar 

  46. Liu L, Ni SY, Yan W, Lu QD, Zhao YM, Xu YY, Mei H, Shi L, Yuan K, Han Y, Deng JH, Sun YK, Meng SQ, Jiang ZD, Zeng N, Que JY, Zheng YB, Yang BN, Gong YM, Ravindran AV, Kosten T, Wing YK, Tang XD, Yuan JL, Wu P, Shi J, Bao YP, Lu L (2021) Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: a systematic review, meta-analysis and call for action. EClinicalMedicine 40:101111. https://doi.org/10.1016/j.eclinm.2021.101111

    Article  PubMed  PubMed Central  Google Scholar 

  47. COVID-19 Mental Disorders Collaborators (2021) Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 398(10312):1700–1712. https://doi.org/10.1016/S0140-6736(21)02143-7

    Article  Google Scholar 

  48. Dong L, Bouey J (2020) Public mental health crisis during COVID-19 pandemic, China. Emerg Infect Dis 26(7):1616–1618. https://doi.org/10.3201/eid2607.200407

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Jin Y, Sun T, Zheng P, An J (2021) Mass quarantine and mental health during COVID-19: a meta-analysis. J Affect Disord 295:1335–1346. https://doi.org/10.1016/j.jad.2021.08.067

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. GBD 2017 Causes of Death Collaborators (2018) Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392(10159):1736–1788. https://doi.org/10.1016/S0140-6736(18)32203-7

    Article  Google Scholar 

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Acknowledgements

The authors are grateful to the Institute for Health Metrics and Evaluation for the development of the GBD database.

Funding

The study was supported by the National Natural Science Foundation of China (Grant no. 82204111) and Tai’an Science and Technology Innovation Development Project (Grant no. 2021NS335). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Yang Deng, Siwei Sun and Shixing Wu contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China

    Yang Deng, Kun Chen, Yan Liu, Wannian Wei, Ning Bei, Chengjun Qiu & Xiaomei Li

  2. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China

    Siwei Sun

  3. Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

    Shixing Wu

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  1. Yang Deng
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Contributions

YD and XL designed the study protocol. SS, SW, KC, YL, WW, NB, and CQ performed the acquisition, analysis, or interpretation of data. YD and SS wrote the manuscript draft. XL supervised the study. All the authors contributed to the article and approved the submitted version.

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Correspondence to Yang Deng or Xiaomei Li.

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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Ethics approval and consent from individuals were not required, as only aggregated non-identifiable data were used in this study.

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Deng, Y., Sun, S., Wu, S. et al. Burden and trends of mental disorders in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Soc Psychiatry Psychiatr Epidemiol (2023). https://doi.org/10.1007/s00127-023-02594-x

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