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Article(id=1320436313250181730, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320436284418544199, articleNumber=null, orderNo=null, doi=10.16016/j.2097-0927.202510063, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1761062400000, receivedDateStr=2025-10-22, revisedDate=1768579200000, revisedDateStr=2026-01-17, acceptedDate=null, acceptedDateStr=null, onlineDate=1792746149599, onlineDateStr=2026-10-23, pubDate=1772208000000, pubDateStr=2026-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746149599, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746149599, creator=13701087609, updateTime=1792746149599, updator=13701087609, issue=Issue{id=1320436284418544199, tenantId=1146029695717560320, journalId=1319373162502258839, year='2026', volume='48', issue='4', pageStart='387', pageEnd='522', issueExtLink='null', onlineDate='null', pubDate='1772208000000', pubDateStr='2026-02-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746142725, creator='13701087609', updateTime=1792750115637, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320452948077953743, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320436284418544199, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320452948077953744, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320436284418544199, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=504, endPage=513, ext={EN=ArticleExt(id=1320436313585726051, articleId=1320436313250181730, tenantId=1146029695717560320, journalId=1319373162502258839, language=EN, title=Effective response: China’s performance and sex-and region-based disparities amid global increase in depressive disorder burden during the COVID-19, columnId=1320434453051199700, journalTitle=Journal of Army Medical University, columnName=Think Tank for Public Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate changes in the depressive disorder burden in China, global, and across socio-demographic index (SDI) regions during the COVID-19(from 2019 to 2021) compared with 1990 to 2019, and to analyze sex-regional disparities.

Methods

Using depressive disorder data from the Global Burden of Disease (GBD) database (from 1990 to 2021) for China, global populations, and 5 SDI regions, we characterized depressive disorder burden distribution during the pandemic via metrics including age-standardized prevalence rate (ASPR), age-standardized disability-adjusted life years (ASR-DALYs), and estimated annual percentage change (EAPC). Joinpoint regression modeled temporal trends, and the Bayesian age-period-cohort (BAPC) model estimated the excess depressive disorder burden attributable to COVID-19 in 2020—2021.

Results

China’s depressive disorder ASPR increased to 2 875.68/100 000 person-years (95%CI: 2 589.96 to 3 203.43) in 2021 from 2 825.00/100 000 (95%CI: 2 550.42 to 3 136.08) in 2019; ASR-DALYs rose to 430.61/100 000 (95%CI: 305.24 to 586.21) from 430.14/100 000 person-years (95%CI: 303.92 to 580.82). Joinpoint analysis identified an inflection point for China’s ASPR in 2019, with a significant upward annual percentage change (APC=0.95, P<0.05) from 2019 to 2021—a smaller increase than global and other SDI regions. No significant inflection was observed for China’s ASR-DALYs, whereas other regions showed clear upward inflection points near 2019 (P<0.05). China exhibited the lowest excess depressive disorder burden due to COVID-19: excess ASPR was 121.67/100 000 and excess ASR-DALYs was 12.25/100 000 person-years in 2021, only 28% and 14% of global levels, respectively. Females had higher ASPR/ASR-DALYs and excess burden than males, with females in high-SDI regions bearing the heaviest burden.

Conclusion

COVID-19 imposed severe excess depressive disorder burdens worldwide. China’s effective pandemic response policies and psychological assistance measures mitigated this burden. Countermeasures　Governments should increase investment in mental healthcare resources, enhance public mental health literacy, and ensure rapid implementation of containment measures during public health emergencies—including regular information updates to stabilize public sentiment—alongside community-based psychological support.

, authors=Yuanzhi ZHOU1, Ziquan YUAN1, Jiaxin MA1, Wenwen CHEN2, Xu ZHANG1, Dan GUO1, Shuixiang HE1, Yarui LI1, authorsList=Yuanzhi ZHOU, Ziquan YUAN, Jiaxin MA, Wenwen CHEN, Xu ZHANG, Dan GUO, Shuixiang HE, Yarui LI, authorCompany=null, correspAuthors=Yarui LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=© 2026 Journal of Army Medical University, copyrightOwner=Editorial Office of Journal of Army Medical University, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320436316815340143, articleId=1320436313250181730, tenantId=1146029695717560320, journalId=1319373162502258839, language=CN, title=有效应对：新型冠状病毒感染疫情防控期间全球抑郁症负担加剧背景下的中国表现与性别-地区差异分析, columnId=1320434453520961751, journalTitle=陆军军医大学学报, columnName=论著·公共卫生智库, runingTitle=null, highlight=null, articleAbstract=
目的

探究2019—2021年新型冠状病毒感染疫情防控期间中国、全球及不同社会人口学指数（socio-demographic index，SDI） 地区抑郁症疾病负担较1990—2019年间的变化，分析性别-地区差异。

方法

基于全球疾病负担（Global Burden of Disease，GBD）数据库1990—2021年中国、全球和不同SDI地区的抑郁症相关数据，使用年龄标准化患病率（age-standardized prevalence rate，ASPR）、年龄标化伤残调整生命年（age-standardized disability-adjusted life years，ASR-DALYs）、估计年百分比变化（estimated annual percentage change，EAPC）等指标，描述新型冠状病毒感染疫情防控期间各地区的抑郁症疾病负担的分布特征。使用Joinpoint模型分析负担的时间变化趋势，贝叶斯年龄-时期-队列（Bayesian age-period-cohort，BAPC）模型估算2020、2021年新型冠状病毒感染带来的抑郁症超额疾病负担。

结果

2021年我国抑郁症ASPR为2 875.68/10万（95%CI：2 589.96~3 203.43），较2019年的2 825.00/10万（95%CI：2 550.42~3 136.08）升高；2021年我国ASR-DALYs为430.61/10万人年（95%CI：305.24~586.21），较2019年的430.14/10万人年（95%CI：303.92~580.82）升高。Joinpoint分析显示，我国抑郁症ASPR在2019年出现拐点，2019—2021年的年度变化百分比（annual percentage change， APC）为0.95（P<0.05）呈现上升趋势，相比全球和各SDI水平地区，我国上升幅度较小。我国抑郁症ASR-DALYs在2019年未拟合到明显拐点，而其他地区ASR-DALYs在2019年附近出现拐点，呈明显上升趋势（P<0.05）。我国新型冠状病毒感染带来的抑郁症超额疾病负担最轻，2021年超额ASPR为121.67（每10万人），超额ASR-DALYs为12.25（每10万人年），全球水平分别为我国的3.6倍和7.0倍。女性的ASPR和ASR-DALYs水平均高于男性，女性超额疾病负担高于男性水平，高SDI地区的女性超额疾病负担最重。

结论

新型冠状病毒感染为全球各地区带来严重的抑郁症超额疾病负担。我国有效的疫情应对政策和心理援助措施，有助于缓解这一负担。对策 政府应加大精神卫生保健资源的投入，加强精神卫生知识的宣传，提高全人群对抑郁症的认知水平。面对突发公共卫生事件时，应迅速采取防控措施，保证规律、即时的信息发布，稳定社会情绪，联合基层社会组织实施心理援助与情绪安抚。

, authors=周元植1, 袁子泉1, 马佳昕1, 陈雯雯2, 张旭1, 郭丹1, 和水祥1, 李雅睿1, authorsList=周元植, 袁子泉, 马佳昕, 陈雯雯, 张旭, 郭丹, 和水祥, 李雅睿, authorCompany=null, correspAuthors=李雅睿, authorNote=null, correspAuthorsNote=
李雅睿，E-mail：
LI Yarui，E-mail：
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a： P<0.05

, figureFileSmall=ybQufNp79aRdsi209rZulg==, figureFileBig=EnbVZypKjUfntTavCTXlaQ==, tableContent=null), ArticleFig(id=1320436322729308855, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=EN, label=Figure 4, caption=Gender distribution of depressive disorder in China， global， and 5 SDI regions in 1990， 2020， and 2021, figureFileSmall=+q++r1EViGBBzi1uR/rvlA==, figureFileBig=Q42kyxc+kU0Lmuu/xiOH/g==, tableContent=null), ArticleFig(id=1320436322796417720, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=CN, label=图4, caption=1990、2020、2021年我国、全球及5个不同SDI地区抑郁症疾病负担的性别分布, figureFileSmall=+q++r1EViGBBzi1uR/rvlA==, figureFileBig=Q42kyxc+kU0Lmuu/xiOH/g==, tableContent=null), ArticleFig(id=1320436322871915193, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=EN, label=Figure 5, caption=Gender distribution of the excess disease burden of depressive disorder in China， global and in 5 SDI regions in 2020 and 2021, figureFileSmall=UvS+/lWT7Zv1uD0bHhdrfw==, figureFileBig=P7syk0qCb9eJP7tsWLWYsg==, tableContent=null), ArticleFig(id=1320436322947412666, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=CN, label=图5, caption=2020年和2021年我国、全球及5个不同SDI地区抑郁症超额疾病负担的性别分布, figureFileSmall=UvS+/lWT7Zv1uD0bHhdrfw==, figureFileBig=P7syk0qCb9eJP7tsWLWYsg==, tableContent=null), ArticleFig(id=1320436323010327227, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=EN, label=Table 1, caption=

Excess prevalence of depressive disorder in different regions in 2020 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
YearRegionNumber of prevalence cases/（×105）ASPR/per 100 000 person-years
EstimateObservedExcessEstimateObservedExcess
2020China502.23526.6324.402 764.952 883.85118.90
Global2 927.763 252.99325.233 566.153 969.99403.84
High SDI455.76514.1558.393 698.504 275.40576.90
High-middle SDI520.89562.9942.113 309.113 592.62283.51
Middle SDI861.90957.1695.263 251.863 616.38364.52
Low-middle SDI718.39812.4394.034 029.054 522.89493.84
Low SDI369.80403.8434.034 486.614 841.76355.15
2021China505.70531.1525.442 754.012 875.68121.67
Global2 968.443 324.10355.663 570.124 006.82436.70
High SDI458.26520.3362.073 707.274 312.34605.08
High-middle SDI523.75576.2652.513 310.053 666.90356.85
Middle SDI872.63979.74107.113 249.233 654.36405.13
Low-middle SDI731.96828.6196.644 028.294 528.90500.60
Low SDI381.12416.6535.534 489.644 849.64360.00
), ArticleFig(id=1320436323094213308, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=CN, label=表1, caption=

2020和2021年各地区抑郁症的超额患病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
YearRegionNumber of prevalence cases/（×105）ASPR/per 100 000 person-years
EstimateObservedExcessEstimateObservedExcess
2020China502.23526.6324.402 764.952 883.85118.90
Global2 927.763 252.99325.233 566.153 969.99403.84
High SDI455.76514.1558.393 698.504 275.40576.90
High-middle SDI520.89562.9942.113 309.113 592.62283.51
Middle SDI861.90957.1695.263 251.863 616.38364.52
Low-middle SDI718.39812.4394.034 029.054 522.89493.84
Low SDI369.80403.8434.034 486.614 841.76355.15
2021China505.70531.1525.442 754.012 875.68121.67
Global2 968.443 324.10355.663 570.124 006.82436.70
High SDI458.26520.3362.073 707.274 312.34605.08
High-middle SDI523.75576.2652.513 310.053 666.90356.85
Middle SDI872.63979.74107.113 249.233 654.36405.13
Low-middle SDI731.96828.6196.644 028.294 528.90500.60
Low SDI381.12416.6535.534 489.644 849.64360.00
), ArticleFig(id=1320436323182293693, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=EN, label=Table 2, caption=

Excess DALYs of depressive disorder in different regions in 2020 and 2021

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YearRegionNumber of DALYs/（×105）ASR-DALYs/per 100 000 person-years
EstimateObservedExcessEstimateObservedExcess
2020China75.3580.014.66420.74442.4021.65
Global486.96553.0666.11594.59676.7682.17
High SDI77.2789.1711.90641.73760.39118.66
High-middle SDI83.9292.468.53542.62599.9457.32
Middle SDI139.36158.7119.35527.95602.1974.24
Low-middle SDI122.72141.7719.04684.08783.9499.86
Low SDI63.4870.567.08763.45837.2073.76
2021China75.7278.662.94418.36430.6112.25
Global493.64563.3069.67595.34681.1485.80
High SDI77.6690.0812.42643.28766.07122.79
High-middle SDI84.3194.089.77542.72610.0867.36
Middle SDI140.97161.5820.61527.36605.9178.55
Low-middle SDI125.14144.4019.26684.54784.0799.53
Low SDI65.4772.737.26764.46837.5373.07
), ArticleFig(id=1320436324843238078, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320436313250181730, language=CN, label=表2, caption=

2020和2021年各地区抑郁症的超额DALYs

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YearRegionNumber of DALYs/（×105）ASR-DALYs/per 100 000 person-years
EstimateObservedExcessEstimateObservedExcess
2020China75.3580.014.66420.74442.4021.65
Global486.96553.0666.11594.59676.7682.17
High SDI77.2789.1711.90641.73760.39118.66
High-middle SDI83.9292.468.53542.62599.9457.32
Middle SDI139.36158.7119.35527.95602.1974.24
Low-middle SDI122.72141.7719.04684.08783.9499.86
Low SDI63.4870.567.08763.45837.2073.76
2021China75.7278.662.94418.36430.6112.25
Global493.64563.3069.67595.34681.1485.80
High SDI77.6690.0812.42643.28766.07122.79
High-middle SDI84.3194.089.77542.72610.0867.36
Middle SDI140.97161.5820.61527.36605.9178.55
Low-middle SDI125.14144.4019.26684.54784.0799.53
Low SDI65.4772.737.26764.46837.5373.07
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有效应对：新型冠状病毒感染疫情防控期间全球抑郁症负担加剧背景下的中国表现与性别-地区差异分析
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周元植 1 , 袁子泉 1 , 马佳昕 1 , 陈雯雯 2 , 张旭 1 , 郭丹 1 , 和水祥 1 , 李雅睿 1
陆军军医大学学报 | 论著·公共卫生智库 2026,48(4): 504-513
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陆军军医大学学报 |论著·公共卫生智库 2026 , 48 (4) : 504 -513
有效应对：新型冠状病毒感染疫情防控期间全球抑郁症负担加剧背景下的中国表现与性别-地区差异分析
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周元植1, 袁子泉1, 马佳昕1, 陈雯雯2, 张旭1, 郭丹1, 和水祥1, 李雅睿1
作者信息
  • 1西安交通大学第一附属医院，消化内科，陕西 西安
  • 2西安交通大学第一附属医院，重症外科，陕西 西安
通讯作者:
李雅睿，E-mail：
LI Yarui，E-mail：
Effective response: China’s performance and sex-and region-based disparities amid global increase in depressive disorder burden during the COVID-19
Yuanzhi ZHOU1, Ziquan YUAN1, Jiaxin MA1, Wenwen CHEN2, Xu ZHANG1, Dan GUO1, Shuixiang HE1, Yarui LI1
Affiliations
  • 1Department of Gastroenterology, the First Affiliated Hospital of Xi’an Jiaotong University，Xi’an， Shaanxi，China
  • 2Surgical Intensive Care Unit, the First Affiliated Hospital of Xi’an Jiaotong University，Xi’an， Shaanxi，China
出版时间: 2026-02-28 doi: 10.16016/j.2097-0927.202510063
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摘要
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目的

探究2019—2021年新型冠状病毒感染疫情防控期间中国、全球及不同社会人口学指数（socio-demographic index，SDI） 地区抑郁症疾病负担较1990—2019年间的变化，分析性别-地区差异。

方法

基于全球疾病负担（Global Burden of Disease，GBD）数据库1990—2021年中国、全球和不同SDI地区的抑郁症相关数据，使用年龄标准化患病率（age-standardized prevalence rate，ASPR）、年龄标化伤残调整生命年（age-standardized disability-adjusted life years，ASR-DALYs）、估计年百分比变化（estimated annual percentage change，EAPC）等指标，描述新型冠状病毒感染疫情防控期间各地区的抑郁症疾病负担的分布特征。使用Joinpoint模型分析负担的时间变化趋势，贝叶斯年龄-时期-队列（Bayesian age-period-cohort，BAPC）模型估算2020、2021年新型冠状病毒感染带来的抑郁症超额疾病负担。

结果

2021年我国抑郁症ASPR为2 875.68/10万（95%CI：2 589.96~3 203.43），较2019年的2 825.00/10万（95%CI：2 550.42~3 136.08）升高；2021年我国ASR-DALYs为430.61/10万人年（95%CI：305.24~586.21），较2019年的430.14/10万人年（95%CI：303.92~580.82）升高。Joinpoint分析显示，我国抑郁症ASPR在2019年出现拐点，2019—2021年的年度变化百分比（annual percentage change， APC）为0.95（P<0.05）呈现上升趋势，相比全球和各SDI水平地区，我国上升幅度较小。我国抑郁症ASR-DALYs在2019年未拟合到明显拐点，而其他地区ASR-DALYs在2019年附近出现拐点，呈明显上升趋势（P<0.05）。我国新型冠状病毒感染带来的抑郁症超额疾病负担最轻，2021年超额ASPR为121.67（每10万人），超额ASR-DALYs为12.25（每10万人年），全球水平分别为我国的3.6倍和7.0倍。女性的ASPR和ASR-DALYs水平均高于男性，女性超额疾病负担高于男性水平，高SDI地区的女性超额疾病负担最重。

结论

新型冠状病毒感染为全球各地区带来严重的抑郁症超额疾病负担。我国有效的疫情应对政策和心理援助措施，有助于缓解这一负担。对策 政府应加大精神卫生保健资源的投入，加强精神卫生知识的宣传，提高全人群对抑郁症的认知水平。面对突发公共卫生事件时，应迅速采取防控措施，保证规律、即时的信息发布，稳定社会情绪，联合基层社会组织实施心理援助与情绪安抚。

抑郁症  /  新型冠状病毒感染  /  全球疾病负担  /  患病率  /  伤残调整生命年
Objective

To investigate changes in the depressive disorder burden in China, global, and across socio-demographic index (SDI) regions during the COVID-19(from 2019 to 2021) compared with 1990 to 2019, and to analyze sex-regional disparities.

Methods

Using depressive disorder data from the Global Burden of Disease (GBD) database (from 1990 to 2021) for China, global populations, and 5 SDI regions, we characterized depressive disorder burden distribution during the pandemic via metrics including age-standardized prevalence rate (ASPR), age-standardized disability-adjusted life years (ASR-DALYs), and estimated annual percentage change (EAPC). Joinpoint regression modeled temporal trends, and the Bayesian age-period-cohort (BAPC) model estimated the excess depressive disorder burden attributable to COVID-19 in 2020—2021.

Results

China’s depressive disorder ASPR increased to 2 875.68/100 000 person-years (95%CI: 2 589.96 to 3 203.43) in 2021 from 2 825.00/100 000 (95%CI: 2 550.42 to 3 136.08) in 2019; ASR-DALYs rose to 430.61/100 000 (95%CI: 305.24 to 586.21) from 430.14/100 000 person-years (95%CI: 303.92 to 580.82). Joinpoint analysis identified an inflection point for China’s ASPR in 2019, with a significant upward annual percentage change (APC=0.95, P<0.05) from 2019 to 2021—a smaller increase than global and other SDI regions. No significant inflection was observed for China’s ASR-DALYs, whereas other regions showed clear upward inflection points near 2019 (P<0.05). China exhibited the lowest excess depressive disorder burden due to COVID-19: excess ASPR was 121.67/100 000 and excess ASR-DALYs was 12.25/100 000 person-years in 2021, only 28% and 14% of global levels, respectively. Females had higher ASPR/ASR-DALYs and excess burden than males, with females in high-SDI regions bearing the heaviest burden.

Conclusion

COVID-19 imposed severe excess depressive disorder burdens worldwide. China’s effective pandemic response policies and psychological assistance measures mitigated this burden. Countermeasures　Governments should increase investment in mental healthcare resources, enhance public mental health literacy, and ensure rapid implementation of containment measures during public health emergencies—including regular information updates to stabilize public sentiment—alongside community-based psychological support.

depressive disorder  /  Coronavirus Disease 2019  /  global burden of disease  /  prevalence  /  disability-adjusted life years
周元植, 袁子泉, 马佳昕, 陈雯雯, 张旭, 郭丹, 和水祥, 李雅睿. 有效应对：新型冠状病毒感染疫情防控期间全球抑郁症负担加剧背景下的中国表现与性别-地区差异分析. 陆军军医大学学报, 2026 , 48 (4) : 504 -513 . DOI: 10.16016/j.2097-0927.202510063
Yuanzhi ZHOU, Ziquan YUAN, Jiaxin MA, Wenwen CHEN, Xu ZHANG, Dan GUO, Shuixiang HE, Yarui LI. Effective response: China’s performance and sex-and region-based disparities amid global increase in depressive disorder burden during the COVID-19[J]. Journal of Army Medical University, 2026 , 48 (4) : 504 -513 . DOI: 10.16016/j.2097-0927.202510063
正文
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抑郁症是一种常见而严重的精神障碍，全球范围内发病率高，不仅损害个体健康，还造成显著的社会与经济负担［1-2］。据世界卫生组织（World Health Organization，WHO）报道，抑郁症影响着全球约3.8%的人口，其中包括约2.8亿成年人，它被认为是导致全球疾病负担的主要原因之一［3］。根据我国精神卫生调查结果，我国成年人抑郁障碍的终生患病率为6.8%，其中抑郁症为3.4%，目前我国抑郁症患者已经达9 500万［4］，然而国内该领域研究相对国外仍处于初步阶段［5］。
新型冠状病毒感染是一种系统性疾病，不仅影响呼吸系统，还可能对中枢神经系统产生影响。近期，多项研究提出，新型冠状病毒可能通过炎症、免疫系统紊乱及脑血管损伤等方式诱发抑郁症等精神健康问题［6-9］。新型冠状病毒感染也是重要的心理压力源，对疾病、死亡和未来不确定性的恐惧，以及失去结构化的教育和工作活动带来的社会孤立，均可能加剧公众的心理健康问题［10］。因此，有必要对新型冠状病毒感染疫情防控期间我国、全球及不同社会人口学指数（socio-demographic index，SDI）地区的抑郁症疾病负担变化进行探究。
本研究基于2021年全球疾病负担（Global Burden of Disease，GBD）研究的数据，分析我国在新型冠状病毒感染疫情防控期间抑郁症的疾病负担及变化趋势，计算新型冠状病毒感染带来的抑郁症超额疾病负担，并与全球及各SDI地区进行比较，以期为我国抑郁症预防效果的评估和策略措施的调整提供科学依据。
1　资料与方法
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1.1　资料来源
GBD 2021研究使用流行病学数据和标准化方法综合评估了204个国家和地区的371种疾病和伤害以及88种风险因素［11］，其数据来源包括全国和国际健康调查、医院记录和临床研究、死亡记录和登记以及文献和系统评价等。本研究基于GBD 2021数据库（https://vizhub.healthdata.org/gbd-results/），分析了我国、全球及各SDI地区的1990—2021年抑郁症的患病数、伤残调整生命年（disability-adjusted life years，DALYs）、年龄标化患病率（age-standardized prevalence rate，ASPR）和年龄标化伤残调整生命年（age-standardized disability-adjusted life years，ASR-DALYs）指标，并按性别进行划分。抑郁症在国际疾病分类（International Classification of Disease，ICD-10）中对应的编码包括F32-F33.9， F34.1。
1.2　分析指标及方法
本研究采用了患病数、DALYs及其95%不确定区间（uncertainty interval，UI），以及对应的ASPR、ASR- DALYs作为疾病负担指标，采用GBD 2021全球标准人口结构对年龄标化率进行计算。抑郁症导致的疾病负担以DALYs表示，该指标综合反映了因早逝导致的寿命损失年（years of life lost， YLL）和因伤残导致的健康寿命损失年（years lived with disability， YLDs）［12］。采用年度百分比变化估计值（estimated annual percentage change，EAPC）及其95%置信区间（confidence interval，CI）、年度变化百分比（annual percentage change， APC）和平均年度变化百分率（average annual percent change， AAPC）评估疾病负担的变化趋势。APC的计算公式为：APC=（eβ-1）×100%（β是对数线性模型lny=β×x的回归系数），AAPC根据时间跨度对各段APC进行加权。SDI是根据人均滞后分配收入、15岁及以上人口平均受教育年限以及25岁以下个人总生育率综合评估的国家/地区发展水平指标［13］。根据SDI 的不同水平，GBD 2021 将全球国家/地区分为5个社会经济发展等级：高SDI（>0.81）、中高SDI（0.71<SDI≤0.81）、中SDI（0.61<SDI≤0.71）、中低SDI（0.46<SDI≤0.61）和低SDI（SDI≤0.46）［14］。
Joinpoint回归模型［15］用于评估疾病患病率或死亡率的时间趋势，该模型巧妙地识别和定量表征了我国、全球及各SDI地区内抑郁症负担的时间序列数据中的重要变化点，使用对数刻度拟合多个线段来分析数据随时间的变化趋势。贝叶斯年龄-时期-队列（Bayesian age-period-cohort，BAPC）模型可以估算年龄、时期和队列对疾病所产生的影响，该模型在处理时间序列数据方面的灵活性和稳健性使其特别适用于长期疾病负担预测。超额疾病负担指某种疾病或健康事件的实际负担与基于大流行未发生年份估算所得的疾病负担的差值，反映了疫情对疾病直接或间接造成的影响，采用如下公式计算超额负担：超额负担=实际负担-预估负担。
1.3　统计学分析
本研究使用R 4.3.3软件进行统计分析，并采用GraphPad Prism 8.0进行数据可视化。P<0.05为差异具有统计学意义。
2　结果
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2.1　新型冠状病毒感染疫情防控期间我国、全球及各SDI地区抑郁症疾病负担变化情况
使用GBD 2021统计我国、全球及各SDI地区抑郁症的患病数、DALYs、ASPR和ASR-DALYs在1990—2021各年的数值，反映抑郁症疾病负担的变化特征。从2019年到2021年，全球抑郁症ASPR由3 564.77/10万人年（95%CI：3 211.82~4 002.90）升高为4 006.82/10万（95%CI：3 581.26~4 539.01），ASR-DALYs由593.50/10万人年（95%CI：413.34~810.07）升高为681.14/10万人年（95%CI：475.19~923.83）；我国的抑郁症ASPR由2 825.00/10万（95%CI：2 550.42~3 136.08）升高为2 875.68/10万（95%CI：2 589.96~3 203.43），ASR-DALYs由430.14/10万人年（95%CI：303.92~580.82）升高为430.61/10万人年（95%CI：305.24~586.21，图1）。在1990—2021年期间，我国、全球、以及各SDI地区的抑郁症患病数、DALYs、ASPR和ASR-DALYs的时间变化趋势基本相同，4项指标均在2020年呈现明显升高趋势。相比全球和各SDI地区，我国上升幅度较小。
统计我国、全球及不同SDI地区分别在1990—2019年和2019—2021年的抑郁症ASPR和ASR-DALYs的EAPC值。在1990—2019年期间，除高SDI地区外其他地区的ASPR和ASR-DALYs的EAPC为负值，其中，我国ASPR的EAPC为-0.48（95%CI：-0.53~-0.42），ASR-DALYs的EAPC为-0.58（95%CI：-0.67~-0.48）；全球ASPR的EAPC为-0.17（95%CI：-0.23~-0.11），ASR-DALYs的EAPC为-0.20（95%CI：-0.27~-0.13）；高SDI地区ASPR的EAPC为0.13（95%CI：0.08~0.18），ASR-DALYs的EAPC为0.20（95%CI：0.11~0.28，图2）。提示在1990-2019年期间，除高SDI地区外，其余地区的ASPR和ASR-DALYs呈现下降趋势，而在2019—2021年期间，所有地区的EAPC均为正值，不再呈现下降趋势。
进一步使用Joinpoint模型进行分段拟合，分析我国、全球及各SDI地区内抑郁症负担在不同时间节点内的变化趋势。在新型冠状病毒感染疫情防控期间，我国、全球和各SDI地区ASPR均由2019年之前的平缓趋势变为上升趋势，除了我国上升趋势缓慢，其他地区显著上升；全球和各SDI地区ASR-DALYs均由2019年之前的平缓趋势变为明显上升趋势，我国未见明显拐点（图3）。
统计1990年、2020年、2021年我国、全球及不同SDI地区男女各自的ASPR和ASR-DALYs值，分析抑郁症疾病负担的性别差异。结果显示，女性的ASPR和ASR-DALYs整体均高于男性。此外，除了我国，其他地区不论男女，2021年的抑郁症ASPR和ASR-DALYs均高于2019年的水平（图4）。
2.2　新型冠状病毒感染疫情防控期间我国、全球及各SDI水平地区抑郁症的超额疾病负担
我国2020年超额ASPR为118.90（每10万人），超额ASR-DALYs为21.65（每10万人年），2021年分别为121.67（每10万人）和12.25（每10万人年）；全球2020年超额ASPR为403.84（每10万人），超额ASR-DALYs为82.17（每10万人年），2021年分别为436.70（每10万人）和85.80（每10万人年），见表1、2。我国和中高SDI地区负担相对较轻，高SDI地区超额负担较重。
分析新型冠状病毒感染带来的抑郁症超额疾病负担的性别分布。新型冠状病毒感染给抑郁症患者带来了超额疾病负担，女性超额疾病负担高于男性水平，高SDI地区的女性超额疾病负担最重（图5）。
3　讨论
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3.1　新型冠状病毒感染疫情防控期间各地区抑郁症疾病负担现况分析
本研究基于GBD 2021的最新数据，使用患病数、DALYs、ASPR和ASR-DALYs等指标阐述了我国、全球及各SDI地区的抑郁症疾病负担的时间、性别分布特征，并计算了新型冠状病毒感染造成的抑郁症超额疾病负担。1990—2021年间，我国、全球及各SDI地区抑郁症的疾病负担持续存在，在新型冠状病毒感染疫情防控期间，各地区的负担均呈加重趋势，而相比于全球和其他地区抑郁症负担的爆发式加剧，我国的增长趋势相对平缓；新型冠状病毒感染为全球各地区带来了严重的抑郁症超额疾病负担，其中我国和中高SDI地区的超额负担相对较轻，高SDI地区的超额负担较重；性别分析结果显示，女性抑郁症疾病负担与新型冠状病毒感染导致的超额负担均高于男性。
最近几项荟萃分析表明，新型冠状病毒感染疫情防控期间，普通人群心理健康问题的患病率很高，从20%到36%不等［16］，而受新型冠状病毒感染影响的人群，其抑郁症的患病率（15.97%）是普通人群（4.40%）的3倍多［17-18］。此外，既往研究发现，中东国家和意大利等西方国家的女性在新型冠状病毒感染期间出现抑郁症的风险比男性更高［19-21］，与本研究结果一致。
3.2　新型冠状病毒感染疫情防控期间抑郁症的超额疾病负担：整体上升趋势与中国相对缓和的政策归因
2019年后，我国、全球及各SDI地区抑郁症的ASPR和ASR-DALYs呈显著上升趋势，表明新型冠状病毒感染可能加重了抑郁症的疾病负担。一方面，新型冠状病毒感染会诱导全身免疫炎症反应，造成机体外周免疫激活介导的中枢神经系统间接损伤，可能影响抑郁症的发生发展［6］。新型冠状病毒会影响人们的神经认知功能、睡眠、生活质量等［22］，增加抑郁症的易感性。另一方面，新型冠状病毒对感染者造成的重大健康后果甚至死亡［23-25］，会为患者及其家属带来沉重的心理负担，增加公众对新型冠状病毒的害怕和恐惧。此外，社会限制、封锁、学校和企业关闭、生计丧失、经济活动减少以及政府在试图控制新型冠状病毒感染时部分政策实施的优先级变化等，均会扰乱公众的正常生活，引发不安情绪［26］。疫情期间许多地区的精神健康资源供应不足，未能及时满足人们的心理健康需求，从而加剧了这一趋势［27-28］。
新型冠状病毒感染疫情防控期间，我国的抑郁症超额疾病负担及其上升幅度低于其他地区。这一现象发生在特定政策与社会高度协同的背景下，我国所实施的一系列综合性应对措施可能构成了潜在的解释因素：“动态清零”政策在短时间内有效控制了病毒传播，可能降低了人群对感染的普遍恐惧和不确定感［29］。其次，重大疫情发生时的信息混乱可能引发公众广泛的恐慌和焦虑［30-31］。我国统一的官方信息发布可以使公众维持清晰的风险认知，可能有助于减轻信息混乱带来的次级心理压力。在心理援助方面，我国在疫情初期即发布了国家心理危机干预指南，为公众提供在线心理健康教育、心理健康评估和心理咨询等服务，一定程度上缓解了民众的心理压力［30］。同时，政府组织了必要的生活物资配送，基本保证了个人及家庭的正常生活。这些政策和措施为应对此类重大突发公共卫生事件提供了宝贵经验。
3.3　新型冠状病毒感染疫情防控期间抑郁症疾病负担与超额负担的性别差异
在性别层面上，女性群体患抑郁症的疾病负担和超额疾病负担均高于男性群体。一方面，男女性在脑结构和功能方面的区别可能造成了疾病负担的差异［32］；另一方面，女性在青春期、月经期等荷尔蒙变化时期受雌性激素水平波动的影响，出现抑郁的可能性更大。而我国近年来女性抑郁症疾病负担的下降，可能与更多的女性获得了心理健康支持以及社会意识的提高有关［33］。本研究发现经济发展水平与性别抑郁差异相关，高SDI地区有更显著的性别差异。女性在经济发展较高的地区面临更多社会角色期望，同时有更好的抑郁识别与诊断条件可能是造成此种差异的原因［33］。
3.4　本研究的局限性
尽管对新型冠状病毒感染疫情防控期间的抑郁症疾病负担进行了描述，但本研究仍存在着一定的局限性。本研究的结果受到GBD 2021的数据量、数据质量及统计模型的影响［11］。GBD 2021研究依赖于全球不同地区和国家的数据，但一些低收入国家和地区的数据缺乏或质量较低，可能影响分析的准确性。统计模型涉及多种假设，如疾病负担的转移模式、死亡率和发病率等。这些假设在不同人群中可能并不适用，导致结果可能偏离实际情况。此外，本研究旨在为后续研究提供方向，仅报告了国家与地区层面的流行病学趋势，没有对这些趋势背后的具体驱动因素（如特定政策、经济变化或社会事件）进行定量归因分析。
综上所述，本研究基于2021年GBD研究的数据，探究新型冠状病毒感染疫情防控期间我国、全球及各SDI地区抑郁症的疾病负担。我国抑郁症疾病负担虽较全球水平低，但新型冠状病毒感染带来的社会限制和心理压力仍造成了广泛的精神健康影响。我国有效的疫情应对政策和心理援助措施在缓解这一负担方面起到了一定作用。面对此类全球范围内重大突发公共卫生事件，政府应在危机初期，快速、积极地号召与行动以稳定社会情绪，并与媒体合作，提供清晰、一致、基于科学的风险沟通，主动打击谣言，鼓励传播提供正向情绪价值的事迹；同时，应强化基层社区组织的公共卫生和社会服务职能，加强精神卫生知识的宣传，积极预防危险因素，并采取有针对性的干预措施提高全人群对抑郁症的认知水平，加大精神卫生保健资源的投入。

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doi: 10.16016/j.2097-0927.202510063
  • 接收时间：2025-10-22
  • 首发时间：2026-10-23
  • 出版时间：2026-02-28
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  • 收稿日期：2025-10-22
  • 修回日期：2026-01-17
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    1西安交通大学第一附属医院，消化内科，陕西 西安
    2西安交通大学第一附属医院，重症外科，陕西 西安

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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