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Effective response: China’s performance and sex-and region-based disparities amid global increase in depressive disorder burden during the COVID-19
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Yuanzhi ZHOU1, Ziquan YUAN1, Jiaxin MA1, Wenwen CHEN2, Xu ZHANG1, Dan GUO1, Shuixiang HE1, Yarui LI1
Journal of Army Medical University | 2026, 48(4) : 504 - 513
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Journal of Army Medical University | 2026, 48(4): 504-513
• Think Tank for Public Health •
Effective response: China’s performance and sex-and region-based disparities amid global increase in depressive disorder burden during the COVID-19
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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
Published: 2026-02-28 doi: 10.16016/j.2097-0927.202510063
Outline
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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
Year 2026 volume 48 Issue 4
107
35
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Article Info
doi: 10.16016/j.2097-0927.202510063
  • Receive Date:2025-10-22
  • Online Date:2026-10-23
  • Published:2026-02-28
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History
  • Received:2025-10-22
  • Revised:2026-01-17
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
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表12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
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Genus
种数
Number of
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Percentage of total
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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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