Full
Outline
To analyze long-term trends in the burden of major depressive disorder(MDD) in China and globally from 1990 to 2023 based on the Global Burden of Disease 2023(GBD 2023), characterize pre- and post-pandemic patterns and demographic drivers, and project future burden trends.
Data were extracted from the GBD 2023 database covering 204 countries/territories. Age-standardized incidence rate(ASIR), age-standardized prevalence rate(ASPR), age-standardized disability-adjusted life year rate(ASDR), and their 95% uncertainty intervals(UI) were calculated. Joinpoint regression analysis was used to estimate average annual percent change(AAPC) with 95% confidence intervals(CI), along with correlations with sociodemographic index(SDI), inequality, and frontier gaps. Das Gupta decomposition was applied to assess demographic contributions. Autoregressive integrated moving average(ARIMA) models were developed based on 1990 to 2018 time-series to forecast trends from 2024 to 2040. Attributable burdens of major modifiable social risk factors were also analyzed.
In 2023, China’s ASIR, ASPR, and ASDR were 3 002.50/100 000, 2 107.50/100 000, and 429.44/100 000, respectively, all lower than the global estimates of 3 464.17/100 000, 2 815.75/100 000, and 567.77/100 000, correspondingly. From 1990 to 2023, all 3 age-standardized rates showed upward trends. In China, AAPC was 1.214%(P<0.05) for ASIR, 0.920%(P<0.05) for ASPR, and 0.947%(P<0.05) for ASDR; globally, corresponding AAPCs were 1.222%(P<0.05), 1.385%(P<0.05), and 1.380%(P<0.05), respectively. Post-pandemic ASPR and ASDR maintained high plateau levels: in 2023, China’s rate increased by 7.5% and 7.4% relative to 2019, while global rates increased by 24.5% and 24.1%, respectively. Age distribution patterns showed that in 2023, China’s crude incidence rate peaked at 3 909.88/100 000(95%UI: 3 009.15 to 4 874.13) in the 15 to 19 years age group, and crude DALY rate also peaked at 584.29/100 000(95%UI: 361.23 to 887.27) in the same age group. Whereas the crude prevalence rate increased with age and peaked at age of ≥95 years at 3 084.41/100 000(2 410.08 to 4 107.62). In 2023, correlations between ASIR/ASPR/ASDR and SDI were weak and not statistically significant(P>0.05). ARIMA projections suggested that by 2040, China’s ASIR, ASPR, and ASDR would reach 3 648.92/100 000, 2 576.16/100 000, and 536.31/100 000, respectively. In 2023, attributable proportions of DALYs(China/global) were 8.70%/8.32% for intimate partner violence, 8.24%/6.82% for bullying victimization, and 7.48%/8.20% for childhood sexual abuse. Sex-stratified analyses consistently showed higher burdens in females than in males.
From 1990 to 2023, the burden of MDD in China and globally continued to rise. The COVID-19 pandemic produced an additional surge, with accumulated burden maintaining high levels post-pandemic. Age patterns indicate coexistence of “high incidence and high health loss in adolescence” and “accumulation of absolute burden in middle-aged and older adults.” Projections based on pre-pandemic trends suggest that China’s future burden may continue to increase. Countermeasures While improving service accessibility, we recommend advancing screening and stratified interventions to priority populations, especially adolescents and females, and integrating social risk governance measures, such as anti-domestic violence, anti-bullying, and child protection, into a comprehensive MDD prevention and control system.
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| 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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