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Article(id=1241022951445811804, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410362, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729612800000, receivedDateStr=2024-10-23, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812528715, onlineDateStr=2026-03-18, pubDate=1742832000000, pubDateStr=2025-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812528715, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812528715, creator=13701087609, updateTime=1773812528715, updator=13701087609, issue=Issue{id=1241022939957621542, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812525976, creator=13701087609, updateTime=1773815469296, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241035285174219432, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241035285174219433, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1063, endPage=1068, ext={EN=ArticleExt(id=1241022951806521985, articleId=1241022951445811804, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Disease burden and trend of anxiety disorders in adolescents aged 10-24 in China, 1990-2021, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the disease burden and trend of anxiety disorders in adolescents aged 10-24 in China from 1990 to 2021.

Methods

Based on the 2021 global burden of disease (GBD) database, the incidence, prevalence, and disability-adjusted life years (DALYs) rate of anxiety disorders in adolescents aged 10-24, along with their corresponding standardized rates, were extracted as indicators of disease burden. With 1990 as the baseline, the overall and gender- and age-specific changes in these indicators in 2021 were analyzed. Joinpoint regression analysis was used to dynamically analyze the changes in these three disease burden indicators from 1990 to 2021. The grey prediction model GM(1,1) was employed to estimate the disease burden trend of anxiety disorders in adolescents over the next decade.

Results

In 2021, incident case number, prevalent case number, and DALYs of anxiety disorders in adolescents were 1 637 600, 10 267 500, and 12 793 000, respectively, which decreased by 30.51%, 33.91%, and 33.59%, as compared with 1990; however, the standardized incidence, standardized prevalence, and standardized DALYs rate of anxiety disorders in adolescents were 451.49/100 000, 3 481.74/100 000, and 418.95/100 000, respectively, which represented an increase of 2.29%, 2.03%, and 2.37%, as compared to 1990; there are differences in the disease burden for anxiety disorders between genders, which were manifested that girls are more likely to suffer from anxiety disorders than boys; and the standardized incidence of anxiety disorders among adolescents between the ages of 10-14 years was higher, while the standardized prevalence and the standardized DALYs rate among them between the ages of 15-19 years were higher. The Joinpoint regression model showed that the standardized incidence, standardized prevalence, and standardized DALYs rate of anxiety disorders in adolescents aged 10-24 increased from 1990 to 2021, with a larger increase from 2019 to 2021. The grey prediction model indicated that by 2031, the standardized incidence, standardized prevalence, and standardized DALYs rate would reach 559.44/100 000, 3 597.01/100 000, and 430.65/100 000, respectively.

Conclusion

The disease burden of anxiety disorders in adolescents aged 10-24 years is concerning, and interventions for anxiety disorders should be performedinadolescents of different genders and ages.

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目的

分析1990—2021年中国10~24岁青少年焦虑症疾病负担及变化趋势。

方法

基于2021年全球疾病负担(Global Burden of Bisease, GBD)数据库，选取10~24岁青少年焦虑症发病率、患病率及伤残调整寿命年率（disability-adjusted life years, DALYs）及相应的标化率作为疾病负担指标，以1990年为基准，分析2021年各指标总体及不同性别、年龄变化情况；利用Joinpoint回归分析1990—2021年疾病负担三个指标的动态变化；通过灰色预测模型GM(1,1)估测青少年焦虑症未来十年的疾病负担趋势。

结果

2021年发病人数、患病人数、DALYs分别为163.76万人、1 026.75万人、1 279.30万人年，相比1990年分别下降了30.51%、33.91%和33.59%；但青少年焦虑症的标化发病率、标化患病率、标化DALYs率分别为451.49/10万、3 481.74/10万、418.95/10万，相比1990年分别增长了2.29%、2.03%和2.37%；性别间焦虑症疾病负担存在差异，表现为女孩高于男孩；10~14岁青少年焦虑症标化发病率较高，15~19岁标化患病率和标化DALYs率较高。Joinpoint回归模型显示，1990—2021年10~24岁青少年焦虑症标化发病率、标化患病率和标化DALYs率呈现增长趋势，其中2019—2021年增幅较大。灰色预测模型显示，到2031年青少年焦虑症标化发病率、标化患病率、标化DALYs率分别达到559.44/10万、3 597.01/10万和430.65/10万。

结论

10~24岁青少年焦虑症疾病负担不容乐观，应针对不同性别和年龄组的青少年制定焦虑症干预措施。

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秦浩，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=W7Fbi67w9NeKc83gACIxsg==, magXml=sBaRn81KFwLvEx6gIFqZow==, pdfUrl=null, pdf=pjzJv6kOqIe3PyLBljV8jA==, pdfFileSize=643272, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=YobsVBnX/sMjyKoZ0tJsjw==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=HbnsdsNpmDVpgJe5ufGwYg==, mapNumber=null, authorCompany=null, fund=null, authors=

张诗婷（1999—），女，硕士在读，研究方向：公共卫生

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张诗婷（1999—），女，硕士在读，研究方向：公共卫生

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(In Chinese), articleTitle=Status quo of cyberbullying among children and adolescents and its correlation with anxiety and depressive symptoms, refAbstract=null)], funds=[Fund(id=1241022960522285206, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, awardId=C-YX20190201-09, language=CN, fundingSource=全国医学专业学位研究生教育指导委员会研究课题(C-YX20190201-09), fundOrder=null, country=null), Fund(id=1241022960614559903, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, awardId=SDYKC20152, language=CN, fundingSource=山东省研究生教育优质课程(SDYKC20152), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241022953538769700, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, xref=1．, ext=[AuthorCompanyExt(id=1241022953547158309, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, companyId=1241022953538769700, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China), AuthorCompanyExt(id=1241022953555546919, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, companyId=1241022953538769700, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1．山东第二医科大学公共卫生学院，山东　潍坊　261053)]), AuthorCompany(id=1241022953660404529, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, xref=2．, ext=[AuthorCompanyExt(id=1241022953672987443, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, companyId=1241022953660404529, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2．“健康山东”重大社会风险预测与治理协同创新中心)])], figs=[ArticleFig(id=1241022958135726151, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=EN, label=Fig.1, caption=Predicting values for the standardized incidence, standardized prevalence and standardized DALYs rate of anxiety disorders in 10~24 years old adolescents in China from 2022 to 2031, figureFileSmall=1hrUm5v2hXRLdxFNvNPpOA==, figureFileBig=YobsVBnX/sMjyKoZ0tJsjw==, tableContent=null), ArticleFig(id=1241022958248972367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=CN, label=图1, caption=2022—2031年中国10~24岁青少年焦虑症标化发病率、标化患病率和标化DALYs率预测趋势, figureFileSmall=1hrUm5v2hXRLdxFNvNPpOA==, figureFileBig=YobsVBnX/sMjyKoZ0tJsjw==, tableContent=null), ArticleFig(id=1241022958446104672, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=EN, label=Table 1, caption=

Disease burden of anxiety disorders among adolescents aged 10~24 years old in China in 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
指标男孩女孩总计
1990年2021年变化率(%)1990年2021年变化率(%)1990年2021年变化率(%)
发病数(万人)946.64689.46-27.171 409.88948.12-32.75235.65163.76-30.51
发病率(1/10万)510.75551.828.04802.83869.078.25652.85699.707.18
标化发病率(1/10万)441.40451.492.29634.43652.532.85533.99546.512.34
患病数(万人)6 173.684 236.67-31.389 362.946 030.87-35.591 553.661 026.75-33.91
患病率(1/10万)3 330.923 390.881.805 331.555 528.013.684 304.274 387.101.92
标化患病率(1/10万)2 600.622 632.791.244 255.554 380.912.953 412.303 481.742.03
DALYs(万人年)768.51529.37-31.12115.7774.99-35.231 926.171 279.26-33.59
DALYs率(1/10万)414.64423.692.18659.20687.364.27533.64546.602.43
标化DALYs率(1/10万)314.48318.791.37508.11525.583.44409.26418.952.37
), ArticleFig(id=1241022958538379367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=CN, label=表1, caption=

1990年和2021年中国10~24岁青少年焦虑症疾病负担情况

, figureFileSmall=null, figureFileBig=null, tableContent=
指标男孩女孩总计
1990年2021年变化率(%)1990年2021年变化率(%)1990年2021年变化率(%)
发病数(万人)946.64689.46-27.171 409.88948.12-32.75235.65163.76-30.51
发病率(1/10万)510.75551.828.04802.83869.078.25652.85699.707.18
标化发病率(1/10万)441.40451.492.29634.43652.532.85533.99546.512.34
患病数(万人)6 173.684 236.67-31.389 362.946 030.87-35.591 553.661 026.75-33.91
患病率(1/10万)3 330.923 390.881.805 331.555 528.013.684 304.274 387.101.92
标化患病率(1/10万)2 600.622 632.791.244 255.554 380.912.953 412.303 481.742.03
DALYs(万人年)768.51529.37-31.12115.7774.99-35.231 926.171 279.26-33.59
DALYs率(1/10万)414.64423.692.18659.20687.364.27533.64546.602.43
标化DALYs率(1/10万)314.48318.791.37508.11525.583.44409.26418.952.37
), ArticleFig(id=1241022958601293935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=EN, label=Table 2, caption=

Changes in the disease burden rates of anxiety disorders among different gender and age in China in 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组项目标化发病率(1/10万)标化患病率(1/10万)标化DALYs率(1/10万)
男孩女孩总计男孩女孩总计男孩女孩总计
10~14岁1990年703.67105.17872.083 197.895 027.524 083.14399.20627.88509.85
2021年730.35110.27904.013 312.705 279.874 230.19416.09662.55531.04
变化率(%)3.794.853.663.595.023.604.235.524.16
15~19岁1990年485.79767.14622.693 645.235 770.684 679.45454.90715.10581.51
2021年501.54802.16640.793 730.946 071.004 814.89465.97754.07599.42
变化率(%)3.244.572.912.355.202.892.435.453.08
20~24岁1990年383.91645.91511.903 132.215 145.194 115.62387.93629.82506.10
2021年392.41662.16519.163 132.715 271.344 135.37389.07649.18511.02
变化率(%)2.212.521.420.022.450.480.293.070.97
), ArticleFig(id=1241022958718734456, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=CN, label=表2, caption=

1990年和2021年中国不同性别及不同年龄组焦虑症疾病负担率的变化情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组项目标化发病率(1/10万)标化患病率(1/10万)标化DALYs率(1/10万)
男孩女孩总计男孩女孩总计男孩女孩总计
10~14岁1990年703.67105.17872.083 197.895 027.524 083.14399.20627.88509.85
2021年730.35110.27904.013 312.705 279.874 230.19416.09662.55531.04
变化率(%)3.794.853.663.595.023.604.235.524.16
15~19岁1990年485.79767.14622.693 645.235 770.684 679.45454.90715.10581.51
2021年501.54802.16640.793 730.946 071.004 814.89465.97754.07599.42
变化率(%)3.244.572.912.355.202.892.435.453.08
20~24岁1990年383.91645.91511.903 132.215 145.194 115.62387.93629.82506.10
2021年392.41662.16519.163 132.715 271.344 135.37389.07649.18511.02
变化率(%)2.212.521.420.022.450.480.293.070.97
), ArticleFig(id=1241022960224489603, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=EN, label=Table 3, caption=

Trend analysis of disease burden of anxiety disorders among different gender in adolescents aged 10~24 years old in China from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
趋势标化发病率标化患病率标化DALYs率
年份（年）APC(95% CI)年份（年）APC(95% CI)年份（年）APC(95% CI)
男孩
趋势11990—1995-0.31(-0.86~0.24)1990—1995-0.11(-0.80~-0.58)1990—1995-0.07(-0.72~0.59)
趋势21995—20001.63a(0.87~2.40)1995—20002.00a(1.02~2.99)1995—20002.01a(1.08~2.95)
趋势32000—2004-1.80a(-2.93~-0.66)2000—2004-2.40a(-3.83~-0.94)2000—2004-2.34a(-3.74~-0.92)
趋势42004—2019-0.44a(-0.54~-0.33)2004—2019-0.82a(-0.96~-0.68)2004—2019-0.80a(-0.94~-0.67)
趋势52019—20214.36a(1.72~7.07)2019—20217.17a(3.64~10.81)2019—20216.98a(3.95~10.11)
AAPC1990—20210.04a(-0.22~0.30)1990—20210.04a(-0.29~0.37)1990—20210.05(-0.25~0.36)
女孩
趋势11990—20000.12a(0.08~0.16)1990—2000-0.08a(-0.10~-0.06)1990—2000-0.05a(-0.07~-0.03)
趋势22000—2005-1.60a(-1.74~-1.46)2000—2005-1.78a(-1.86~-1.71)2000—2005-1.76a(-1.83~-1.69)
趋势32005—20100.63a(0.49~0.77)2005—20100.56a(0.48~0.63)2005—20100.55a(0.48~0.62)
趋势42010—2015-0.53a(-0.67~-0.38)2010—2015-0.49a(-0.56~-0.41)2010—2015-0.47a(-0.54~-0.41)
趋势52015—20190.48a(0.25~0.72)2015—20190.40a(0.28~0.52)2015—20190.31a(0.20~0.42)
趋势62019—20213.08a(2.53~3.63)2019—20214.13a(3.83~4.42)2019—20214.15a(3.93~4.38)
AAPC1990—20210.05a(-0.01~0.11)1990—20210.02a(-0.02~0.04)1990—20210.02a(-0.01~0.04)
总计
趋势11990—1995-0.15a(-0.20~-0.10)1990—20010.50a(0.29~0.72)1990—1995-0.03(-0.10~0.04)
趋势21995—20001.01a(0.94~1.08)2001—2004-2.51(-5.45~0.53)1995—20001.19a(1.09~1.28)
趋势32000—2005-1.69a(-1.75~-1.62)2004—2019-0.52a(-0.66~-0.38)2000—2005-2.02a(-2.12~-1.93)
趋势42005—20100.29a(0.22~0.35)2019—20216.10a(2.53~9.79)2005—20100.02(-0.07~0.12)
趋势52010—2015-0.82a(-0.89~-0.76)-2010—2015-1.29a(-1.44~-1.14)
趋势62015—20190.27a(0.16~0.37)-2015—2019-0.03(-0.13~0.07)
趋势72019—20213.50a(3.25~3.75)-2019—20215.40a(5.07~5.72)
AAPC1990—20210.03a(0.01~0.06)1990—20210.06a(-0.30~0.43)1990—20210.07a(-0.27~0.42)
), ArticleFig(id=1241022960354513033, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022951445811804, language=CN, label=表3, caption=

1990—2021年中国10~24岁青少年不同性别组焦虑症疾病负担趋势分析

, figureFileSmall=null, figureFileBig=null, tableContent=
趋势标化发病率标化患病率标化DALYs率
年份（年）APC(95% CI)年份（年）APC(95% CI)年份（年）APC(95% CI)
男孩
趋势11990—1995-0.31(-0.86~0.24)1990—1995-0.11(-0.80~-0.58)1990—1995-0.07(-0.72~0.59)
趋势21995—20001.63a(0.87~2.40)1995—20002.00a(1.02~2.99)1995—20002.01a(1.08~2.95)
趋势32000—2004-1.80a(-2.93~-0.66)2000—2004-2.40a(-3.83~-0.94)2000—2004-2.34a(-3.74~-0.92)
趋势42004—2019-0.44a(-0.54~-0.33)2004—2019-0.82a(-0.96~-0.68)2004—2019-0.80a(-0.94~-0.67)
趋势52019—20214.36a(1.72~7.07)2019—20217.17a(3.64~10.81)2019—20216.98a(3.95~10.11)
AAPC1990—20210.04a(-0.22~0.30)1990—20210.04a(-0.29~0.37)1990—20210.05(-0.25~0.36)
女孩
趋势11990—20000.12a(0.08~0.16)1990—2000-0.08a(-0.10~-0.06)1990—2000-0.05a(-0.07~-0.03)
趋势22000—2005-1.60a(-1.74~-1.46)2000—2005-1.78a(-1.86~-1.71)2000—2005-1.76a(-1.83~-1.69)
趋势32005—20100.63a(0.49~0.77)2005—20100.56a(0.48~0.63)2005—20100.55a(0.48~0.62)
趋势42010—2015-0.53a(-0.67~-0.38)2010—2015-0.49a(-0.56~-0.41)2010—2015-0.47a(-0.54~-0.41)
趋势52015—20190.48a(0.25~0.72)2015—20190.40a(0.28~0.52)2015—20190.31a(0.20~0.42)
趋势62019—20213.08a(2.53~3.63)2019—20214.13a(3.83~4.42)2019—20214.15a(3.93~4.38)
AAPC1990—20210.05a(-0.01~0.11)1990—20210.02a(-0.02~0.04)1990—20210.02a(-0.01~0.04)
总计
趋势11990—1995-0.15a(-0.20~-0.10)1990—20010.50a(0.29~0.72)1990—1995-0.03(-0.10~0.04)
趋势21995—20001.01a(0.94~1.08)2001—2004-2.51(-5.45~0.53)1995—20001.19a(1.09~1.28)
趋势32000—2005-1.69a(-1.75~-1.62)2004—2019-0.52a(-0.66~-0.38)2000—2005-2.02a(-2.12~-1.93)
趋势42005—20100.29a(0.22~0.35)2019—20216.10a(2.53~9.79)2005—20100.02(-0.07~0.12)
趋势52010—2015-0.82a(-0.89~-0.76)-2010—2015-1.29a(-1.44~-1.14)
趋势62015—20190.27a(0.16~0.37)-2015—2019-0.03(-0.13~0.07)
趋势72019—20213.50a(3.25~3.75)-2019—20215.40a(5.07~5.72)
AAPC1990—20210.03a(0.01~0.06)1990—20210.06a(-0.30~0.43)1990—20210.07a(-0.27~0.42)
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1990—2021年中国10~24岁青少年焦虑症疾病负担及变化趋势分析
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张诗婷 1, 2 , 黄霞 1, 2 , 刘春莹 1, 2 , 康睿欣 1, 2 , 秦浩 1, 2
现代预防医学 | 儿少卫生与妇幼保健 2025,52(6): 1063-1068
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(6): 1063-1068
1990—2021年中国10~24岁青少年焦虑症疾病负担及变化趋势分析
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张诗婷1, 2, 黄霞1, 2, 刘春莹1, 2, 康睿欣1, 2, 秦浩1, 2
作者信息
  • 1．山东第二医科大学公共卫生学院，山东　潍坊　261053
  • 2．“健康山东”重大社会风险预测与治理协同创新中心

    • 张诗婷（1999—），女，硕士在读，研究方向：公共卫生

通讯作者:

秦浩，E-mail：
Disease burden and trend of anxiety disorders in adolescents aged 10-24 in China, 1990-2021
Shi-ting ZHANG1, 2, Xia HUANG1, 2, Chun-ying LIU1, 2, Rui-xin KANG1, 2, Hao QIN1, 2
Affiliations
  • School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2025-03-25 doi: 10.20043/j.cnki.MPM.202410362
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摘要
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目的

分析1990—2021年中国10~24岁青少年焦虑症疾病负担及变化趋势。

方法

基于2021年全球疾病负担(Global Burden of Bisease, GBD)数据库，选取10~24岁青少年焦虑症发病率、患病率及伤残调整寿命年率（disability-adjusted life years, DALYs）及相应的标化率作为疾病负担指标，以1990年为基准，分析2021年各指标总体及不同性别、年龄变化情况；利用Joinpoint回归分析1990—2021年疾病负担三个指标的动态变化；通过灰色预测模型GM(1,1)估测青少年焦虑症未来十年的疾病负担趋势。

结果

2021年发病人数、患病人数、DALYs分别为163.76万人、1 026.75万人、1 279.30万人年，相比1990年分别下降了30.51%、33.91%和33.59%；但青少年焦虑症的标化发病率、标化患病率、标化DALYs率分别为451.49/10万、3 481.74/10万、418.95/10万，相比1990年分别增长了2.29%、2.03%和2.37%；性别间焦虑症疾病负担存在差异，表现为女孩高于男孩；10~14岁青少年焦虑症标化发病率较高，15~19岁标化患病率和标化DALYs率较高。Joinpoint回归模型显示，1990—2021年10~24岁青少年焦虑症标化发病率、标化患病率和标化DALYs率呈现增长趋势，其中2019—2021年增幅较大。灰色预测模型显示，到2031年青少年焦虑症标化发病率、标化患病率、标化DALYs率分别达到559.44/10万、3 597.01/10万和430.65/10万。

结论

10~24岁青少年焦虑症疾病负担不容乐观，应针对不同性别和年龄组的青少年制定焦虑症干预措施。

焦虑症  /  青少年  /  疾病负担  /  变化趋势
Objective

To analyze the disease burden and trend of anxiety disorders in adolescents aged 10-24 in China from 1990 to 2021.

Methods

Based on the 2021 global burden of disease (GBD) database, the incidence, prevalence, and disability-adjusted life years (DALYs) rate of anxiety disorders in adolescents aged 10-24, along with their corresponding standardized rates, were extracted as indicators of disease burden. With 1990 as the baseline, the overall and gender- and age-specific changes in these indicators in 2021 were analyzed. Joinpoint regression analysis was used to dynamically analyze the changes in these three disease burden indicators from 1990 to 2021. The grey prediction model GM(1,1) was employed to estimate the disease burden trend of anxiety disorders in adolescents over the next decade.

Results

In 2021, incident case number, prevalent case number, and DALYs of anxiety disorders in adolescents were 1 637 600, 10 267 500, and 12 793 000, respectively, which decreased by 30.51%, 33.91%, and 33.59%, as compared with 1990; however, the standardized incidence, standardized prevalence, and standardized DALYs rate of anxiety disorders in adolescents were 451.49/100 000, 3 481.74/100 000, and 418.95/100 000, respectively, which represented an increase of 2.29%, 2.03%, and 2.37%, as compared to 1990; there are differences in the disease burden for anxiety disorders between genders, which were manifested that girls are more likely to suffer from anxiety disorders than boys; and the standardized incidence of anxiety disorders among adolescents between the ages of 10-14 years was higher, while the standardized prevalence and the standardized DALYs rate among them between the ages of 15-19 years were higher. The Joinpoint regression model showed that the standardized incidence, standardized prevalence, and standardized DALYs rate of anxiety disorders in adolescents aged 10-24 increased from 1990 to 2021, with a larger increase from 2019 to 2021. The grey prediction model indicated that by 2031, the standardized incidence, standardized prevalence, and standardized DALYs rate would reach 559.44/100 000, 3 597.01/100 000, and 430.65/100 000, respectively.

Conclusion

The disease burden of anxiety disorders in adolescents aged 10-24 years is concerning, and interventions for anxiety disorders should be performedinadolescents of different genders and ages.

Anxiety disorders  /  Adolescents  /  Burden of disease  /  Variation tendency
张诗婷, 黄霞, 刘春莹, 康睿欣, 秦浩. 1990—2021年中国10~24岁青少年焦虑症疾病负担及变化趋势分析. 现代预防医学, 2025 , 52 (6) : 1063 -1068 . DOI: 10.20043/j.cnki.MPM.202410362
Shi-ting ZHANG, Xia HUANG, Chun-ying LIU, Rui-xin KANG, Hao QIN. Disease burden and trend of anxiety disorders in adolescents aged 10-24 in China, 1990-2021[J]. Modern Preventive Medicine, 2025 , 52 (6) : 1063 -1068 . DOI: 10.20043/j.cnki.MPM.202410362
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焦虑症是一种以持续性担忧、过度紧张和恐惧为主要特征的精神障碍，除影响患者的情绪稳定性和社交功能外[1]，还会引发一系列身体症状，如心悸、肌肉紧张和睡眠障碍等[2]。2019年，全球大约有3.01亿人患有焦虑症，且女性患者比例高于男性，症状常于儿童期或青春期出现，遗憾的是当前只有约27.60%的患者接受治疗[3]。《中国国民心理健康发展报告：2021—2022》指出，我国儿童青少年精神障碍流行率为17.50%，其中焦虑症患病率为4.70%[4]。青少年期是个体发展中极为敏感的时期，焦虑症的发生不仅影响学业表现，还可能对社交能力、职业发展和整体幸福感造成长期影响[5]。为了全面展现我国10~24岁青少年焦虑症的增幅及动态变化，本研究基于全球疾病负担(Global Burden of Disease, GBD)2021年数据库，从整体增幅、动态变化及未来预测三个维度，深入分析该年龄段青少年焦虑症的疾病负担及变化趋势，旨在为政策制定者提供科学依据。
1　资料与方法
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1.1　数据来源
基于GBD 2021年数据库，依据《国际疾病分类第十版》（ICD-10）提取1990—2021年中国10~24岁青少年焦虑症疾病负担指标数据，其中纳入焦虑症的编码为F93.0-93.2、F93.8、F43.1、F43.0、F40-42和DSM-IV-TR：208.3、300.0-300.3、309.21、309.81；疾病负担指标包括发病数/率、患病数/率及伤残调整寿命年（disability-adjusted life years, DALYs）数/率及相应的标化率（以世界卫生组织标准人口计算）[6]。在指标变化方面，整体增幅设定为：变化率=[（2021年值-1990年值）/1990年值]×100%；年龄段划分为：10~14岁组、15~19岁组和20~24岁组。
1.2　统计学分析
采用Excel 2019对GBD数据库进行整理与分析。运用Joinpoint 5.2.0软件进行回归分析1990年至2021年我国10~24岁青少年焦虑症疾病负担的变化情况，使用线性模型估算的年度百分比（annual percent change, APC）和平均年度百分比（average annual percentage, AAPC）及其95%可信区间（confidence internal, CI）分别呈现青少年焦虑症疾病负担指标的年平均变化趋势和时间变化趋势。当APC和AAPC的取值小于0，表明出现下降趋势，相反，两项取值大于0表明出现上升趋势；检验水准α=0.05。另外，以1990—2021年10~24岁儿童青少年焦虑症的疾病负担数据为基础，利用灰色预测模型GM(1,1)预测青少年焦虑症未来十年疾病负担趋势，其中灰色模型GM(1,1)应用前需计算数列的级比，即(k)=x0(k)/x0(k-1)，其中k=2,3,…,n，当所有级比均位于可接受范围X=(e-2,e)时，表明该数据适用于该模型。
2　结果
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2.1　1990—2021年中国10~24岁青少年焦虑症疾病负担变化情况
与1990年相比，2021年我国10~24岁青少年焦虑症发病数、患病数和DALYs虽呈现下降趋势，但发病率、患病率和DALYs率及对应的标化率有所上升。具体表现如下：2021年与1990年相比青少年焦虑症的发病数（163.76万人 vs. 235.65万人）、患病数（1 026.7万人 vs. 1 553.66万人）、DALYs（1 279.26万人年 vs. 1 926.17万人年）分别降低30.51%、33.91%、33.59%；2021年与1990年相比青少年焦虑症的标化发病率（546.51/10万 vs. 533.99/10万），标化患病率（3 481.74/10万 vs. 3 412.30/10万），标化DALYs率（418.95/10万 vs. 409.26/10万）分别上升2.29%、2.03%和2.37%，见表1。1990—2021年我国10~24岁青少年焦虑症标化发病率、标化患病率和标化DALYs率总体上均呈现先上升后下降再上升的趋势。因此，我国10~24岁青少年的焦虑症疾病负担仍不容忽视。
2.2　2021年与1990年相比中国10~24岁不同性别及年龄组青少年焦虑症疾病负担状况
2021年我国青少年焦虑症的标化发病率、标化患病率和标化DALYs率均高于1990年，且女孩焦虑症疾病负担较男孩更严重。具体体现如下：与1990年相比，2021年男孩焦虑症的发病数、患病数、DALYs分别降低了27.17%、31.38%、31.12%，均低于女孩（32.75%、35.59%、35.23%）；男孩的标化发病率、标化患病率和标化DALYs率分别上升了2.29%、1.24%、1.37%，均低于女孩（8.25%、3.68%、4.27%），见表1。男孩的标化发病率、标化患病率和标化DALYs率AAPC分别为0.04%、0.04%、0.05%（t值分别为0.30、0.21、0.32）；女孩的AAPC分别为0.05%、0.02%、0.02%（t值分别为1.82、0.43、0.96），P均<0.05。
与1990年相比，2021年我国10~14岁焦虑症标化发病率、标化患病率和标化DALYs率呈上升趋势，而15~19岁和20~24岁三个指标呈略下降趋势。1990—2021年10~14岁青少年焦虑症标化发病率、标化患病率与标化DALYs率的AAPC分别为0.10%、0.12%、0.14%（t值分别为0.58、0.71、0.84，）；15~19岁分别为-0.02%、-0.06%、-0.05%（t值分别为-0.70、-0.42、-0.37）；20~24岁分别为-0.07%、-0.09%、-0.07%（t值分别为-0.77、-1.59、-1.21），（P均<0.05）。2021年，10~14岁标化发病率为904.01/10万，15~19岁640.79/10万，20~24岁519.16/10万，10~14岁组高于其他年龄组；15~19岁标化患病率为4 814.89/10万，10~14岁4 230.19/10万，20~24岁4 135.37/10万；15~19岁标化DALYs率为599.42/10万，10~14岁531.04/10万，20~24岁511.02/10万，15~19岁标化患病率和标化DALYs率均高于其它年龄组，见表2。
2.3　1990—2021年中国10~24岁青少年焦虑症疾病负担的Joinpoint分析
利用Joinpoint回归模型对1990—2021年我国10~24岁青少年焦虑症疾病负担的变化趋势进行分析。结果显示，这期间我国10~24岁青少年焦虑症标化发病率、标化患病率和标化DALYs率总体呈波动上升趋势，全人群的标化发病率在1990—1995、2000—2005和2010—2015年呈下降趋势，平均每年分别降低0.15%、1.69%和0.82%；在1995—2000、2005—2010、2015—2019和2019—2021年呈上升趋势，平均每年分别上升1.01%、0.29%、0.27%和3.50%，P<0.05；标化DALYs率的变化趋势与标化发病率相似；标化患病率在1990—2001年呈现连续上升，平均每年上升0.50%，随后在2001—2004和2004—2019年又分别以2.51%和0.52%的速度降低，后在2019—2021年以6.10%的速度上升。Joinpoint性别分析结果显示，男孩焦虑症的标化发病率、标化患病率和标化DALYs率均在1995年后开始上升，到2000年开始下降，又在2019年开始大幅上升；而女孩的标化发病率、标化DALYs率和标化患病率于2005年开始上升，到2010年开始下降，2015年再次呈上升趋势，2019—2021年间上升幅度较大，见表3。
2.4　2022—2031年中国10~24岁青少年焦虑症模型构建与预测
利用灰色预测模型GM(1,1)估测2022—2031年我国10~24岁青少年焦虑症的疾病负担趋势。经检验，标化发病率、标化患病率和标化DALYs率的原始数据序列的比值均落在0.938至1.067的范围内，表明这些数据适合用于模型构建。进一步分析显示，这些比率的后验差比值C分别为0.162、0.163和0.167（C均<0.35），说明模型精度优秀。此外，标化发病率（1.54%）、标化患病率（2.18%）和标化DALYs率（2.15%）的平均相对误差表明其模型的拟合效果良好。预测结果显示，到2031年，我国10~24岁青少年焦虑症的标化发病率、标化患病率和标化DALYs率总体呈上升趋势。具体来说，到2031年这些指标将分别升至559.44/10万、3 597.01/10万和430.65/10万。我国10~24岁青少年焦虑症疾病负担的标化发病率、标化患病率、标化DALYs率预测趋势见图1。
3　讨论与建议
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本研究基于GBD 2021数据库，旨在系统分析1990—2021年中国10~24岁青少年焦虑症的疾病负担情况，并按性别和年龄对近三十年的青少年焦虑症的变化趋势进行动态分析，同时预测其在2022—2031年的发展趋势，为我国青少年焦虑症的防控提供借鉴。研究结果显示，青少年焦虑症标化发病率、标化患病率和标化DALYs率呈现出波动增长的趋势，这一趋势可能与社会心理因素如学业压力、家庭环境变化等有关[7]。Joinpoint回归结果显示上述三指标均在2019年开始大幅上升，可能原因是COVID-19大流行期间，实施的居家隔离等措施增加了青少年的心理压力，促使焦虑症的发生，其中女性和青春早期青少年所受影响相对更为严重[8]。结合动态变化和预测分析可见，我国整体面临的焦虑症疾病负担情况不容乐观，可能对我国社会经济发展、公共卫生体系以及国民心理健康产生深远影响[9]。这提示我们近年来卫生和教育等相关部门对青少年心理健康教育的重视程度有待提高，实际心理健康工作中仍存在诸多问题亟待完善[10]，例如，缺乏专业的心理健康教育师资队伍，心理健康课程往往形式大于内容等，无法真正满足青少年的心理需求[11]。
从年龄分层分析来看，10~14岁年龄段的青少年焦虑症发病率相对较高，与江笑寒等人研究中国居民焦虑症疾病负担中关于青少年发病率的研究结果一致[12]。这主要与青春期的到来紧密相关。青春期是一个开始追求独立、渴望获得社会影响力的阶段，他们开始探索自我身份，寻求自我价值的确认[13]，但与此同时，不适宜的家庭教育方式、学业压力和社交困境等因素的交织影响，使得这一年龄段的青少年更加容易出现心理问题[14]。当这些问题在10~14岁年龄段未能得到有效识别和解决时，便可能在15~19岁年龄段形成累积效应，导致患病率和DALYs率达到峰值。因此，早期识别和干预青少年的心理健康问题尤为重要，特别是10~14岁这一关键时期的心理辅导，可以帮助青少年建立自信，学习焦虑应对策略，提高解决问题的能力[15]，对于预防焦虑症的发生发展具有重要意义。
从性别层面来看，女孩各项指标上的变化率明显高于男孩，且变化幅度更大。如2021年女孩标化患病率是男孩的1.66倍，该结果与王志勇、Vasiliadis等人关于焦虑症性别差异的研究结论一致[16-17]。其主要原因为生理、心理和社会因素的综合作用：生理上，女孩的杏仁核对负性情绪刺激更敏感[18]，相关脑区功能紊乱可能影响其对情绪和身体感觉的整合与调节，从而增加焦虑症的风险。心理上，女孩在情绪表达和处理上与男孩有所不同，在面对日常琐事或潜在问题时，女孩更容易反复自我反省和担忧，导致问题被放大，进而加剧焦虑感。社会因素上，尽管社会文化倡导男女平等，但女孩在情绪表达方面仍可能受限，传统观念可能使其在面对压力时更加内敛，不善于直接表达情绪[19]。此外，社交媒体充斥着各种经过美化的图片和信息，女孩更容易受到外貌、身材等形象压力的困扰，从而产生自卑感和焦虑感[20]。
灰色模型预测结果显示，未来十年10~24岁青少年焦虑症的标化发病率、标化患病率和标化DALYs率总体呈平缓增长趋势，焦虑症疾病负担仍在加重。结合目前我国性别间及年龄间青少年焦虑症疾病负担的差异性，即发病的重点关注对象应为10~14岁青少年，患病则重点关注15~19岁群体，尤其是女孩。由此，建议有关部门针对不同年龄组的青少年制定预防和干预措施，开展性别差异化的心理健康教育。同时，政府应进一步鼓励教育部门积极开展针对青少年的心理健康教育普及工作，定期开展心理健康筛查，及早发现潜在的焦虑症等心理问题；积极开展家长培训，提高其对青少年焦虑症的认识和应对能力；建立卫生、教育、社区等多部门合作机制，共同推进青少年焦虑症的防治工作。
本研究基于GBD 2021数据库，聚焦1990—2021年中国10~24岁青少年这一特定群体，分析了不同性别和年龄组焦虑症的疾病负担动态变化情况，并对未来十年变化趋势进行了预测，为青少年焦虑症的干预策略和心理健康资源的配置规划提供参考。本研究的局限性在于，GBD数据库内未涵盖地区差异、未对焦虑症的不同类别进行细分，未来可进一步细化焦虑症分类并纳入地域差异因素，以更全面地揭示中国青少年焦虑症的疾病负担情况，为制定更具针对性的焦虑症防治策略提供有力支持。
基金
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  • 全国医学专业学位研究生教育指导委员会研究课题(C-YX20190201-09)
  • 山东省研究生教育优质课程(SDYKC20152)
文献
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2025年第52卷第6期
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doi: 10.20043/j.cnki.MPM.202410362
  • 接收时间：2024-10-23
  • 首发时间：2026-03-18
  • 出版时间：2025-03-25
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  • 收稿日期：2024-10-23
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全国医学专业学位研究生教育指导委员会研究课题(C-YX20190201-09)
山东省研究生教育优质课程(SDYKC20152)
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    1．山东第二医科大学公共卫生学院，山东　潍坊　261053
    2．“健康山东”重大社会风险预测与治理协同创新中心

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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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