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Article(id=1241023850251612389, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023847537897695, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202408207, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1723737600000, receivedDateStr=2024-08-16, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812743007, onlineDateStr=2026-03-18, pubDate=1737734400000, pubDateStr=2025-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812743007, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812743007, creator=13701087609, updateTime=1773812743007, updator=13701087609, issue=Issue{id=1241023847537897695, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812742361, creator=13701087609, updateTime=1773812823817, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024189247845056, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023847537897695, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024189247845057, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023847537897695, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=203, endPage=210, ext={EN=ArticleExt(id=1241023850582962410, articleId=1241023850251612389, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Burden of disease of Chinese depressive disorders, 1990-2021, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the trends and characteristics of the number of patients, prevalence, incidence, disability-adjusted life years (DALY), and years lived with disability (YLD) of depressive disorders among the Chinese population from 1990 to 2021, with the hope of providing a theoretical basis for early prevention, intervention, and clinical decision-making regarding depressive disorders.

Methods

Depressive disorders data from the GBD 2021 database (Global Burden of Disease Study 2021 Data Resources) were extracted to analyze the number of patients, incidence, prevalence, DALY and YLD in the Chinese population. The software STATA 14.0 and Joinpoint Regression Program 4.8.0.1 were utilized to analyze the incidence, prevalence, DALY, and YLD of depressive disorders across different genders and age groups. Furthermore, the average annual percent change (AAPC) in depressive disorders was calculated.

Results

In 2021, there were 42.3602 million new cases of depressive disorders in China, an increase of 38.9% from 30.4910 million in 1990. The number of patients was 53.1147 million, an increase of 54.0% from 34.4794 million in 1990. Both the standardized incidence and prevalence showed a slow downward trend (the AAPC was -0.57% and -0.44%, respectively, P<0.001). The incidence of depressive disorders in people aged 10 to 24 showed a sudden increase in different years, and the incidence of depressive disorders in people over 65 also showed an accelerating upward trend. The DALY in 1990 and 2021 were 5.4267 million and 7.8659 million person-years, respectively, with a cumulative increase of 44.9%. The DALY rate increased from 461.27 /100 000 to 552.87 /100 000, with an increase of 19.8%. The standardized DALY and YLD rates decreased slowly with each year (the AAPC was -0.53% and -0.53%, respectively, P<0.001).

Conclusion

Depressive disorder is still one of the main causes of global disease burden and a major public health issue facing our country. There is an urgent need to actively explore and implement effective prevention and treatment strategies to reduce the disease burden of depressive disorders.

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目的

本研究旨在分析1990—2021年中国人群抑郁症（Depressive disorders）的发病人数、患病人数、发病率、患病率、伤残调整寿命年（disability-adjusted life years，DALY）和伤残损失寿命年（years lived with disability，YLD）等疾病负担指标的变化趋势和特征，以期为抑郁症的早期预防干预和临床决策提供理论依据。

方法

提取GBD 2021数据库（Global Burden of Disease Study 2021 Data Resources）中的抑郁症数据，分析中国人群抑郁症的发病人数、患病人数、发病率、患病率、DALY和YLD指标水平，采用STATA 14.0与Joinpoint Regression Program 4.8.0.1软件分析不同性别、年龄别人群的抑郁症发病率、患病率、DALY和YLD指标变化趋势和特征，并计算疾病负担指标的平均年度变化百分比（average annual percent change，AAPC）。

结果

2021年中国新发抑郁症4 236.02万人，较1990年的3 049.10万人增加38.9%；患病人数5 311.47万人，较1990年的3 447.94万人增加54.0%。标化发病率和标化患病率随年度均呈下降趋势（AAPC分别为-0.57%和-0.44%，P<0.001）。10~24岁人群的抑郁症发病率在不同年份均呈现突增特点，65岁以上人群的抑郁症发病率也呈现加速上升特征。1990年与2021年的DALY分别为542.67万人年和786.59万人年，累计增长44.9%，抑郁症DALY率由461.27/10万增加至552.87/10万，增长19.8%。抑郁症的DALY标化率和YLD标化率随年度呈缓慢下降趋势（AAPC分别为-0.53%和-0.53%，P<0.001）。

结论

抑郁症当前仍是全球疾病负担的主要原因之一，也是我国面临的重大公共卫生议题，亟需开展积极的探索并实施有效的预防与治疗策略，以减轻抑郁症的疾病负担。

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张洋，E-mail：
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黄磊（1989—），男，博士，讲师，研究方向：医学教育

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黄磊（1989—），男，博士，讲师，研究方向：医学教育

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BMC Research Notes, 2017, 10(1): 673., articleTitle=Factors associated with unwillingness to seek professional help for depression: a web-based survey, refAbstract=null), Reference(id=1241023864860373990, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, doi=null, pmid=null, pmcid=null, year=2023, volume=50, issue=6, pageStart=901, pageEnd=911, url=null, language=null, rfNumber=[15], rfOrder=15, authorNames=Ao MQ, Xia L, Wang XQ, journalName=Administration and Policy in Mental Health, refType=null, unstructuredReference=Ao MQ, Xia L, Wang XQ, et al. Help-Seeking intentions for depression from mental health professionals among Community-Dwelling persons in central China[J]. Administration and Policy in Mental Health, 2023, 50(6): 901-911., articleTitle=Help-Seeking intentions for depression from mental health professionals among Community-Dwelling persons in central China, refAbstract=null), Reference(id=1241023864977814515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, doi=null, pmid=null, pmcid=null, year=2022, volume=400, issue=10366, pageStart=1821, pageEnd=null, url=null, language=null, rfNumber=[16], rfOrder=16, authorNames=The Lancet, journalName=Lancet, refType=null, unstructuredReference=The Lancet. Population ageing in China: crisis or opportunity?[J]. 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Frontiers in Public Health, 2022, 10: 998769., articleTitle=Editorial: aging and health in China, refAbstract=null)], funds=[Fund(id=1241023861412655888, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, awardId=2023NSFSC1736, language=CN, fundingSource=四川省自然科学基金青年基金项目(2023NSFSC1736), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241023852508148003, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, xref=1．, ext=[AuthorCompanyExt(id=1241023852516536612, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, companyId=1241023852508148003, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China Hospital, Sichuan University/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1241023852520730917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, companyId=1241023852508148003, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1．四川大学华西医院/四川大学华西临床医学院，四川　成都　610041)]), AuthorCompany(id=1241023852625588524, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, xref=2．, ext=[AuthorCompanyExt(id=1241023852633977133, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, companyId=1241023852625588524, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2．四川大学华西公共卫生学院/华西第四医院)])], figs=[ArticleFig(id=1241023859172897325, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Fig.1, caption=Incidence and prevalence of depression in Chinese population with different sex groups from 1990 to 2021, figureFileSmall=YKTcH0ELMLEtYEa6VgbkcA==, figureFileBig=VKG21Ja6EY1P8a88/XaNBw==, tableContent=null), ArticleFig(id=1241023859256783412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=图1, caption=1990—2021年中国人群抑郁症分性别发病及患病情况

注：A为不同年度男性和女性抑郁症发病率；B为不同年度男性和女性抑郁症标化发病率；C为不同年度男性和女性抑郁症患病率；D为不同年度男性和女性抑郁症标化患病率。

, figureFileSmall=YKTcH0ELMLEtYEa6VgbkcA==, figureFileBig=VKG21Ja6EY1P8a88/XaNBw==, tableContent=null), ArticleFig(id=1241023859655242333, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Fig.2, caption=Age-specific incidence and prevalence of depression in Chinese population from 1990 to 2021, figureFileSmall=mojo19NykdbgAwHYX31YiQ==, figureFileBig=FsegGpeGRKXuu0QnutG07w==, tableContent=null), ArticleFig(id=1241023859797848685, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=图2, caption=1990—2021年中国人群抑郁症年龄别发病与患病情况

注：A为1990年和2021年不同年龄段人群抑郁症发病率；B为1990年和2021年不同年龄段人群抑郁症发病率。

, figureFileSmall=mojo19NykdbgAwHYX31YiQ==, figureFileBig=FsegGpeGRKXuu0QnutG07w==, tableContent=null), ArticleFig(id=1241023859919483512, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Fig.3, caption=Incidence and prevalence of depression in Chinese population of different age groups in 1990 and 2021, figureFileSmall=+Scm/kW3jUjiNLNy3iACuw==, figureFileBig=DRhL/fjHAoRHaFmwDrufZw==, tableContent=null), ArticleFig(id=1241023860049506947, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=图3, caption=1990与2021年不同年龄组中国人群抑郁症发病与患病情况

注：A为1990年不同年龄段男性和女性抑郁症发病率；B为1990年不同年龄段男性和女性抑郁症患病率；C为2021年不同年龄段男性和女性抑郁症发病率；D为2021年不同年龄段男性和女性抑郁症患病率。

, figureFileSmall=+Scm/kW3jUjiNLNy3iACuw==, figureFileBig=DRhL/fjHAoRHaFmwDrufZw==, tableContent=null), ArticleFig(id=1241023860259222158, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Fig.4, caption=DALY and YLD of depression in different age groups in Chinese population in 1990 and 2021, figureFileSmall=LyA+zO3BJUJ22UvY/zJQ4A==, figureFileBig=S0qWLGydHpKjScggL9CSrg==, tableContent=null), ArticleFig(id=1241023860380856983, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=图4, caption=1990与2021年不同年龄中国人群抑郁症的DALY和YLD

注：A为1990年和2021年不同年龄段人群的抑郁症DALY；B为1990年和2021年不同年龄段人群的抑郁症DALY标化率；C为1990年和2021年不同年龄段人群的抑郁症YLD；D为1990年和2021年不同年龄段人群的抑郁症YLD标化率。

, figureFileSmall=LyA+zO3BJUJ22UvY/zJQ4A==, figureFileBig=S0qWLGydHpKjScggL9CSrg==, tableContent=null), ArticleFig(id=1241023860510880418, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Table 1, caption=

Incidence and prevalence of depression in Chinese population from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份发病人数
（万）		发病率
（1/10万）		年龄标化发病率
（1/10万）		患病人数
（万）		患病率
（1/10万）		年龄标化患病率
（1/10万）
19903 049.102 591.772 628.673 447.942 930.783 071.84
19953 508.082 843.432 845.073 926.613 182.673 211.64
20003 296.892 618.482 517.984 008.003 183.263 059.33
20053 489.392 698.982 456.824 343.753 359.813 019.30
20103 544.462 651.182 296.074 552.293 405.022 875.88
20154 073.522 957.482 437.234 883.073 545.242 852.24
20204 458.213 140.732 489.455 266.283 709.992 883.85
20214 236.022 977.352 345.085 311.473 733.252 875.68
AAPC(95%CI)0.92(0.75～1.09)0.34(0.18～0.49)-0.57(-0.73～-0.41)1.23(1.18～1.28)0.64(0.60～0.68)-0.44(-0.50～-0.37)
P<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1241023860603155114, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=表1, caption=

1990—2021年中国人群抑郁症总体发病与患病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份发病人数
（万）		发病率
（1/10万）		年龄标化发病率
（1/10万）		患病人数
（万）		患病率
（1/10万）		年龄标化患病率
（1/10万）
19903 049.102 591.772 628.673 447.942 930.783 071.84
19953 508.082 843.432 845.073 926.613 182.673 211.64
20003 296.892 618.482 517.984 008.003 183.263 059.33
20053 489.392 698.982 456.824 343.753 359.813 019.30
20103 544.462 651.182 296.074 552.293 405.022 875.88
20154 073.522 957.482 437.234 883.073 545.242 852.24
20204 458.213 140.732 489.455 266.283 709.992 883.85
20214 236.022 977.352 345.085 311.473 733.252 875.68
AAPC(95%CI)0.92(0.75～1.09)0.34(0.18～0.49)-0.57(-0.73～-0.41)1.23(1.18～1.28)0.64(0.60～0.68)-0.44(-0.50～-0.37)
P<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1241023860699624118, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Table 2, caption=

DALY and YLD of depression in the Chinese population from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份DALY
（万人年）		DALY率
（1/10万）		DALY标化率
（1/10万）		YLD
（万人年）		YLD率
（1/10万）		YLD标化率
（1/10万）
1990542.67461.27473.32542.67461.27473.32
1995621.12503.45502.63621.12503.45502.63
2000609.49484.07462.92609.49484.07462.92
2005653.27505.29454.38653.27505.29454.38
2010673.65503.88428.27673.65503.88428.27
2015740.40537.55436.23740.40537.55436.23
2020800.07563.63442.40800.07563.63442.40
2021786.59552.87430.61786.59552.87430.61
AAPC(95%CI)1.04(0.95～1.13)0.45(0.37～0.53)-0.53(-0.62～-0.43)1.04(0.95～1.13)0.45(0.37～0.53)-0.53(-0.62～-0.43)
P<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1241023860791898818, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=表2, caption=

1990—2021年中国人群抑郁症的DALY和YLD

, figureFileSmall=null, figureFileBig=null, tableContent=
年份DALY
（万人年）		DALY率
（1/10万）		DALY标化率
（1/10万）		YLD
（万人年）		YLD率
（1/10万）		YLD标化率
（1/10万）
1990542.67461.27473.32542.67461.27473.32
1995621.12503.45502.63621.12503.45502.63
2000609.49484.07462.92609.49484.07462.92
2005653.27505.29454.38653.27505.29454.38
2010673.65503.88428.27673.65503.88428.27
2015740.40537.55436.23740.40537.55436.23
2020800.07563.63442.40800.07563.63442.40
2021786.59552.87430.61786.59552.87430.61
AAPC(95%CI)1.04(0.95～1.13)0.45(0.37～0.53)-0.53(-0.62～-0.43)1.04(0.95～1.13)0.45(0.37～0.53)-0.53(-0.62～-0.43)
P<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1241023860892562126, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Table 3, caption=

DALY and YLD of depression in Chinese population with different sex groups from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份DALY（万人年）DALY率（1/10万）DALY标化率（1/10万）
男女男女男女
1990199.44343.23328.65602.56343.83608.67
1995247.05374.07387.33627.73389.62619.83
2000240.49369.00370.74604.50358.11570.46
2005257.26396.01387.97628.82353.12557.27
2010261.51412.14382.70630.55329.81527.80
2015280.16460.25398.34682.82328.85545.10
2020298.13501.94410.47724.12329.74557.11
2021302.85483.74415.94696.39330.60533.04
AAPC (95%CI)0.94(0.79～1.09)1.103(0.96～1.25)0.39(0.26～0.520.47(0.34～0.59)-0.55(-0.67～-0.43)-0.53(-0.64～-0.42
P<0.001<0.001<0.001<0.001<0.001<0.001
年份YLD（万人年）YLD率（1/10万）YLD标化率（1/10万）
男女男女男女
1990199.44343.23328.65602.56343.83608.67
1995247.05374.07387.33627.73389.62619.83
2000240.49369.00370.74604.50358.11570.46
2005257.26396.01387.97628.82353.12557.27
2010261.51412.14382.70630.55329.81527.80
2015280.16460.25398.34682.82328.85545.10
2020298.13501.94410.47724.12329.74557.11
2021302.85483.74415.94696.39330.60533.04
AAPC (95%CI)0.94(0.79～1.09)1.103(0.96～1.25)0.39(0.26～0.520.47(0.34～0.59)-0.55(-0.67～-0.43)-0.53(-0.64～-0.42
P<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1241023861010002650, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=表3, caption=

1990—2021年不同性别组中国人群抑郁症的DALY和YLD

, figureFileSmall=null, figureFileBig=null, tableContent=
年份DALY（万人年）DALY率（1/10万）DALY标化率（1/10万）
男女男女男女
1990199.44343.23328.65602.56343.83608.67
1995247.05374.07387.33627.73389.62619.83
2000240.49369.00370.74604.50358.11570.46
2005257.26396.01387.97628.82353.12557.27
2010261.51412.14382.70630.55329.81527.80
2015280.16460.25398.34682.82328.85545.10
2020298.13501.94410.47724.12329.74557.11
2021302.85483.74415.94696.39330.60533.04
AAPC (95%CI)0.94(0.79～1.09)1.103(0.96～1.25)0.39(0.26～0.520.47(0.34～0.59)-0.55(-0.67～-0.43)-0.53(-0.64～-0.42
P<0.001<0.001<0.001<0.001<0.001<0.001
年份YLD（万人年）YLD率（1/10万）YLD标化率（1/10万）
男女男女男女
1990199.44343.23328.65602.56343.83608.67
1995247.05374.07387.33627.73389.62619.83
2000240.49369.00370.74604.50358.11570.46
2005257.26396.01387.97628.82353.12557.27
2010261.51412.14382.70630.55329.81527.80
2015280.16460.25398.34682.82328.85545.10
2020298.13501.94410.47724.12329.74557.11
2021302.85483.74415.94696.39330.60533.04
AAPC (95%CI)0.94(0.79～1.09)1.103(0.96～1.25)0.39(0.26～0.520.47(0.34～0.59)-0.55(-0.67～-0.43)-0.53(-0.64～-0.42
P<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1241023861114860262, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=EN, label=Table 4, caption=

DALY and YLD of depression in different age groups in Chinese population in 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）DALY（万人年）DALY率（1/10万）YLD（万人年）YLD率（1/10万）
1990年2021年1990年2021年1990年2021年1990年2021年
<50.020.010.140.170.020.010.140.17
5～91.111.0210.6010.671.111.0210.6010.67
10～1411.137.81108.7690.5611.137.81108.7690.56
15～1944.2418.01349.26241.1744.2418.01349.26241.17
20～2472.1925.31546.86345.9272.1925.31546.86345.92
25～2963.5733.72578.51389.9263.5733.72578.51389.92
30～3453.7753.92609.29445.0953.7753.92609.29445.09
35～3960.7654.61665.16515.3560.7654.61665.16515.35
40～4447.7355.33711.36604.4347.7355.33711.36604.43
45～4938.0078.76736.2713.9438.0078.76736.2713.94
50～5435.9598.19753.41812.4335.9598.19753.41812.43
55～5933.2799.11767.23901.5133.2799.11767.23901.51
60～6427.8270.10787.24960.1827.8270.10787.24960.18
65～6922.2075.24813.77980.9522.2075.24813.77980.95
70～7415.4452.32820.66981.7215.4452.32820.66981.72
75～799.3332.10819.80969.099.3332.10819.80969.09
80～844.3818.78827.11948.874.3818.78827.11948.87
85～891.468.91863.69935.321.468.91863.69935.32
90～940.282.74916.11933.960.282.74916.11933.96
≥950.040.60959.12939.200.040.60959.12939.20
), ArticleFig(id=1241023861223912182, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023850251612389, language=CN, label=表4, caption=

1990与2021年不同年龄中国人群的DALY和YLD

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）DALY（万人年）DALY率（1/10万）YLD（万人年）YLD率（1/10万）
1990年2021年1990年2021年1990年2021年1990年2021年
<50.020.010.140.170.020.010.140.17
5～91.111.0210.6010.671.111.0210.6010.67
10～1411.137.81108.7690.5611.137.81108.7690.56
15～1944.2418.01349.26241.1744.2418.01349.26241.17
20～2472.1925.31546.86345.9272.1925.31546.86345.92
25～2963.5733.72578.51389.9263.5733.72578.51389.92
30～3453.7753.92609.29445.0953.7753.92609.29445.09
35～3960.7654.61665.16515.3560.7654.61665.16515.35
40～4447.7355.33711.36604.4347.7355.33711.36604.43
45～4938.0078.76736.2713.9438.0078.76736.2713.94
50～5435.9598.19753.41812.4335.9598.19753.41812.43
55～5933.2799.11767.23901.5133.2799.11767.23901.51
60～6427.8270.10787.24960.1827.8270.10787.24960.18
65～6922.2075.24813.77980.9522.2075.24813.77980.95
70～7415.4452.32820.66981.7215.4452.32820.66981.72
75～799.3332.10819.80969.099.3332.10819.80969.09
80～844.3818.78827.11948.874.3818.78827.11948.87
85～891.468.91863.69935.321.468.91863.69935.32
90～940.282.74916.11933.960.282.74916.11933.96
≥950.040.60959.12939.200.040.60959.12939.20
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1990—2021年中国人群的抑郁症疾病负担分析
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黄磊 1 , 丰国文 1 , 兰亚佳 2 , 张洋 1
现代预防医学 | 流行病与统计方法 2025,52(2): 203-210
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现代预防医学 | 流行病与统计方法 2025, 52(2): 203-210
1990—2021年中国人群的抑郁症疾病负担分析
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黄磊1, 丰国文1, 兰亚佳2, 张洋1
作者信息
  • 1．四川大学华西医院/四川大学华西临床医学院，四川　成都　610041
  • 2．四川大学华西公共卫生学院/华西第四医院

    • 黄磊（1989—），男，博士，讲师，研究方向：医学教育

通讯作者:

张洋，E-mail：
Burden of disease of Chinese depressive disorders, 1990-2021
Lei HUANG1, Guo-wen FENG1, Ya-jia LAN2, Yang ZHANG1
Affiliations
  • West China Hospital, Sichuan University/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2025-01-25 doi: 10.20043/j.cnki.MPM.202408207
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摘要
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目的

本研究旨在分析1990—2021年中国人群抑郁症（Depressive disorders）的发病人数、患病人数、发病率、患病率、伤残调整寿命年（disability-adjusted life years，DALY）和伤残损失寿命年（years lived with disability，YLD）等疾病负担指标的变化趋势和特征，以期为抑郁症的早期预防干预和临床决策提供理论依据。

方法

提取GBD 2021数据库（Global Burden of Disease Study 2021 Data Resources）中的抑郁症数据，分析中国人群抑郁症的发病人数、患病人数、发病率、患病率、DALY和YLD指标水平，采用STATA 14.0与Joinpoint Regression Program 4.8.0.1软件分析不同性别、年龄别人群的抑郁症发病率、患病率、DALY和YLD指标变化趋势和特征，并计算疾病负担指标的平均年度变化百分比（average annual percent change，AAPC）。

结果

2021年中国新发抑郁症4 236.02万人，较1990年的3 049.10万人增加38.9%；患病人数5 311.47万人，较1990年的3 447.94万人增加54.0%。标化发病率和标化患病率随年度均呈下降趋势（AAPC分别为-0.57%和-0.44%，P<0.001）。10~24岁人群的抑郁症发病率在不同年份均呈现突增特点，65岁以上人群的抑郁症发病率也呈现加速上升特征。1990年与2021年的DALY分别为542.67万人年和786.59万人年，累计增长44.9%，抑郁症DALY率由461.27/10万增加至552.87/10万，增长19.8%。抑郁症的DALY标化率和YLD标化率随年度呈缓慢下降趋势（AAPC分别为-0.53%和-0.53%，P<0.001）。

结论

抑郁症当前仍是全球疾病负担的主要原因之一，也是我国面临的重大公共卫生议题，亟需开展积极的探索并实施有效的预防与治疗策略，以减轻抑郁症的疾病负担。

抑郁症  /  发病率  /  患病率  /  疾病负担  /  平均年度变化
Objective

To analyze the trends and characteristics of the number of patients, prevalence, incidence, disability-adjusted life years (DALY), and years lived with disability (YLD) of depressive disorders among the Chinese population from 1990 to 2021, with the hope of providing a theoretical basis for early prevention, intervention, and clinical decision-making regarding depressive disorders.

Methods

Depressive disorders data from the GBD 2021 database (Global Burden of Disease Study 2021 Data Resources) were extracted to analyze the number of patients, incidence, prevalence, DALY and YLD in the Chinese population. The software STATA 14.0 and Joinpoint Regression Program 4.8.0.1 were utilized to analyze the incidence, prevalence, DALY, and YLD of depressive disorders across different genders and age groups. Furthermore, the average annual percent change (AAPC) in depressive disorders was calculated.

Results

In 2021, there were 42.3602 million new cases of depressive disorders in China, an increase of 38.9% from 30.4910 million in 1990. The number of patients was 53.1147 million, an increase of 54.0% from 34.4794 million in 1990. Both the standardized incidence and prevalence showed a slow downward trend (the AAPC was -0.57% and -0.44%, respectively, P<0.001). The incidence of depressive disorders in people aged 10 to 24 showed a sudden increase in different years, and the incidence of depressive disorders in people over 65 also showed an accelerating upward trend. The DALY in 1990 and 2021 were 5.4267 million and 7.8659 million person-years, respectively, with a cumulative increase of 44.9%. The DALY rate increased from 461.27 /100 000 to 552.87 /100 000, with an increase of 19.8%. The standardized DALY and YLD rates decreased slowly with each year (the AAPC was -0.53% and -0.53%, respectively, P<0.001).

Conclusion

Depressive disorder is still one of the main causes of global disease burden and a major public health issue facing our country. There is an urgent need to actively explore and implement effective prevention and treatment strategies to reduce the disease burden of depressive disorders.

Depressive disorders  /  Incidence  /  Prevalence  /  Burden of disease  /  Average annual percent change
黄磊, 丰国文, 兰亚佳, 张洋. 1990—2021年中国人群的抑郁症疾病负担分析. 现代预防医学, 2025 , 52 (2) : 203 -210 . DOI: 10.20043/j.cnki.MPM.202408207
Lei HUANG, Guo-wen FENG, Ya-jia LAN, Yang ZHANG. Burden of disease of Chinese depressive disorders, 1990-2021[J]. Modern Preventive Medicine, 2025 , 52 (2) : 203 -210 . DOI: 10.20043/j.cnki.MPM.202408207
正文
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抑郁症（Depressive disorders）是一种常见的精神障碍，其主要特征是显著而持久的情绪低落。抑郁症发病率高但就诊率却很低，特别是在中低收入国家和地区，超过75%的精神障碍患者得不到或未寻求治疗[1]。抑郁症已成为一项全球性的公共卫生问题。2019全球疾病负担（Global Burden of Disease，GBD）数据显示，全球精神障碍患者从1990年的6.5亿增长至2019年的9.7亿，30年间增长48.1%[2]。WHO报告也显示，2019年全球估计有2.8亿人罹患抑郁症[1]。WHO报告全球每年因抑郁症和焦虑症造成约120亿个工作日损失，年损失高达1万亿美元[1]。据估计，中国有超过1亿人饱受各种心理健康问题的困扰[3]。从抑郁症年龄分布来看，80.6%的疾病负担发生在青壮年（16～65岁）人群中，约9.2%发生在16岁以下的人群中[2]。抑郁症如不及时进行干预和治疗，随病情进展可产生严重后果。研究发现，重度抑郁症患者的自杀风险升高，此外抑郁症与一系列健康问题如心血管疾病、癌症、糖尿病和呼吸系统疾病等均存在密切关系[2, 4]。本研究利用GBD数据分析了1990—2021年中国人群抑郁症的疾病负担水平及变化特征，旨在为抑郁症的早期干预与临床决策提供依据。
1　资料与方法
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1.1　数据来源
数据来源于最新发布的GBD 2021数据库（Global Burden of Disease Study 2021 Data Resources）。该数据库包含了1990—2021年全球所有死因及疾病负担的数据。本研究的GBD 2021数据提取策略：数据类型选择“Cause of death or injury”，疾病原因选择“B.6.2 Depressive disorders”，地区选择“China”，测量指标选择“Incidence”、“Prevalence”、“DALY”和“YLD”，年份选择“1990—2021”。
1.2　疾病分类与指标解释
抑郁症采用《疾病和有关健康问题的国际统计分类》（简称ICD）第9版（ICD-9）与第10版（ICD-10）进行分类编码。抑郁症发病人数、患病人数、发病率、患病率、标化发病率、标化患病率数据均来源于GBD 2021数据库。抑郁症所致疾病负担采用伤残调整寿命年（disability-adjusted life years，DALY）和伤残损失寿命年（years lived with disability，YLD）进行描述。GBD 2021数据库未报告抑郁症的过早死亡损失寿命年（years of life lost，YLL）数据，对于未被认定为死亡原因的精神障碍类疾病，YLD约等于DALY[4]。指标计算方法：YLD估算方法为各年龄组发病人数乘以伤残权重[4-5]，DALY率和YLD率为损失寿命年除以人口总数得出。
1.3　数据分析
采用抑郁症发病人数、患病人数、发病率、患病率、标化发病率、标化患病率等指标分析1990—2021年中国人群抑郁症发病与患病情况；采用DALY、YLD、DALY率、YLD率等指标分析疾病所致过早死亡与伤残的疾病负担；采用Joinpoint regression program软件分析不同疾病负担指标的平均年度变化百分比（average annual percent of change，AAPC），用以描述抑郁症疾病负担指标的年度变化趋势，检验水准α=0.05。
2　结果
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2.1　抑郁症发病与患病总体情况
1990—2021年中国人群抑郁症的发病人数、患病人数、发病率和患病率均呈逐年上升趋势，标化发病率和标化患病率呈下降趋势（表1）。2021年发病人数为4 236.02万人，较1990年的3 049.10万人增加了38.9%；2021年的抑郁症发病率为2 591.77/10万，较1990年的2 977.35/10万增加了14.9%；2021年患病人数为5 311.47万人，较1990年的3 447.94万人增加了54.0%；2021年的抑郁症患病率为2 930.78/10万，较1990年的3 733.25/10万增加了27.4%。年龄标化发病率由1990年的2 628.67/10万降至2021年的2 345.08/10万，年龄标化患病率由1990年的3 071.84/10万降至2021年的2 875.68/10万（表2）。
2.2　不同性别人群抑郁症发病与患病情况
1990—2021年中国人群男女性的抑郁症发病率和患病率呈上升趋势（发病率AAPC分别为0.26%和0.36%，P<0.001；患病率AAPC分别为0.60%和0.64%，P<0.001），但标化发病率和标化患病率均呈下降趋势（标化发病率AAPC分别为-0.59%和-0.57%，P<0.001；标化患病率AAPC分别为-0.45%和-0.45%，P<0.001，图1）。不同年份的女性抑郁症发病率、患病率、标化发病率和标化患病率均高于同期男性。
2.3　不同年龄人群抑郁症发病与患病情况
1990年和2021年各年龄别发病率和患病率随年龄呈上升趋势，95岁以上人群抑郁症发病率和患病率最高。10～24岁人群的发病率和患病率有明显突增，而后随年龄的上升趋势变缓（图2）。1990年和2021年各个年龄段女性的抑郁症发病率和患病率均高于男性（图3）。
2.4　抑郁症的DALY和YLD
1990—2021年中国人群抑郁症的DALY和YLD呈缓慢上升趋势（AAPC分别为1.04%和1.04%，P<0.001）。1990年与2021年抑郁症的DALY分别为542.67万人年和786.59万人年，期间增长44.9%，DALY率由461.27/10万增加至552.87/10万，期间增长19.8%；YLD的变化趋势与DALY相同。1990年至2021年中国人群抑郁症的DALY标化率和YLD标化率出现缓慢下降趋势（AAPC分别为-0.53%和-0.53%，P<0.001）。
2.5　不同性别人群抑郁症的DALY和YLD
1990—2021年中国女性的DALY、DALY率、DALY标化率、YLD、YLD率和YLD标化率均高于男性。男性DALY由1990年的199.44万人年增长至2021年的302.85万人年；女性DALY由1990年的343.23万人年增长至2021年的483.74万人年；男性DALY率由1990年的328.65/10万增长至2021年的415.94/10万；女性DALY率由1990年的602.56/10万增长至2021年的696.39/10万；男性DALY标化率由1990年的343.83/10万减少至2021年的330.60/10万；女性DALY标化率由1990年的608.67/10万减少至2021年的533.04 /10万。不同性别人群的YLD指标变化趋势与DALY相同（表3）。
2.6　不同年龄人群抑郁症的DALY和YLD
在39岁以下人群中，1990年的DALY和YLD要高于2021年，而在40岁以上群体中，2021年高于1990年；1990年的DALY和YLD峰值出现在20～24岁年龄段，2021年的DALY和YLD峰值出现在55～59岁年龄段。
1990年数据显示，DALY标化率和YLD标化率在10～24岁年龄段出现突增，而后随年龄呈缓慢上升特征；2021年数据显示，DALY标化率和YLD标化率在70～74岁年龄段达到峰值后出现缓慢下降的特征（表4和图4）。
3　讨论
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抑郁症当前仍是全球疾病负担的主要原因之一，2019年位列DALY指标的第13位[2]。精神障碍相关疾病在高收入国家发病率较高，在中低收入国家和地区发病率最低，但受限于中低收入国家和地区的流行病学数据覆盖率最低，因此估计值存在较大的不确定性。此外研究报告，家庭暴力高发[4]、冲突和战争高发国家和地区[6]的抑郁症DALY率较高。
本研究利用1990—2021年全球疾病负担研究数据对中国人群的抑郁症的发病人数、患病人数、发病率、患病率、DALY和YLD等指标进行分析。结果显示，1990—2021年中国人群抑郁症的发病人数、患病人数、发病率和患病率呈逐年缓慢上升趋势，但经过年龄标化后，标化发病率和标化患病率未呈现上升趋势。DALY和YLD指标也表现出相同的变化特征，呈现这种反差的原因可能与中国人群年龄结构的变化有关。值得注意的是，2020年抑郁症发病率和患病率均出现异常的突增，这可能与2019年12月开始的全球新型冠状病毒（coronavirus disease 2019, COVID-19）疫情大流行有关，全球抑郁症发病数据也印证了这一点[7]。流行病学研究表明，疫情对心理的直接影响以及对人口经济和社会状况的长期影响可能会增加常见精神障碍的疾病负担，COVID-19疫情创造了一种特殊环境，其中许多导致不良心理健康结局的因素都得到了加剧[2]。
从性别来看，女性抑郁症的发病率、患病率、DALY和YLD指标均高于男性，提示了抑郁症患病模式的性别差异。不同国家和地区报告的数据中，女性抑郁症患病率和严重程度均高于男性，患病率大约是男性的两倍[8]。女性抑郁症高发的原因可能与性染色体遗传、激素分泌、神经递质水平和社会地位等因素有关[9-10]。围产期的女性也是抑郁症的高发人群之一，多达15%的女性会出现产后抑郁症[11]，这可能与怀孕和产后类固醇及肽类激素水平的剧烈变化有关[10]。
从年龄来看，抑郁症发病率和患病率随年龄增加呈逐渐上升的趋势。10～24岁人群的抑郁症发病率在不同年份均呈现出突增特点，65岁以上人群的抑郁症发病率也呈现加速上升趋势。这可能与该年龄段人群的身心发育特点、社会适应状态变化有关，如青春期阶段生理、心理和认知的急剧改变[12]，老年人丧亲、社会孤立和躯体疾病等均可能是加速抑郁发病的因素[13]。DALY和YLD指标在不同年龄段呈现不同特征，1990年的DALY和YLD峰值出现在20～24岁年龄段，2021年的DALY和YLD峰值出现在55～59岁年龄段，考虑到1990—2021年的时间跨度为34年，两个年龄段人群事实上为同一群体。
从年度变化来看，抑郁症相关的年龄标化指标随年度均呈缓慢下降的趋势，表明中国的抑郁症发病趋势有所减缓，但考虑到抑郁症有较强的隐匿性和就诊意愿低等特点[14-15]，因此现有估计可能存在一定的不确定性。而抑郁症相关的疾病负担指标粗率呈现一致上升趋势更能反应现实的问题，随着中国老龄化加剧和人口结构老化[16-17]，发病和患病人群数量仍在持续增长，伴随的疾病负担亦逐年累积，意味着抑郁症仍是中国乃至全世界面临的重大公共卫生议题。
抑郁症不仅对个人心理健康构成了严重威胁，还会对社会经济发展产生深远影响。在此背景下，探索并实施有效的预防与治疗策略成为了当前紧迫的需求。亟需通过科学研究揭示抑郁症的发病机制，并开发创新的干预手段，以期从早期预防和干预的层面做出行动，减轻抑郁症疾病负担。
基金
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  • 四川省自然科学基金青年基金项目(2023NSFSC1736)
文献
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2025年第52卷第2期
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doi: 10.20043/j.cnki.MPM.202408207
  • 接收时间：2024-08-16
  • 首发时间：2026-03-18
  • 出版时间：2025-01-25
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  • 收稿日期：2024-08-16
基金
四川省自然科学基金青年基金项目(2023NSFSC1736)
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    1．四川大学华西医院/四川大学华西临床医学院，四川　成都　610041
    2．四川大学华西公共卫生学院/华西第四医院

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