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Article(id=1241023933290435136, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202409487, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727193600000, receivedDateStr=2024-09-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812762806, onlineDateStr=2026-03-18, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812762806, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812762806, creator=13701087609, updateTime=1773812762806, updator=13701087609, issue=Issue{id=1241023927812682133, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812761500, creator=13701087609, updateTime=1773812858867, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024336258200259, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024336258200260, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=406, endPage=411, ext={EN=ArticleExt(id=1241023935018488409, articleId=1241023933290435136, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Burden and trend changes of depression among Chinese residents from 1990 to 2021 and predictions, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To describe the changes in the burden of depression among Chinese residents from 1990 to 2021 and to forecast future trends, providing reference for the prevention and control of depression.

Methods

Based on the 2021 Global Burden of Disease data, indicators such as the number of cases, incidence rate, prevalence rate, and disability-adjusted life years (DALYs) along with DALYs rates were selected to calculate the rate of change. The Join point regression model was employed to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze the trend of disease burden. Future trends were predicted using R software combined with the GM (1,1) model.

Results

In 2021, the total number of depression cases in China was approximately 42.36 million, with an incidence rate of 2 977.354 per 100 000 and a standardized incidence rate of 2 345.079 per 100 000. The total DALYs attributed to depression were 7.8659 million years, with a total DALYs rate of 552.87 per 100 000 and a standardized DALYs rate of 430.61 per 100 000. Compared to 1990, the standardized prevalence rates for the total population, males, and females decreased by 6.39%, 2.4%, and 9.17%, respectively; the standardized incidence rates decreased by 10.79%, 3.96%, and 14.93%; and the standardized DALYs rates decreased by 9.02%, 3.85%, and 12.43%. Join point regression analysis indicated that from 1990 to 1995 and from 2010 to 2015, the standardized incidence rate of depression among the total population in China showed an increasing trend (APC of 1.56% and 1.37%, respectively), while from 1995 to 2000 and 2005 to 2010, it exhibited a decreasing trend (APC of -2.74% and -1.45%,respectively). The standardized prevalence rates from 1990 to 1992, 1992 to 1995, and 2019 to 2021 all showed an upward trend (APC of 1.67%, 0.48%, and 0.96%, respectively), whereas from 1995 to 2000, 2000 to 2005, 2005 to 2010, and 2010 to 2019, they demonstrated a downward trend (APC of -1.06%, -0.22%, -1.02%, and -0.15%, respectively). The standardized DALYs rate increased from 1990 to 1994 (APC of 1.75%) and showed a decreasing trend from 1994 to 2000 and from 2000 to 2006 (APC of-1.55% and -0.46%, respectively).

Conclusion

The burden of depression among Chinese residents is increasing, with a higher burden observed in females. The risk of depression among the elderly should not be overlooked. Continued efforts are needed to enhance public awareness of depression-related health knowledge and implement preventive interventions.

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目的

描述1990—2021年中国居民抑郁症疾病负担变化趋势并预测，为防控抑郁症疾病提供参考。

方法

基于2021年全球疾病负担数据，选取发病例数、发病率、患病率、伤残调整寿命年（DALYs）及DALYs率等指标，计算变化率；利用joinpoint回归模型计算年度变化百分比（APC）和平均年度变化百分比（AAPC），分析其疾病负担趋势；用R软件结合GM（1,1）方法预测未来疾病负担趋势。

结果

2021年中国抑郁总发病例数为4 236.018万例，发病率2 977.354/10万，标化发病率2 345.079/10万。因抑郁造成的总DALYs为786.59万人年，总DALYs率为552.87/10万，总标化DALYs率为430.61/10万。中国居民总人群、男性和女性标化患病率与1990年比较分别降低6.39%、2.4%、9.17%，标化发病率分别降低10.79%、3.96%、14.93%，标化DALYs率分别降低9.02%、3.85%、12.43%。Joinpoint回归显示1990—1995和2010—2015年中国抑郁症总人群标化发病率呈上升趋势，APC分别为1.56%、1.37%；1995—2000和2005—2010年呈降低趋势，APC分别为-2.74%、-1.45%。1990—1992、1992—1995和2019—2021年标化患病率均呈上升趋势，APC分别为1.67%、0.48%、0.96%，1995—2000、2000—2005、2005—2010和2010—2019年呈降低趋势，APC分别为-1.06%、-0.22%、-1.02%、-0.15%。标化DALYs率在1990—1994年呈上升趋势，APC为1.75%，1994—2000和2000—2006年均呈降低趋势，APC分别为-1.55%、-0.46%。

结论

中国居民抑郁疾病负担不断加重，女性抑郁疾病负担更高，老年人抑郁疾病负担风险状况不容忽视，应继续加强抑郁相关健康知识宣传和防控干预。

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吕军城，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=NNOieElIE38pQGR+dSYUow==, magXml=qYIHrYTNXB+pfRUs/xbaRg==, pdfUrl=null, pdf=pt1QvQva1b6DUs/JjohAAQ==, pdfFileSize=976742, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=zBrbq5aHq6oaWAd7zY4p4g==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=RjPGsE/U73JAWoSIpCrhaQ==, mapNumber=null, authorCompany=null, fund=null, authors=

穆弘杰（2000—），女，硕士在读，研究方向：流行病与卫生统计学

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穆弘杰（2000—），女，硕士在读，研究方向：流行病与卫生统计学

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穆弘杰（2000—），女，硕士在读，研究方向：流行病与卫生统计学

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Modern Preventive Medicine, 2024, 51(5): 854-858.(In Chinese), articleTitle=Study on the relationship between nicotine dependence and depression in rural Dai elderly in Jinggu county,Yunnan Province, refAbstract=null), Reference(id=1241023948972937676, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, doi=null, pmid=null, pmcid=null, year=2023, volume=45, issue=3, pageStart=206, pageEnd=210, 214, url=null, language=null, rfNumber=[22], rfOrder=36, authorNames=王海艳, 施杰, 黄晓玉, journalName=北京医学, refType=null, unstructuredReference=王海艳， 施杰， 黄晓玉.酒依赖患者时间洞察力与抑郁的相关性分析[J].北京医学，2023，45（3）：206-210, 214., articleTitle=酒依赖患者时间洞察力与抑郁的相关性分析, refAbstract=null), Reference(id=1241023949094572497, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, doi=null, pmid=null, pmcid=null, year=2023, volume=45, issue=3, pageStart=206, pageEnd=210, 214, url=null, language=null, rfNumber=[22], rfOrder=37, authorNames=Wang HY, Shi J, Huang XY, journalName=Beijing Medical Journal, refType=null, unstructuredReference=Wang HY, Shi J, Huang XY. Correlation analysis between time perspective and depression in patients with alcohol dependence[J]. Beijing Medical Journal, 2023, 45(3): 206-210, 214.(In Chinese), articleTitle=Correlation analysis between time perspective and depression in patients with alcohol dependence, refAbstract=null), Reference(id=1241023949199430099, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=11, pageStart=1647, pageEnd=1652, url=null, language=null, rfNumber=[23], rfOrder=38, authorNames=陈静, 施旭爱, journalName=中国健康心理学杂志, refType=null, unstructuredReference=陈静， 施旭爱.抑郁症患者自杀意念调查及其与家庭功能的关系:情绪调节自我效能感的中介作用[J].中国健康心理学杂志，2024，32（11）：1647-1652., articleTitle=抑郁症患者自杀意念调查及其与家庭功能的关系:情绪调节自我效能感的中介作用, refAbstract=null), Reference(id=1241023949350425047, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=11, pageStart=1647, pageEnd=1652, url=null, language=null, rfNumber=[23], rfOrder=39, authorNames=Chen J, Shi XA, journalName=China Journal of Health Psychology, refType=null, unstructuredReference=Chen J, Shi XA. Investigation of suicidal ideation in patients with depression and its relationship with family function: The mediating role of emotional regulation self-efficacy[J]. China Journal of Health Psychology,2024, 32(11): 1647-1652.(In Chinese), articleTitle=Investigation of suicidal ideation in patients with depression and its relationship with family function: The mediating role of emotional regulation self-efficacy, refAbstract=null)], funds=[Fund(id=1241023944661192917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, awardId=23YJAZH095, language=CN, fundingSource=2023年度教育部人文社会科学研究项目(23YJAZH095), fundOrder=null, country=null), Fund(id=1241023944782827743, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, awardId=ZR2021MH408, language=CN, fundingSource=山东省自然科学基金项目(ZR2021MH408), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241023936482300596, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, xref=1., ext=[AuthorCompanyExt(id=1241023936490689205, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, companyId=1241023936482300596, 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=1241023936503272118, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, companyId=1241023936482300596, 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=1241023936599741117, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, xref=2., ext=[AuthorCompanyExt(id=1241023936608129726, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, companyId=1241023936599741117, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.潍坊市人民医院，山东第二医科大学第一附属医院，山东 潍坊 261000)])], figs=[ArticleFig(id=1241023941775511600, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Figure 1, caption=he current status of depression incidence among　different ages and genders in China in 2021, figureFileSmall=oBB/ws94cXkoBcpq2iVOBw==, figureFileBig=zBrbq5aHq6oaWAd7zY4p4g==, tableContent=null), ArticleFig(id=1241023941884563515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=图1, caption=2021年中国不同年龄、不同性别抑郁症发病现状Figure1, figureFileSmall=oBB/ws94cXkoBcpq2iVOBw==, figureFileBig=zBrbq5aHq6oaWAd7zY4p4g==, tableContent=null), ArticleFig(id=1241023942140416080, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Figure 2, caption=Burden of depression among different age groups and genders in China in 2021, figureFileSmall=52FkoQYMAb0kWxBku8+KgA==, figureFileBig=xNjjMf91NQEDm2xz1ajdWQ==, tableContent=null), ArticleFig(id=1241023942262050910, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=图2, caption=2021年中国分年龄段不同性别人群抑郁症疾病负担情况, figureFileSmall=52FkoQYMAb0kWxBku8+KgA==, figureFileBig=xNjjMf91NQEDm2xz1ajdWQ==, tableContent=null), ArticleFig(id=1241023942371102821, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Table 1, caption=

Standardized rates of depression burden for different genders in China in 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
性别年份（年）标化患病率标化发病率标化DALYs率
率（1/10万）95%UI率（1/10万）95%UI率（1/10万）95%UI
男性19902 277.122 037.51～2538.681 838.071 625.99～2116.303 43.832 42.01～468.06
20212 222.581 992.07～2475.331 765.371 549.40～2048.613 30.602 33.39～450.37
变化率（%）-2.40-3.96-3.85
AAPC（%）-0.085a-0.156～-0.014b-0.446a-0.803～-0.087b-0.124a-0.210～-0.037b
女性19903 900.993 528.46～4325.693 449.633 033.90～3956.096 08.674 25.43～818.52
20213 543.443 194.80～3960.412 934.552 587.88～3398.245 33.043 78.22～723.93
变化率（%）-9.17-14.93-12.43
AAPC（%）-0.315a-0.435～-0.195b-0.446a-0.803～-0.087b-0.368a-0.592～-0.144b
合计19903 071.842 779.10～3404.492 628.672 315.01～3014.834 73.323 31.33～639.58
20212 875.682 589.96～3203.432 345.082 070.08～2722.304 30.613 05.24～586.21
变化率（%）-6.39-10.79-9.02
AAPC（%）-0.200a-0.237～-0.163b-0.348a-0.654～-0.042b-0.280a-0.513～-0.047b
), ArticleFig(id=1241023943482593396, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=表1, caption=

1990和2021年中国不同性别抑郁疾病负担标化率

, figureFileSmall=null, figureFileBig=null, tableContent=
性别年份（年）标化患病率标化发病率标化DALYs率
率（1/10万）95%UI率（1/10万）95%UI率（1/10万）95%UI
男性19902 277.122 037.51～2538.681 838.071 625.99～2116.303 43.832 42.01～468.06
20212 222.581 992.07～2475.331 765.371 549.40～2048.613 30.602 33.39～450.37
变化率（%）-2.40-3.96-3.85
AAPC（%）-0.085a-0.156～-0.014b-0.446a-0.803～-0.087b-0.124a-0.210～-0.037b
女性19903 900.993 528.46～4325.693 449.633 033.90～3956.096 08.674 25.43～818.52
20213 543.443 194.80～3960.412 934.552 587.88～3398.245 33.043 78.22～723.93
变化率（%）-9.17-14.93-12.43
AAPC（%）-0.315a-0.435～-0.195b-0.446a-0.803～-0.087b-0.368a-0.592～-0.144b
合计19903 071.842 779.10～3404.492 628.672 315.01～3014.834 73.323 31.33～639.58
20212 875.682 589.96～3203.432 345.082 070.08～2722.304 30.613 05.24～586.21
变化率（%）-6.39-10.79-9.02
AAPC（%）-0.200a-0.237～-0.163b-0.348a-0.654～-0.042b-0.280a-0.513～-0.047b
), ArticleFig(id=1241023943587451005, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Table 2, caption=

Joinpoint regression analysis of standardized incidence rate of depression in China from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
分类年份（年）APC（%）95%CIt值P值
男性1990—19925.623.90～7.377.25<0.001
1992—19952.220.61～3.863.000.011
1995—2000-2.64-3.10～-2.18-12.25<0.001
2000—2005-0.29-0.73～0.16-1.390.191
2005—2010-1.68-2.11～-1.25-8.47<0.001
2010—20140.760.05～1.472.340.037
2014—2021-0.14-0.36～0.07-1.430.178
女性1990—19950.56-0.38～1.511.260.226
1995—1999-2.88-4.74～-0.99-3.190.005
1999—2010-1.00-1.28～-0.73-7.64<0.001
2010—20151.680.50～2.873.000.008
2015—2021-0.36-1.06～0.35-1.060.302
总人群1990—19951.570.83～2.324.56<0.001
1995—2000-2.74-3.66～-1.82-6.27<0.001
2000—2005-0.41-1.30～0.49-0.970.346
2005—2010-1.45-2.32～-0.58-3.530.003
2010—20151.370.45～2.293.190.006
2015—2021-0.35-0.90～0.20-1.370.191
), ArticleFig(id=1241023943679725703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=表2, caption=

1990—2021年中国抑郁症标化发病率的joinpoint回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分类年份（年）APC（%）95%CIt值P值
男性1990—19925.623.90～7.377.25<0.001
1992—19952.220.61～3.863.000.011
1995—2000-2.64-3.10～-2.18-12.25<0.001
2000—2005-0.29-0.73～0.16-1.390.191
2005—2010-1.68-2.11～-1.25-8.47<0.001
2010—20140.760.05～1.472.340.037
2014—2021-0.14-0.36～0.07-1.430.178
女性1990—19950.56-0.38～1.511.260.226
1995—1999-2.88-4.74～-0.99-3.190.005
1999—2010-1.00-1.28～-0.73-7.64<0.001
2010—20151.680.50～2.873.000.008
2015—2021-0.36-1.06～0.35-1.060.302
总人群1990—19951.570.83～2.324.56<0.001
1995—2000-2.74-3.66～-1.82-6.27<0.001
2000—2005-0.41-1.30～0.49-0.970.346
2005—2010-1.45-2.32～-0.58-3.530.003
2010—20151.370.45～2.293.190.006
2015—2021-0.35-0.90～0.20-1.370.191
), ArticleFig(id=1241023943772000401, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Table 3, caption=

Joinpoint regression analysis of standardized prevalence of depression in China from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
分类年份（年）APC（%）95%CIt值P值
男性1990—19923.042.52～3.5612.86<0.001
1992—19951.230.74～1.725.46<0.001
1995—2000-1.19-1.34～-1.05-17.92<0.001
2000—2005-0.14-0.29～0.01-2.060.062
2005—2010-1.18-1.33～-1.03-17.09<0.001
2010—2019-0.32-0.38～-0.27-13.64<0.001
2019—20211.651.14～1.657.09<0.001
女性1990—19920.500.07～0.942.440.025
1994—2000-0.95-1.24～-0.66-6.78<0.001
2000—2005-0.33-0.75～1.10-1.620.122
2005—2010-0.97-1.38～-0.56-4.95<0.001
2010—20210.04-0.05～0.130.910.376
总人群1990—19921.671.41～1.9314.16<0.001
1992—19950.480.23～0.734.210.001
1995—2000-1.06-1.14～-0.98-29.73<0.001
2000—2005-0.22-0.30～-0.15-6.18<0.001
2005—2010-1.02-1.10～-0.94-28.28<0.001
2010—2019-0.15-0.17～-0.12-11.34<0.001
2019—20210.960.70～1.237.86<0.001
), ArticleFig(id=1241023943876858012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=表3, caption=

1990—2021年中国抑郁症标化患病率的joinpoint回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分类年份（年）APC（%）95%CIt值P值
男性1990—19923.042.52～3.5612.86<0.001
1992—19951.230.74～1.725.46<0.001
1995—2000-1.19-1.34～-1.05-17.92<0.001
2000—2005-0.14-0.29～0.01-2.060.062
2005—2010-1.18-1.33～-1.03-17.09<0.001
2010—2019-0.32-0.38～-0.27-13.64<0.001
2019—20211.651.14～1.657.09<0.001
女性1990—19920.500.07～0.942.440.025
1994—2000-0.95-1.24～-0.66-6.78<0.001
2000—2005-0.33-0.75～1.10-1.620.122
2005—2010-0.97-1.38～-0.56-4.95<0.001
2010—20210.04-0.05～0.130.910.376
总人群1990—19921.671.41～1.9314.16<0.001
1992—19950.480.23～0.734.210.001
1995—2000-1.06-1.14～-0.98-29.73<0.001
2000—2005-0.22-0.30～-0.15-6.18<0.001
2005—2010-1.02-1.10～-0.94-28.28<0.001
2010—2019-0.15-0.17～-0.12-11.34<0.001
2019—20210.960.70～1.237.86<0.001
), ArticleFig(id=1241023943969132711, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Table 4, caption=

Joinpoint regression analysis of standardized DALYs rates for depression in China from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
分类年份（年）APC（%）95%CIt值P值
男性1990—19924.203.58～4.8215.05<0.001
1992—19951.681.08～2.296.09<0.001
1995—2000-1.86-2.05～-1.68-21.66<0.001
2000—2005-0.24-0.42～-0.05-2.760.017
2005—2010-1.39-1.57～-1.21-16.71<0.001
2010—2019-0.13-0.19～-0.06-4.330.001
2019—20210.820.22～1.413.010.011
女性1990—19950.38-0.27～1.041.220.236
1995—1999-1.91-3.33～-0.48-2.770.011
1999—2010-0.75-0.97～-0.53-7.03<0.001
2010—20210.240.05～0.442.640.015
总人群1990—19941.751.09～2.425.58<0.001
1994—2000-1.55-2.00～-1.09-7.13<0.001
2000—2006-0.46-0.91～-0.00*-2.120.048
2006—2009-1.58-3.53～0.41-1.670.112
2009—20210.11-0.01～0.231.870.078
), ArticleFig(id=1241023944053018802, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=表4, caption=

1990—2021年中国抑郁病标化DALYs率的joinpoint回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分类年份（年）APC（%）95%CIt值P值
男性1990—19924.203.58～4.8215.05<0.001
1992—19951.681.08～2.296.09<0.001
1995—2000-1.86-2.05～-1.68-21.66<0.001
2000—2005-0.24-0.42～-0.05-2.760.017
2005—2010-1.39-1.57～-1.21-16.71<0.001
2010—2019-0.13-0.19～-0.06-4.330.001
2019—20210.820.22～1.413.010.011
女性1990—19950.38-0.27～1.041.220.236
1995—1999-1.91-3.33～-0.48-2.770.011
1999—2010-0.75-0.97～-0.53-7.03<0.001
2010—20210.240.05～0.442.640.015
总人群1990—19941.751.09～2.425.58<0.001
1994—2000-1.55-2.00～-1.09-7.13<0.001
2000—2006-0.46-0.91～-0.00*-2.120.048
2006—2009-1.58-3.53～0.41-1.670.112
2009—20210.11-0.01～0.231.870.078
), ArticleFig(id=1241023944157876411, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=EN, label=Table 5, caption=

Prediction of depression prevalence and DALYs rate in China from 2022 to 2031

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）抑郁症患病率（1/10万）抑郁症DALYs率（1/10万）
20223 699.11546.11
20233 722.13548.46
20243 745.29550.83
20253 768.59553.20
20263 792.04555.58
20273 815.64557.97
20283 839.38560.38
20293 863.27562.79
20303 887.31565.21
20313 911.50567.65
), ArticleFig(id=1241023944266928322, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023933290435136, language=CN, label=表5, caption=

2022—2031年中国抑郁症患病率及DALYs率预测

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）抑郁症患病率（1/10万）抑郁症DALYs率（1/10万）
20223 699.11546.11
20233 722.13548.46
20243 745.29550.83
20253 768.59553.20
20263 792.04555.58
20273 815.64557.97
20283 839.38560.38
20293 863.27562.79
20303 887.31565.21
20313 911.50567.65
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1990—2021年中国居民抑郁症疾病负担和变化趋势及预测
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穆弘杰 1 , 翟艳 2 , 王杰 1 , 苗立鹏 1 , 任柯好 1 , 吕军城 1
现代预防医学 | 流行病与统计方法 2025,52(3): 406-411
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现代预防医学 | 流行病与统计方法 2025, 52(3): 406-411
1990—2021年中国居民抑郁症疾病负担和变化趋势及预测
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穆弘杰1, 翟艳2, 王杰1, 苗立鹏1, 任柯好1, 吕军城1
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.潍坊市人民医院，山东第二医科大学第一附属医院，山东 潍坊 261000

    • 穆弘杰（2000—），女，硕士在读，研究方向：流行病与卫生统计学

通讯作者:

吕军城，E-mail:
Burden and trend changes of depression among Chinese residents from 1990 to 2021 and predictions
Hong-jie MU1, Yan ZHAI2, Jie WANG1, Li-peng MIAO1, Ke-hao REN1, Jun-cheng LV1
Affiliations
  • School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2025-02-10 doi: 10.20043/j.cnki.MPM.202409487
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摘要
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目的

描述1990—2021年中国居民抑郁症疾病负担变化趋势并预测，为防控抑郁症疾病提供参考。

方法

基于2021年全球疾病负担数据，选取发病例数、发病率、患病率、伤残调整寿命年（DALYs）及DALYs率等指标，计算变化率；利用joinpoint回归模型计算年度变化百分比（APC）和平均年度变化百分比（AAPC），分析其疾病负担趋势；用R软件结合GM（1,1）方法预测未来疾病负担趋势。

结果

2021年中国抑郁总发病例数为4 236.018万例，发病率2 977.354/10万，标化发病率2 345.079/10万。因抑郁造成的总DALYs为786.59万人年，总DALYs率为552.87/10万，总标化DALYs率为430.61/10万。中国居民总人群、男性和女性标化患病率与1990年比较分别降低6.39%、2.4%、9.17%，标化发病率分别降低10.79%、3.96%、14.93%，标化DALYs率分别降低9.02%、3.85%、12.43%。Joinpoint回归显示1990—1995和2010—2015年中国抑郁症总人群标化发病率呈上升趋势，APC分别为1.56%、1.37%；1995—2000和2005—2010年呈降低趋势，APC分别为-2.74%、-1.45%。1990—1992、1992—1995和2019—2021年标化患病率均呈上升趋势，APC分别为1.67%、0.48%、0.96%，1995—2000、2000—2005、2005—2010和2010—2019年呈降低趋势，APC分别为-1.06%、-0.22%、-1.02%、-0.15%。标化DALYs率在1990—1994年呈上升趋势，APC为1.75%，1994—2000和2000—2006年均呈降低趋势，APC分别为-1.55%、-0.46%。

结论

中国居民抑郁疾病负担不断加重，女性抑郁疾病负担更高，老年人抑郁疾病负担风险状况不容忽视，应继续加强抑郁相关健康知识宣传和防控干预。

疾病负担  /  抑郁症  /  中国居民  /  趋势分析  /  预测
Objective

To describe the changes in the burden of depression among Chinese residents from 1990 to 2021 and to forecast future trends, providing reference for the prevention and control of depression.

Methods

Based on the 2021 Global Burden of Disease data, indicators such as the number of cases, incidence rate, prevalence rate, and disability-adjusted life years (DALYs) along with DALYs rates were selected to calculate the rate of change. The Join point regression model was employed to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze the trend of disease burden. Future trends were predicted using R software combined with the GM (1,1) model.

Results

In 2021, the total number of depression cases in China was approximately 42.36 million, with an incidence rate of 2 977.354 per 100 000 and a standardized incidence rate of 2 345.079 per 100 000. The total DALYs attributed to depression were 7.8659 million years, with a total DALYs rate of 552.87 per 100 000 and a standardized DALYs rate of 430.61 per 100 000. Compared to 1990, the standardized prevalence rates for the total population, males, and females decreased by 6.39%, 2.4%, and 9.17%, respectively; the standardized incidence rates decreased by 10.79%, 3.96%, and 14.93%; and the standardized DALYs rates decreased by 9.02%, 3.85%, and 12.43%. Join point regression analysis indicated that from 1990 to 1995 and from 2010 to 2015, the standardized incidence rate of depression among the total population in China showed an increasing trend (APC of 1.56% and 1.37%, respectively), while from 1995 to 2000 and 2005 to 2010, it exhibited a decreasing trend (APC of -2.74% and -1.45%,respectively). The standardized prevalence rates from 1990 to 1992, 1992 to 1995, and 2019 to 2021 all showed an upward trend (APC of 1.67%, 0.48%, and 0.96%, respectively), whereas from 1995 to 2000, 2000 to 2005, 2005 to 2010, and 2010 to 2019, they demonstrated a downward trend (APC of -1.06%, -0.22%, -1.02%, and -0.15%, respectively). The standardized DALYs rate increased from 1990 to 1994 (APC of 1.75%) and showed a decreasing trend from 1994 to 2000 and from 2000 to 2006 (APC of-1.55% and -0.46%, respectively).

Conclusion

The burden of depression among Chinese residents is increasing, with a higher burden observed in females. The risk of depression among the elderly should not be overlooked. Continued efforts are needed to enhance public awareness of depression-related health knowledge and implement preventive interventions.

Disease burden  /  Depression  /  Chinese residents  /  Trend analysis  /  Prediction
穆弘杰, 翟艳, 王杰, 苗立鹏, 任柯好, 吕军城. 1990—2021年中国居民抑郁症疾病负担和变化趋势及预测. 现代预防医学, 2025 , 52 (3) : 406 -411 . DOI: 10.20043/j.cnki.MPM.202409487
Hong-jie MU, Yan ZHAI, Jie WANG, Li-peng MIAO, Ke-hao REN, Jun-cheng LV. Burden and trend changes of depression among Chinese residents from 1990 to 2021 and predictions[J]. Modern Preventive Medicine, 2025 , 52 (3) : 406 -411 . DOI: 10.20043/j.cnki.MPM.202409487
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抑郁症是一种常见可发于任何年龄段的心理疾病，表现为连续且长期消沉等[1]。中国精神卫生调查显示，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%，我国抑郁症患者已达9 500万[2]，2022年中国有28万人自杀[3]，其中40%患有抑郁症。世卫组织研究认为，由于中国抑郁症相关工作的缺失，导致包括医疗、丧葬等费用估计每年给中国造成78亿美元损失。本研究基于2021全球疾病负担数据库(Global Burden of Disease 2021, GBD 2021)，分析1990—2021年中国居民抑郁症疾病负担的变化趋势，为中国居民抑郁症的预治提供参考依据。
1　资料与方法
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1.1　资料来源
数据来源于GBD 2021，报告了1990—2021年204个国家和地区371种疾病和伤害的发病率等趋势估计数[4]。疾病患病率、严重程度和死亡等共同构成了对疾病负担的全面评估[5]。其中对中国抑郁负担的估计源于中国的监测数据、统计年鉴、临床数据、文献及未发表的数据等多种途径。GBD 2021将抑郁症分为心境恶劣和重度抑郁，采用《国际疾病分类》第10版（International Classification of Diseases-Tenth edition,ICD-10)规定的诊断标准。
1.2　研究方法
本研究采用患病例数、发病率、患病率、伤残调整寿命年（disability-adjusted life years,DALYs）和DALYs率等指标系统描述我国抑郁症疾病负担。由于抑郁是非致命性疾病，伤残损失健康生命年与DALYs基本相等[6]，本文以DALYs评估抑郁疾病负担。采用joinpoint对数线性模型，计算年度变化百分比（annual percent change, APC）和平均年度变化百分比（average annual percent change, AAPC)，分析各指标的时间变化趋势[7]。采用GM（1,1）灰色预测模型预测十年中国居民抑郁症的患病率和DALYs率。
1.3　统计学处理
利用Excel整理数据，对1990年和2021年我国抑郁症各项指标进行描述。根据公式（ASR为年龄别标化率，ai为第i年龄组的粗率，wi第i年龄组中标准人口构成比，A为年龄组数）结合世界标准人口结构计算标化年龄别患病率、年龄别发病率和标化DALYs率。根据（2021年数值-1990年数值）/1990年数值×100%，计算抑郁症指标的变化率。
利用Joinpoint 5.2.0软件，通过数线性模型分别对1990—2021年标化患病率、标化发病率和标化DALYs率变化趋势进行拟合，通过蒙特卡洛Permutation法选择最优模型进行计算，检验水平为α=0.05。
利用R 4.4.0软件，建立GM（1,1）灰色预测模型对未来十年中国居民抑郁症发病率和DALYs率进行预测。
2　结果
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2.1　2021年中国抑郁症疾病负担现状
2021年中国抑郁症发病例数为4 236.018万例，发病率为2 977.35/10万，标化发病率为2 345.08/10万。发病率随着年龄增长而增加，95岁以上群体发病率最高。女性发病例数为2 645.82万例，发病率为3 808.90/10万；男性发病例数为1 590.198万例，发病率为2 184.03/10万。见图1
2021年因抑郁造成的总DALYs为786.59万人年，总DALYs率为552.87 /10万，总标化DALYs率为430.61/10万。男性DALYs为302.85万人年，DALYs率为415.94/10万，标化DALYs率为330.6/10万；女性DALYs为483.74万人年，DALYs率为696.39/10万，标化DALYs率为533.04/10万年。随着年龄的增长，DALYs波动增长，在55～59岁这一年龄段达到峰值后逐渐下降，而DALYs率在70～74岁这一年龄段达到峰值，此后逐渐小幅度下降。见图2。
2.2　中国1990—2021年总人群、性别间抑郁症疾病负担变化趋势
中国总人群、男性和女性的标化患病率分别从1990年的3 071.84/10万、2 277.12/10万、3 900.99/10万降低至2021年的2 875.68/10万、2 222.58/10万、3 543.44/10万。
中国总人群、男性和女性的标化发病率分别从1990年的2 628.67/10万、1 838.07/10万、3 449.63/ 10万降低至2021年的2 345.08/10万、1 765.37/10万、2 934.55/10万。
中国总人群、男性和女性的标化DALYs率分别从1990年的473.32/10万、343.83/10万、608.67/10万降低至2021年的430.61/10万、330.60/10万、533.04/10万。
男性抑郁症的标化患病率，标化发病率和标化DALYs率均低于女性，2021年男性、女性和总人群抑郁症的标化率均低于1990年，不同性别居民1990年和2021年抑郁症疾病负担情况见表1。
2.3　 1990—2021年中国抑郁症疾病负担年度变化趋势
Joinpoint回归分析结果显示，1990—1995和2010—2015年中国抑郁症标化发病率呈上升趋势，APC分别为1.56%、1.37%；1995—2000和2005—2010年呈下降趋势，APC分别为-2.74%、-1.45%；2000—2005和2015—2021年变化趋势无统计学意义（P>0.05）。见表2。
1990—1992、1992—1995和2019—2021年中国抑郁症标化患病率均呈上升趋势，APC分别为1.67%、0.48%、0.96%；1995—2000、2000—2005、2005— 2010和2010—2019年呈下降趋势，APC分别为-1.06%、-0.22%、-1.02%、-0.15%。见表3。
1990—1994年中国抑郁症标化DALYs率呈上升趋势，APC为1.75%；1994—2000和2000—2006年均呈下降趋势，APC分别为-1.55%、-0.46%；2006—2009和2009—2021年变化趋势无统计学意义。见表4。
2.4　中国居民1990—2021年不同抑郁症病种分析
中国居民重度抑郁症、心境恶劣的DALYs分别从1990年386.96万人年、155.70万人年增长至2021年的519.65万人年、266.95万人年；两病种的DALYs率从1990年的328.92/10万、132.35/10万增长至2021年的365.24 /10万、187.63 /10万；两病种的标化DALYs率分别为1990年的330.26/10万、.06/10万和2021年的287.48/10万、.13 /10万。
与1990年比较，2021年重度抑郁症、心境恶劣DALYs率分别增加了11.0%和41.8%，标化重度抑郁症DALYs率降低了13.0%，标化心境恶劣DALYs率却增加了0.05%。
2.5　2022—2031年中国居民抑郁症发病率和DALYs率预测
本研究使用R软件对2022—2031年中国居民抑郁症患病率、DALYs率进行预测。根据GM(1,1)灰色预测模型结果显示，抑郁症患病率的a=-0.006 2，灰色作用量u=3 024.357，后验差比值C=0.022 6，小误差概率p=1。DALYs率的a=-0.004 3，灰色作用量u=474.982 3，后验差比值C=0.208 1，小误差概率p=0.813，预测模型精度等级非常好，模型预测精度比较高。根据GM(1,1)灰色预测模型结果，预计2022—2031年中国居民抑郁症患病率、DALYs率继续呈现上升趋势；至2031年，中国居民抑郁症患病率、DALYs率将为3911.5/10万和567.65/10万。见表5。
3　讨论
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3.1　中国抑郁症防治效果初有成效
与1990年相比，2021年中国居民抑郁症各项标化率总体呈下降趋势，2000年后标化DALYs率一直缓慢下降，提示我国政府已采取积极措施进行抑郁症的防治。可能因为2013年《中华人民共和国精神卫生法》明确将抑郁症定义为精神疾病，2019年发布《健康中国行动》[8]，2020年出台《肺炎疫情紧急心理危机干预指导原则》[9]。但在2019—2021年，标化患病率、男性与女性的标化DALYs率均呈上升趋势，可能与新冠病毒大流行公共卫生事件有关，公众处于高水平心理应激状态，更易抑郁[10]，导致抑郁疾病负担加重。2022年颁布《“十四五”国民健康规划》强调全方位干预，全周期保障人群心理健康，全社会的心理健康意识增强，导致抑郁疾病负担再次减轻。
3.2　应关注重点人群的抑郁症负担
本研究表明中国女性在不同年龄组不同年份抑郁症的各项标化率均高于男性，提示女性的抑郁症疾病负担高于男性。以往研究表明女性在抑郁、焦虑等指标分值均显著高于男性[11]，对于负面情绪和事件的感受更加突出[12]。女性DALYs在50～59年龄段数值较高，可能是围绝经期女性长期缺乏雌激素导致内分泌紊乱，增加了抑郁疾病负担[13]。
中国老年人抑郁症患病例数和DALYs均较高，抑郁疾病负担较重。可能是老年人慢性病群体，长期服药和较重的经济负担，加重其抑郁情绪[14]；独居老年人缺乏情感上支持与联系[15]，子女陪伴缺失[16]和传统观念对老年人再婚观念的束缚[17]，更易导致抑郁症，加重老年人抑郁症疾病负担。
在抑郁症不同病种中，心境恶劣的标化DALYs率增加。心境恶劣抑郁状态较为恒定，若不及时治疗，易发展为重度抑郁[18]，增加疾病负担。
3.3　中国抑郁症疾病负担形式仍然严峻
2021年我国抑郁症发病率、DALYs和DALYs率仍较高。未来十年预测显示DALYs率呈现上升趋势，因抑郁症具有高复发率和高疾病负担特征，提示我国抑郁症疾病负担将持续加重。因近年来社会发展节奏加快，社会生存压力增加，更容易导致抑郁症；劳动力不断向城市转移，农村人群抑郁症疾病负担加重明显[19-20]。生存压力增大，易导致不良生活习惯和不良的家庭功能，这些均与抑郁症成正相关[21-23]，增加其疾病负担。家庭、社区、政府应形成合力，降低抑郁症疾病负担。
本研究利用GBD 2021数据库，分析中国抑郁疾病负担现状、变化趋势和未来趋势预测，对减轻疾病负担具有参考意义。但本研究也存在局限性：一是，数据库可能存在偏性；二是，数据库尚未深入探讨不同地区城乡间的差异分析，将来会深入研究。
基金
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  • 2023年度教育部人文社会科学研究项目(23YJAZH095)
  • 山东省自然科学基金项目(ZR2021MH408)
文献
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2025年第52卷第3期
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doi: 10.20043/j.cnki.MPM.202409487
  • 接收时间：2024-09-25
  • 首发时间：2026-03-18
  • 出版时间：2025-02-10
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  • 收稿日期：2024-09-25
基金
2023年度教育部人文社会科学研究项目(23YJAZH095)
山东省自然科学基金项目(ZR2021MH408)
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.潍坊市人民医院，山东第二医科大学第一附属医院，山东 潍坊 261000

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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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