Burden and trends of major depressive disorders among women of childbearing age and the impact of the COVID-19 pandemic: insights from the global burden of disease study 2021.
{"title":"Burden and trends of major depressive disorders among women of childbearing age and the impact of the COVID-19 pandemic: insights from the global burden of disease study 2021.","authors":"Guobin Liao, Jiaoxue Wang, Qiaozhi Yu, Honglin Ma, Hezhong Yan, Zhaoyun He, Jun Tang","doi":"10.3389/fpsyt.2025.1630601","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) exhibits a pronounced female predominance, contributing substantially to disability-adjusted life-years (DALYs) among women of childbearing age (WCBA; 15-49 years). The COVID-19 pandemic intensified this burden via psychosocial stressors and disrupted healthcare access, yet integrated analyses of pre- and post-pandemic trends are scarce.</p><p><strong>Methods: </strong>Leveraging GBD 2021 data, we assessed MDD prevalence, incidence, and DALYs among WCBA globally, regionally, and nationally (1990-2021). Burden estimates were reported as point values with 95% uncertainty intervals (UIs). Temporal trends were quantified via estimated annual percentage change (EAPC) and absolute percentage change (PC). We employed autoregressive integrated moving average (ARIMA) models to compare pre-pandemic (1990-2019) and pandemic-inclusive (1990-2021) projections through 2036.</p><p><strong>Results: </strong>Global prevalent cases among WCBA surged from 49.6 million (95% UI: 41.6 to 60.2) in 1990 to 85.6 million (95% UI: 70.3 to 103.8) in 2021, reflecting a 25.7% acceleration during 2019-2021 versus 1.2% annual growth pre-pandemic. Prevalence rates declined marginally pre-2019 (EAPC: -0.38, 95% CI: -0.48 to -0.29) but reversed sharply post-pandemic (EAPC: 11.47, 95% CI: -0.56 to 24.95), reaching 4,394.55 per 100,000 population in 2021. Regionally, middle and low-middle socio-demographic index (SDI) regions accounted for over 55% of global cases (23 million [95% UI: 18.9 to 27.8] and 24.2 million [95% UI: 19.6 to 29.9], respectively) in 2021, while low SDI regions showed the fastest growth (160% since 1990). High-SDI regions exhibited extremes: the highest 2021 prevalence rate (5915.76 per 100,000 population) and steepest post-2019 surge (EAPC: 13.66). In 2021, the prevalence rates were highest in high-income North America (8403.17 per 100,000 population) and lowest in East Asia (1856.99 per 100,000 population). Nationally, India reported the highest prevalent cases (16.3 million, 19% of global share), while Greenland had the highest prevalence rate (13,822.85 per 100,000 population). Adolescents (15-19 years) experienced the largest pandemic-driven increase (30.06% PC), except in East Asia where prevalence rates declined (-11.53%). ARIMA projections suggest 103.06 million global prevalent cases by 2036-32% above pre-pandemic estimates-with high SDI regions persisting at 5,617.68 per 100,000 population.</p><p><strong>Conclusions: </strong>Our analysis reveals a dual crisis: high SDI regions face entrenched high prevalence rates (5,617.68 per 100,000 population projected), while low SDI regions carry substantial burden (4,593.77 per 100,000) with rapid case expansion (160% since 1990). The pandemic disproportionately impacted adolescents globally (+30.06% PC), yet East Asia demonstrated resilience (-11.53% PC). These findings demand stratified interventions: digital mental health tools in high-income settings, community-based screening in resource-limited areas, and adolescent-focused programs worldwide. Immediate policy action is needed to avert intergenerational mental health consequences.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1630601"},"PeriodicalIF":3.2000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489947/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fpsyt.2025.1630601","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Major depressive disorder (MDD) exhibits a pronounced female predominance, contributing substantially to disability-adjusted life-years (DALYs) among women of childbearing age (WCBA; 15-49 years). The COVID-19 pandemic intensified this burden via psychosocial stressors and disrupted healthcare access, yet integrated analyses of pre- and post-pandemic trends are scarce.
Methods: Leveraging GBD 2021 data, we assessed MDD prevalence, incidence, and DALYs among WCBA globally, regionally, and nationally (1990-2021). Burden estimates were reported as point values with 95% uncertainty intervals (UIs). Temporal trends were quantified via estimated annual percentage change (EAPC) and absolute percentage change (PC). We employed autoregressive integrated moving average (ARIMA) models to compare pre-pandemic (1990-2019) and pandemic-inclusive (1990-2021) projections through 2036.
Results: Global prevalent cases among WCBA surged from 49.6 million (95% UI: 41.6 to 60.2) in 1990 to 85.6 million (95% UI: 70.3 to 103.8) in 2021, reflecting a 25.7% acceleration during 2019-2021 versus 1.2% annual growth pre-pandemic. Prevalence rates declined marginally pre-2019 (EAPC: -0.38, 95% CI: -0.48 to -0.29) but reversed sharply post-pandemic (EAPC: 11.47, 95% CI: -0.56 to 24.95), reaching 4,394.55 per 100,000 population in 2021. Regionally, middle and low-middle socio-demographic index (SDI) regions accounted for over 55% of global cases (23 million [95% UI: 18.9 to 27.8] and 24.2 million [95% UI: 19.6 to 29.9], respectively) in 2021, while low SDI regions showed the fastest growth (160% since 1990). High-SDI regions exhibited extremes: the highest 2021 prevalence rate (5915.76 per 100,000 population) and steepest post-2019 surge (EAPC: 13.66). In 2021, the prevalence rates were highest in high-income North America (8403.17 per 100,000 population) and lowest in East Asia (1856.99 per 100,000 population). Nationally, India reported the highest prevalent cases (16.3 million, 19% of global share), while Greenland had the highest prevalence rate (13,822.85 per 100,000 population). Adolescents (15-19 years) experienced the largest pandemic-driven increase (30.06% PC), except in East Asia where prevalence rates declined (-11.53%). ARIMA projections suggest 103.06 million global prevalent cases by 2036-32% above pre-pandemic estimates-with high SDI regions persisting at 5,617.68 per 100,000 population.
Conclusions: Our analysis reveals a dual crisis: high SDI regions face entrenched high prevalence rates (5,617.68 per 100,000 population projected), while low SDI regions carry substantial burden (4,593.77 per 100,000) with rapid case expansion (160% since 1990). The pandemic disproportionately impacted adolescents globally (+30.06% PC), yet East Asia demonstrated resilience (-11.53% PC). These findings demand stratified interventions: digital mental health tools in high-income settings, community-based screening in resource-limited areas, and adolescent-focused programs worldwide. Immediate policy action is needed to avert intergenerational mental health consequences.
期刊介绍：
Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.
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