Divergent Trajectories in Adolescent Depression: An Age-Period-Cohort Assessment of the China-Global Divide, 1990–2036
YeGao
MD
1JuntaoGuo
MD
1XuerunYang
MD
1SihanXu
MD
1LiDing
MD
1✉Email903881182@qq.com1Hangzhou Medical CollegeNo. 8, Yikang Street, Jinnan Subdistrict Lin’an DistrictHangzhouZhejiangChina
Ye Gao, MD1; Juntao Guo, MD1; Xuerun Yang, MD1; Sihan Xu, MD1; Li Ding, MD1*
1Hangzhou Medical College, Hangzhou, China
*Corresponding authors
Li Ding
Email: 903881182@qq.com
Hangzhou Medical College No. 8, Yikang Street, Jinnan Subdistrict Lin'an District, Hangzhou, Zhejiang, China
Abstract
Objective
To inform targeted prevention and control strategies, A systematic analysis was conducted to examine the trends and disparities in the burden of depression among teens who aged 10-24y in China compared to globally between 1990 and 2021, with estimates to 2036. Leveraging data from the Global Burden of Disease Study (GBD) 2021.
Methods
Drawing on the GBD 2021
result tools, an analysis was conducted to compare the age-standardized incidence, prevalence, and DALY rates of adolescent depression in China relative to global averages. We evaluated temporal trends by estimating the annual percentage change (EAPC) and utilized Bayesian age-period-cohort (BAPC) models to analyze influencing factors and estimate the future burden.
Results: Between 1990 and 2021, global adolescent depression cases rose by 49.41%, while China saw a striking 57.49% decrease. The gender gap was wider in China, with females bearing a consistently higher burden. Globally, the sharpest incidence increase occurred in the 10–14 age group, whereas China's most notable decline was in the 20–24 group. Projections indicate a continued decline in China's incidence through 2036, contrasting with persistently high global rates.
A
Conclusion: China has achieved a notable decline in adolescent depression from 1990 to 2021, contrasting with the rising global trend. This success is attributed to policy interventions, socioeconomic development, and expanded health services. Sustaining progress requires further refining mental health systems, prioritizing female and younger adolescents, and integrating AI to enhance early detection and intervention.Keywords:
Depressive Disorders
Adolescents
Global Burden of Disease
Bayesian Age-Period-Cohort Model
1. Introduction
The characteristic of depression is chronic distress, low motivation, slowed thinking, insominia, and eating disorders.some patients even have a tendency to take their own life. Depression ranks among the most prevalent chronic mental conditions on a global scale[1–4]. According to data from GBD 2021, the total number of adolescent depression cases globally in 2021 increased by 49.41% compared to 1990, establishing depression as a significant public health issue. In recent years, despite the implementation of a series of effective measures for the preclusion and governance of mental disorders in China, the country remains one of the most severely affected by mental disorders globally [5]. Adolescents are in a critical stage of growth and development, characterized by rapid physical, emotional, and social changes. This period renders them highly vulnerable to psychological problems like depression, with suicide resulting from depression being one of the chief causes of fatality among teenagers [6–8]. In previous studies, several scholars have documented the global burden of depression, providing critical data to guide health policies and public sector resource allocation [9, 10]. However, these analyses primarily adopt a global perspective, overlooking variations across countries and demographic factors, including age, gender, and sociodemographic index, as well as age-specific particularities. As the preeminent developing society in terms of both size and population, China has undergone rapid economic growth over the past three decades. Its development trajectory and projections may offer valuable insights for other nations [11]. Moreover, existing studies often focus on all-age populations, limited geographical regions, or outdated datasets, leaving a comprehensive analysis of regional dynamic trends still largely lacking.
This research was based on the GBD 2021 dataset, stratified by sex, age, region, country, and Socio-demographic Index, to calculate and compare the age-standardized DALYs, incidence and prevalence years of depression among adolescents in China and globally. It examined trends from 1990–2021 and projected the ASIR for the next fifteen years, with the aim of informing prevention and control strategies for adolescent depression.
2. Methods
2.1. Data Collection and Criteria for Study Enrollment
The datasets generated and analysed during the current study are available in the GBD2021 results tool repository, http://ghdx.healthdata.org/gbd-results-tool. The dataset encompasses 204 countries and territories, organized into 21 regions, with records extending back to 1990. Comprehensive data on the prevalence, incidence, and mortality of 371 diseases and injuries are provided, along with metrics such as YLD, YLL, and the resulting disability-adjusted life years. All metrics are provided as counts, proportions, and percentages. Researchers can filter the data by sex, age group, and geographic location based on their requirements [12]. To further investigate the depression-related disease burden in specific age groups across China and globally, Our research centered on the younger population (aged 10 to 24) which is defined as adolescents and young adults [13].
Case definitions for depression in this study were defined in accordance with the GBD study, drawing upon the diagnostic criteria of the DSM-IV-TR and the ICD-10 [14, 15]. The ICD-10 subdivides depressive disorders into two principal forms, which are major depressive disorder and persistent depressive disorder. Consequently, cases of MDD and persistent depressive disorder that aligned with the DSM and ICD diagnostic criteria were encompassed within the present GBD study. As the GBD 2021 data is open-access, ethical approval was not required for this study.
2.2. The age-standardized rate (ASR)
In epidemiological analysis, incidence data are often compared across regions or time periods using the age-standardized rate. Unlike crude rates, ASRs minimize the effect of variations in population age structures, thereby enabling more valid comparisons. The calculation method for age-standardized rates has been well-documented in previous studies. Accordingly, all comparisons of incidence, prevalence, and DALYs across different countries and regions in this study were performed using age-standardized values.
2.3. The Socio-demographic Index (SDI)
A composite index, the SDI assesses the level of development achieved by various countries and regions. It is derived from the geometric mean of a combination of factors, including fertility rate, educational attainment, and income per capita. In GBD 2021, the SDI is grouped into five categories: low SDI (0-0.45), low-middle SDI (0.45–0.61), middle SDI (0.61–0.69), high-middle SDI (0.69–0.81), and high SDI (0.81-1). A higher SDI value indicates better socioeconomic development conditions [16].
2.4. Statistical Analysis
The depression data presented in this study for the 10-24-year-old cohort were obtained from the GBD Results Tool, categorized by sex. The data were primarily analyzed using descriptive analytical methods. The estimated annual percentage change (EAPC) was calculated, along with its 95% confidence interval (CI) for the age-standardized prevalence of depression among 10-24-year-olds across the five SDI and twenty-one GBD regions. An analysis of temporal trends and the disease burden was conducted for the period from 1990 to 2021 [17–19]. The EAPC and its 95% CI were derived from a log-linear regression model. Its expressed as
ln(ASPR) = α + βx + ε
the calendar year is represented by x, β is the regression coefficient, α is the intercept, and the error term is denoted by ε. The EAPC was derived using the formula EAPC = 100 × (exp(β) − 1). The ASPR trend was defined by the EAPC and its 95% CI: increase if EAPC > 0 and lower CI limit > 0; decrease if EAPC < 0 and upper CI limit < 0; otherwise, stable. Additionally, we separately calculated these metrics for China and the global aggregate to compare the trends in age-standardized prevalence, incidence, and DALYs among adolescents.
The APC model was employed to disentangle the period, age, and cohort effects on disease trends. This model estimates the net drift (overall temporal trend) and local drifts (age-specific trends) to reflect the overall and particular age-related changes in disease burden over time [20, 21]. The BAPC model extends the standard APC framework by incorporating Bayesian inference. This model employs the Integrated Nested Laplace Approximation method to generate approximate marginal posterior distributions for incidence rate prediction. Compared to alternative forecasting methods, the BAPC model demonstrates superior coverage probability and accuracy [22]. By this model, we projected the future burden of adolescent depression from 2022 to 2036 for both global and Chinese populations. All analyses were performed with Python (version 3.13.2) and R (version 4.3.3). Statistical significance was defined as a p-value of less than 0.05.
3. Results
3.1. Global Burden of Disease of Adolescent Depression Across 204 Countries and Territories in 2021
Globally in 2021, there were 38,476,683 cases of depressive disorders among adolescents (95% CI: 30,133,092 − 48,956,768), with an ASPR of 3045.32 (95% CI: 2337.53-3914.11). This represents a 49.41% increase from the 1990 case count of 57,488,802 (95% CI: 44,127,193 − 73,889,612) (Supplementary Table 1). Among the ten countries with the highest ASPR, the highest was Greenland (10472.37 [7285.53-14538.78]), followed by the United States (7249.38 [5846.84-8825.56]), Palestine (6576.22 [4544.37-9446.90]), Tunisia (6433.85 [4416.49-9171.22]), Greece (6314.98 [4417.90-9049.26]), Lebanon (5858.45 [3911.06-8253.04]), Portugal (5757.65 [3968.76-8106.31]), Chile (5702.34 [3830.07-7874.17]), Ireland (5678.40 [3892.60-7905.27]), and Finland (5668.28 [3971.72-7728.88]). According to the classification by GBD super-regions, six countries are from high-income regions: Greenland, the United States, Greece, Portugal, Ireland, and Finland. Palestine, Tunisia, and Lebanon are from North Africa and the Middle East, while Chile belongs to Latin America and the Caribbean (Fig. 1). The countries with the highest ASIR and ASDR differ slightly from those with the highest ASPR, but the overall pattern remains largely consistent, primarily comprising high-income regions, high-altitude areas, or conflict-affected zones. China recorded the lowest values per 100,000 population for ASIR, ASPR, and ASDR at 1387.39 (1042.41-1802.23), 1265.38 (1013.95-1581.38), and 218.45 (141.05-316.71), respectively.
A
Fig. 1
The burden of depressive disorders among adolescents across 204 countries and territories worldwide in 2021. (A) Age-standardized incidence rate; (B) Age-standardized prevalence rate; (C )Age-standardized disability-adjusted life years
3.2. Epidemiological Trends of Adolescent Depression Prevalence by GBD Region
From Fig. 2, we observed that during 1990–2021, across regions grouped by the Socio-demographic Index, high-SDI regions exhibited a significant increase in ASPR (EAPC = 0.83 [0.62–1.03]), while the other four regions showed no significant changes. The adolescent depression prevalence rates across all 5 SDI regions demonstrated an overall increasing trend over time, with the most pronounced rise observed in 2020 and 2021. The adolescent depression prevalence rates across all SDI regions demonstrated an overall increasing trend over time, with the ASPR rates in 2020 and 2021 consistently maintaining the following order: high-SDI region > low-SDI region > low-middle-SDI region > high-middle-SDI region > middle-SDI region (Supplementary Fig. 1). Notably, the ASPR in the high-SDI region substantially exceeded those in all other regions. Through the 21 GBD super-regions, East Asia exhibited a significant decreasing trend in the age-standardized prevalence rate (EAPC = -1.13 [-1.32 to -0.94]). Nine regions showed a positive EAPC with 95% CIs not including zero, indicating a significant increase in ASPR: High-income North America (EAPC = 1.05 [0.78–1.31]), Central Latin America (EAPC = 0.79 [0.55–1.03]), Southern Sub-Saharan Africa (EAPC = 0.62 [0.41–0.82]), High-income Asia Pacific (EAPC = 0.50 [0.36–0.63]), Central Asia (EAPC = 0.40 [0.25–0.55]), North Africa and Middle East (EAPC = 0.40 [0.25–0.56]), Andean Latin America (EAPC = 0.38 [0.01–0.75]), Australasia (EAPC = 0.29 [0.16–0.42]), and Southeast Asia (EAPC = 0.26 [0.05–0.46]). The ASPR in the remaining regions showed no significant changes (Fig. 2, Supplementary Table 1).
Fig. 2
Global and Regional Trends in Adolescent Depression Prevalence from 1990 to 2021
3.3. Global and Chinese Adolescent Depression Burden and Trends: A Comparative Analysis
The number of depression cases among Chinese adolescents decreased from 6,967,371 (95% CI: 5,532,091 − 8,874,797) in 1990 to 2,961,493 (95% CI: 2,373,048 − 3,701,057) in 2021, representing an overall reduction of 57.49%. During the same period, the number of depression cases among adolescents worldwide increased from 38,476,683 (95% CI: 30,133,092 − 48,956,768) in 1990 to 57,488,802 (95% CI: 44,127,193 − 73,889,612) in 2021, representing an overall increase of 49.41%. The global ASPR per 100,000 population increased from 2486.87 (95% CI: 1947.60-3164.23) in 1990 to 3045.32 (95% CI: 2337.53-3914.11) in 2021, representing a 22.49% increase. In contrast, China’s ASPR decreased from 1930.24 (95% CI: 1532.61-2458.68) per 100,000 population in 1990 to 1265.38 (95% CI: 1013.95-1581.38) per 100,000 population in 2021, indicating a 34.46% reduction. Meanwhile, both the age-standardized incidence rate and ASDR in China showed a declining trend, with the ASIR decreasing most rapidly (EAPC = -1.62 [-1.79 to -1.45]). The decline in ASDR (EAPC = -1.38 [-1.57 to -1.19]) indicates a substantial reduction in health life loss due to depressive disorders among Chinese adolescents, marking Chinese reversal from a high-burden to a relatively low-burden status. In contrast, the globally ASPR and ASDR increased significantly, while the global ASIR remained relatively stable (Table 1). Depressive disorders among adolescents have now evolved into a global public health crisis.
Position | Measure | 1990 | 2021 | EAPC | ||
|---|---|---|---|---|---|---|
cases | Age-standardized rates per 100,000 people | cases | Age-standardized rates per 100,000 people | |||
n(95%CI) | n(95%CI) | n(95%CI) | n(95%CI) | n(95%CI) | ||
China | Incidence | 8490152.25 (6428751.01-11231687.68) | 2352.11 (1781.02-3111.63) | 3247037.49 (2439644.97-4217916.24) | 1387.39 (1042.41-1802.23) | -1.62 (-1.79- -1.45) |
Prevalence | 6967370.56 (5532091.12-8874797.22) | 1930.24 (1532.61-2458.68) | 2961493.27 (2373048.25-3701057.31) | 1265.38 (1013.95-1581.38) | -1.16 (-1.35 --0.97) | |
DALYs | 1275500.14 (813918.12-1850997.91) | 353.36 (225.49–512.80) | 511264.54 (330115.98-741228.16) | 218.45 (141.05-316.71) | -1.38 (-1.57–1.19) | |
Global | Incidence | 47739041.74 (35706346.80-63520937.78) | 3085.52 (2307.81-4105.56) | 73809680.85 (53637290.78-97618586.15) | 3909.88 (2841.30-5171.10) | 0.16 (-0.06-0.39) |
Prevalence | 38476683.31 (30133091.64-48956768.45) | 2486.87 (1947.60-3164.23) | 57488801.52 (44127193.40-73889611.62) | 3045.32 (2337.53-3914.11) | 0.22 (0.05–0.39) | |
DALYs | 7025089.40 (4512560.16-10171660.99) | 454.05 (291.66-657.43) | 10718194.81 (6792135.50-15633301.28) | 567.77 (359.80-828.13) | 0.21 (0.02–0.41) | |
3.4. Sex-specific prevalence of depressive disorders in adolescent populations
The ASPR, ASIR, and ASDR of depressive disorders among adolescents in both China and globally were consistently higher in women than in males, indicating that females represent a high-risk population for depression (Fig. S1). The ASIR male-to-female ratio in China demonstrated a trend of initial sustained increase followed by decline, rising from 0.471 in 1990 to a peak of 0.608 in 2007, then beginning a gradual decline after 2008, reaching 0.586 in 2021, indicating a relative deterioration in male incidence following an initial improvement (Fig. 3A). The male-to-female ratio of ASPR remained relatively stable, fluctuating within the range of 0.556–0.608 with minimal variation, and consistently stayed at a lower level of 0.556–0.559 during 2016–2019 (Fig. 3B). The male-to-female ratio of ASIR for global adolescent depression showed a gradual increase within the range of 0.576–0.616, while the male-to-female ratio of ASPR demonstrated a steady growth within 0.595–0.626. A slight fluctuation was observed in 2020, but the ratios quickly recovered, reflecting strong resilience at the global level (Fig. 3C, D). The ASIR of depression among females in China is 1.7 to 2.1 times higher than that among males, with the trend exhibiting an inverted U-shaped pattern. Globally, the age-standardized incidence rate among females is 1.6 to 1.7 times higher than that among males, showing a trend of gradual improvement. In comparison, the gender disparity in China is significantly more pronounced than the global level.
Fig. 3
Gender disparity ratios in adolescent depression from 1990 to 2021.(A) Gender disparity ratio of ASIR for adolescent depression in China; (B) Gender disparity ratio of ASPR for adolescent depression in China; (C) Gender disparity ratio of ASIR for adolescent depression globally; (D) Gender disparity ratio of ASPR for adolescent depression globally
3.5. Age-specific prevalence of depression among adolescents
Both in China and globally, the disease burden of depression increases significantly with age; however, fundamental differences exist in growth patterns across different periods and long-term trends. Across all age groups in China, the ASIR exhibited a generally downward albeit sometimes fluctuating trend throughout the observation period, particularly in the 20–24 age group, where the decline was most pronounced decreasing from 3394.41 per 100,000 (95% CI: 4626.42-2540.26) in 1990 to 2008.62 per 100,000 (95% CI: 2785.99-1486.39) in 2021, representing a reduction of 40.84% (Fig. 4A). Consistent with the ASIR trend, the ASPR among Chinese adolescents also showed a decline or remained stable with fluctuations across most age groups (Fig. 4B). In contrast, the global ASIR among adolescents showed a significant increase across all three age groups (10–14, 15–19, and 20–24 years), with the fastest growth observed in the 10–14 age group-rising from 1399.38 (95% CI: 883.38-2029.01) in 1990 to 2013.71 (95% CI: 1282.04-2954.95) in 2021, an increase of approximately 43.89%. This trend toward younger onset warrants attention (Fig. 4C). Similarly, the global ASPR also rose markedly across the three age groups, peaking in 2021, indicating a continuously expanding patient pool and an increasingly severe overall disease burden (Fig. 4D).
Fig. 4
Age-specific trends in adolescent depression from 1990 to 2021. Age-specific ASIR (A) and ASPR (B) of adolescent depression in China; Age-specific ASIR (C) and ASPR (D) of adolescent depression globally
3.6. Trends in Adolescent Depression Prevalence: Projections to 2036
A predictive model was developed in this study to assess the burden of depression among adolescents and young adults aged 10 to 24, analyzing comparative trajectories of ASIR between China and the global level over a 15-year projection period (Fig. 5). In China, the ASIR of depression is projected to decline from 1,387.39 in 2021 (Table 1) to a lower level by 2036 (Fig. 5A), following a minor intermediate peak (1,445.81 per 100,000). Globally, extreme values observed in 2021 and 2022 were excluded to mitigate their undue influence on trend projections. Consequently, only data from 1990 to 2019 were used for forecasting future developments. It is projected that over the coming 15 years, the ASIR will stay around 3050 cases per 100,000 population, with no significant downward trend observed (Fig. 5B). These projections suggest that the burden of depression in China may decrease over the next 15 years, whereas the global burden of major depressive disorder and other mental illnesses is expected to remain high, showing no marked improvement.
Fig. 5
Projected Changes in ASIR in China(A) and Globally(B) from 2022 to 2036
4. Discussion
The onset of mental disorders, including depression, anxiety, eating disorders, and psychosis in individuals aged 10–24 poses a major public health challenge, with their frequent emergence in early life, persistence into adulthood, and consequent long-term morbidity compounding a substantial societal burden [23–26]. Analyzing trends in adolescent depression (10–24 years) from 1990 to 2021, this study found a rising global burden, projected to continue over the next 15 years. Specifically, significant increases were observed in the age-standardized incidence (EAPC = 0.16, 95% CI: -0.06 to 0.39), prevalence (EAPC = 0.22, 95% CI: 0.05 to 0.39), and DALYs (EAPC = 0.21, 95% CI: 0.02 to 0.41), with a notable acceleration during the COVID-19 pandemic. A marked decline was observed across all three indicators in China during the same period, representing an encouraging trend that contrasts sharply with global patterns. This inverse correlation suggests not only successful mental health interventions in China but also highlights the complex role played by varying socioeconomic, cultural, and health policy contexts in shaping the depression burden [27–29]. The notable reduction in China’s adolescent depression burden, positioning it among the lowest globally, was facilitated in part by earlier expansions of essential health services. A critical initiative in this expansion was the ‘686 Program’, launched in 2004, through which central government funds were allocated to subsidize management and treatment for severe mental disorders at the local level [30, 31]. A series of policy measures have been instrumental in mitigating the burden of adolescent depression in China. Key among these are the 2013 Mental Health Law, which mandated the establishment of psychological counseling rooms and the deployment of dedicated personnel in schools to identify and support affected students, and the broader "Healthy China Action Plan (2019–2030)" launched in 2020, which encompassed specific action schemes for child and adolescent mental health. During the COVID-19 pandemic, only a minor increase in the incidence rate was observed in China, which may be associated with the proactive lockdown measures implemented. Furthermore, China’s success may be attributed to its distinctive "developmental dividend." The rapid economic growth over the past three decades has catalyzed widespread poverty reduction, enhanced educational attainment, and facilitated the rapid expansion and improvement of the healthcare system, including mental health services. Conversely, a persistent increase in the global depression burden among adolescents was observed, with a notable surge from 2019 to 2021. This period saw a significant rise in incidence, with the impacts of lockdowns, school closures, and fractured social networks factors identified by numerous studies as having a disproportionately severe impact on adolescents, becoming fully apparent [32–34]. Contrary to a simple linear relationship with the SDI, the adolescent depression burden revealed a complex pattern in our regional analysis. The highest and most rapidly rising prevalence was found in high-SDI regions, including the United States, Greenland, and multiple Western European countries. Meanwhile, China, an upper-middle SDI nation, carries a strikingly lower burden relative to the global average. The conventional assumption that economic advancement automatically translates to better psychological well-being is contradicted by these findings. The heightened burden in high-SDI nations can be partially explained by improved detection capabilities, while also reflecting the psychological toll of competitive social environments and pervasive social media exposure [35, 36]. Rather than alleviating social pressure, economic development in high-income countries may be associated with its exacerbation among adolescents, a phenomenon potentially linked to mounting competitive environments and escalating societal demands. It was observed that the gender disparity in depressive incidence was substantially wider in China than globally. The rate among female adolescents was 1.7–2.1 times that of males, whereas the corresponding global ratio ranged from 1.6 to 1.7. The observed decline in the male-to-female incidence ratio for depression in China since its 2007 peak signals a relative worsening of the male outlook. However, the absolute risk is persistently higher in females, a pattern potentially driven by sex-specific factors like amygdala-mediated emotional processing and estrogen volatility [37, 38]. This underscores the necessity for China’s future depression control strategies to be gender-specific. Age-specific trends revealed a critical divergence: while the global incidence rate increased most rapidly in the 10–14 age group (43.89%), highlighting a worldwide trend toward earlier onset of depression, the most pronounced decline in China was observed in the 20–24 age group. This pattern may reflect differential effectiveness of intervention measures across educational stages in China. The global trend of depression manifesting at increasingly younger ages signals an urgent need for China to preemptively shift interventions earlier, specifically by enhancing focus on and investment in the mental well-being of primary and middle school students, even as older adolescents may see benefits from university services, matured coping skills, or eased pressures post-graduation.
The above findings are further reinforced by projections from our BAPC model, which reveal a continuing decline in China’s ASIR over the next fifteen years. Conversely, the global ASIR is forecast to persist at elevated levels, showing no marked signs of abating. This projection not only validates the sustainability of current trends but also underscores the referential value of the Chinese model, as sustained and targeted national policy investments have demonstrated that the burden of adolescent depression can be effectively managed. While such achievements suggest a replicable framework, they do not warrant complacency, given the persistent challenges: the still substantial absolute number of patients, marked gender disparities, and emerging social stressors, including employment pressures and evolving online environments which necessitate continuous refinement of the mental health system in terms of service accessibility, equity, and early intervention efficiency.
Although we have confirmed the disease burden of depression in China and globally from three dimensions, the GBD study relies on model-based estimates, the accuracy of which is constrained by the quality and completeness of the original data from different countries. This limitation is particularly pronounced in low-resource nations and where there are inconsistent levels of diagnosis and reporting of mental disorders [39]. It is also impossible to fully predict whether public health events that may impact mental health, such as COVID-19, will still occur in the future. With the emergence of artificial intelligence (AI) technology, we are expected to establish a more intelligent, proactive, and equitable global adolescent mental health protection system over the next fifteen years.
5. Conclusions
Between 1990 and 2021, China has made remarkable progress in alleviating the burden of adolescent depression, which stands in stark contrast to the rising global prevalence trend of the disease. Policy interventions, economic development, and the expansion of health services in China are likely the keys to this success. Future efforts should prioritize the continuous refinement of mental health services, particularly for females and younger adolescents. Schools and communities must strengthen collaborative mental health support systems. The integration of AI technologies is recommended to enhance early identification and intervention efficiency. Simultaneously, attention should be directed toward socioeconomic factors influencing adolescent psychology, necessitating the implementation of comprehensive prevention strategies.
Abbreviation
DALY
Disability-Adjusted Life Year
EAPC
Estimated Annual Percentage Change
BAPC
Bayesian Age-Period-Cohort
ASIR
Age-Standardized Incidence Rate
ASPR
Age-Standardized Prevalence Rate
ASDR
Age-Standardized Disability-Adjusted Life Year Rate
DSM-IV-TR
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision
INLA
Integrated Nested Laplace Approximation
A
Acknowledgement
The authors are grateful to the Institute for Health Metrics and Evaluation (IHME) and the collaborators of the Global Burden of Disease Study 2021 for making their data openly accessible.
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Author Contribution
Ye Gao : Conceptualization, Formal analysis, Writing – Original Draft. Juntao Guo : Software, Validation, Writing – Review & Editing. Xuerun Yang : Investigation, Resources. Sihan Xu : Project administration, Data Validation. Li Ding : Supervision, Funding acquisition, Writing – Review & Editing.
Declaration of competing interest
Not applicable
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Funding
This research was funded by the Provincial College Students' Innovation and Entrepreneurship Training Program, S202513023045.
Clinical trial number
Not applicable
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Data Availability
The datasets analyzed during the current study are publicly available from the Global Burden of Disease Study 2021 (GBD 2021) results tool, accessible at: http://ghdx.healthdata.org/gbd-results-tool. No original data were generated in this study.
Electronic Supplementary Material
Below is the link to the electronic supplementary material
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