J Affect Disord. 2025 Sep 5:120201. doi: 10.1016/j.jad.2025.120201. Online ahead of print.
ABSTRACT
BACKGROUND: Major depressive disorder (MDD), anxiety disorders, and self-harm are substantial contributors to the global disease burden, exacerbated by the COVID-19 pandemic.
METHODS: We used Global Burden of Diseases Study (GBD) 2021 to estimate global, regional, and national prevalence, mortality, and disability-adjusted life years (DALYs) for MDD, anxiety disorders, and self-harm from 1990 to 2021. Annual percentage changes were calculated for pre-pandemic (1990-2019) and pandemic (2019-2021) periods. Predictive models based on 1990-2019 data estimated 2020-2021 rates in the absence of the pandemic, which were then compared to observed values.
RESULT: From 1990 to 2019, global prevalence rates of MDD, anxiety disorders, and self-harm decreased, although the decline in self-harm was less substantial among men and older adults. However, patterns differed across demographic groups; in North America, self-harm mortality rates rose, particularly among women, while in Latin America and the Caribbean, both the prevalence and mortality rates of self-harm remained relatively unchanged. During the COVID-19 pandemic, prevalence rate point estimates rose sharply for MDD (+18.07 %) and anxiety disorders (+19.21 %), whereas self-harm prevalence and mortality rates remained relatively stable. In 2021, observed DALY estimates for MDD and anxiety disorders exceeded counterfactual projections based on pre-pandemic trends (assuming no pandemic) by 19.97 % and 18.43 %, respectively.
CONCLUSION: Although this study uses secondary GBD 2021 estimates, which may be biased due to uneven data coverage, the COVID-19 pandemic significantly increased the global burden of MDD, anxiety disorders, and self-harm, particularly among women and young adults.
PMID:40915503 | DOI:10.1016/j.jad.2025.120201
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