Global Burden of Depressive Disorders, 1990–2021, During the COVID-19 Pandemic and Projections to 2050: A Global Burden of Disease Study 2021

Objective: Despite an increase in the depressive disorders burden during the coronavirus disease-2019 (COVID-19) pandemic, research remains insufficient. This study aims to advance the understanding of the global depressive disorders burden, focusing on the COVID-19 pandemic. Methods: Global and regional estimates of incidence, prevalence, and disability-adjusted life years (DALYs) for depressive disorders from 1990 to 2021 were analyzed using the Global Burden of Disease Study 2021. Depressive disorders were defined as the aggregate of major depressive disorder and dysthymia. Estimates were stratified by age, sex, Socio-demographic Index (SDI), and region, and trends were assessed by annual percent change. Attributable risk factors and projections to 2050 were assessed by modeling risk factors. Results: In 2021, depressive disorders accounted for 56,330.36 (95% uncertainty interval [UI], 39,339.99 to 76,538.17) DALYs. The agestandardized DALYs rate (ASDR) remained stable until 2019, followed by an increase during the COVID-19 pandemic (ASDR in 1990: 600.51 [95% UI, 420.94 to 818.45] per 100,000; in 2019: 593.50 [413.34 to 810.07]; in 2021: 681.14 [475.19 to 923.83]). The highest ASDRs were observed in low (837.53 [95% UI, 569.85 to 1,140.07] per 100,000) and low-middle (784.07 [542.47 to 1,059.21]) SDI regions. The burden increased rapidly among adolescents and remained higher in females than in males. The burden attributable to intimate partner violence increased during the COVID-19 pandemic. Projections suggest a modest decline in global ASDR, reaching 622.30 (95% UI, 430.96 to 847.82) per 100,000 by 2050. Conclusion: The global burden of depressive disorders increased sharply during the COVID-19 pandemic. It is essential to address regional disparities in mental health care and promote access to tailored treatment.