Abstract

Background: Mental disorders (MDs) and substance use disorders (SUDs) are a growing global health concern. The COVID-19 pandemic has further exacerbated the mental health crisis, and has highlighted socioeconomic inequalities.

OBJECTIVE

Methods: Data from the 2021 GBD study were used for analysis of MDs and SUDs. Results were stratified by age group (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and sex.  The study aimed to estimate the global burden of 12 MDs and SUDs in children and adolescents (aged 5-24 years) from 1990 to 2021 using data from the 2021 Global Burden of Disease (GBD) study.

Results:  In 2021, approximately 12.8% of children and youths aged 5 to 24 globally had at least one MD, and over 1.2% had a SUD. From 1990 to 2021, the prevalence of SUDs decreased by 19.44%, while MD showed a 3.31% decrease until 2019, and a 9.07% increase from 2019 to 2021, particularly in anxiety and depressive disorders. Females experienced a greater impact of MDs post-pandemic, with higher rates of anxiety, depression, and internalizing disorders compared to males, who had higher rates of externalizing and neurodevelopmental disorders. The burden of MDs and SUDs varies by region, with high socio-demographic Index (SDI) regions showing higher prevalence. For MDs, a significant increase in SDI-related inequalities was detected, that the gap in YLDs between the highest SDI country and the lowest SDI country decreased from 850 per 100 000 in 1990 to 845 per 100 000 in 2019, and then increased to 1 109 per 100 000 in 2021. For SUDs, the gap in YLDs between the highest SDI country and the lowest SDI country was similar in 1990 and 2021. Moreover, in 1990, 2019 and 2021, the concentration index was 0.22, 0.26, and 0.27 for MDs, and 0.45, 0.46, and 0.46 for substance use disorders, respectively.

Conclusions: GBD 2021 showed that notable sex and age differences of MDs and SUDs among children and adolescents pointed to an urgent need for policies to be based on sex-specific and age-specific data. Countries with high SDI shouldered disproportionately high burden, with the COVID-19 pandemic further exacerbating the SDI-related inequalities across countries and disparities across regions. A coordinated global response is urgently needed to bridge the mental health treatment gap. Managing MDs is a highly dynamic process, to reflect the evolving burden accurately, we should update estimates regularly.