Global, regional, and national burden of mental disorders among adolescents and young adults, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Mental disorders among adolescents and young adults (ages 10-24) are a significant public health challenge, contributing to long-term morbidity and substantial societal impact. This study analyzes the prevalence, incidence, and years lived with disability (YLDs) of mental disorders in this age group from 1990-2021, with particular attention to the effects of the COVID-19 pandemic during 2019-2021. Using data from the Global Burden of Disease Study 2021, we estimated the prevalence, incidence, and YLDs, along with age-standardized rates (ASR) and 95% uncertainty intervals (95% UIs) for 2021, stratified by sex and age group. Joinpoint regression was employed to calculate annual percentage change (APC) and average annual percentage change (AAPC), along with their corresponding 95% confidence intervals (CIs). In 2021, the global prevalence of mental disorders among adolescents and young adults was 278.98 million (95% UI: 248.61-312.81), with an ASR of 14,764.94 (95% UI: 2804.87-16,908.09). From 2019-2021, there were significant increases in the prevalence, incidence, and YLDs of mental disorders, especially for depressive and anxiety disorders. High-income regions, including North America, Western Europe, and the Asia Pacific, experienced the highest burdens. Globally, the prevalence of mental disorders was higher in males than females among adolescents aged 10-14, but higher in females among those aged 15-24. Joinpoint regression analysis from 1990-2021 revealed an increased burden in depressive disorders, anxiety disorders, bipolar disorder, eating disorders, autism spectrum disorder, conduct disorder, and idiopathic developmental intellectual disability, while decreases were observed in schizophrenia, ADHD, and other mental disorders. This study highlights the significant impact of COVID-19 on the mental health of adolescents and young adults, revealing disparities by region, age, sex, time period, and cohort. It underscores the need for targeted interventions to address the rising mental health burden in this group.