Burden and risk factors of mental and substance use disorders among children aged 5–14 in Asia from 1990 to 2021: results from the Global Burden of Disease study

‌OBJECTIVE: To analyse trends in mental and substance use disorders among Asian children aged 5-14 years, identify key risk factors (eg, bullying, abuse, lead exposure) and compare gender/age disparities using Global Burden of Disease (GBD) 2021 data. ‌DESIGN: Cross-sectional analysis of the GBD 2021 database, focusing on prevalence, disability-adjusted life years (DALYs) and risk factor associations. ‌SETTING: Population-based study across Asian countries, examining the burdens of mental health, especially substance use disorders in high-prevalence regions. ‌PARTICIPANTS: Children aged 5-14 years in Asia, with gender-stratified subgroups (boys vs girls). ‌RESULT: Anxiety, conduct disorders and autism were primary contributors to mental health burdens. Substance use disorders, though less prevalent, rose notably among boys. Girls showed higher burdens of anxiety/depressive disorders. Bullying and childhood abuse were strongly linked to these conditions. Gender disparities in DALYs highlighted boys' vulnerability to substance use and girls to internalising disorders. ‌CONCLUSION: Urgent, region-specific interventions are needed to address bullying, lead exposure and abuse, with gender-sensitive strategies. The study calls for targeted research and policies to mitigate rising mental health challenges in Asian children.