Long-Term Trends in the Burden of Bipolar Disorder in China, 1990–2052: An Analysis of the Global Burden of Disease Study 2023

Derong LinPengpeng GuoMenglin KouXiaohua XieYue LiShuxiong LuoAiguo XueJingrong LiangDongguan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of ChinaThe First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of ChinaCorrespondence: Jingrong Liang, Dongguan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Dongguan, Guangdong, People’s Republic of China, Email [email protected]: Bipolar disorder is a chronic mood disorder that imposes substantial long-term disability. Updated national evidence is needed to inform mental health planning in China.Objective: To assess temporal trends in the burden of bipolar disorder in China from 1990 to 2023 and project its burden from 2024 to 2052.Methods: Using Global Burden of Disease Study 2023 (GBD 2023) estimates, we analyzed incidence, prevalence, and disability-adjusted life-years (DALYs) by year and sex. Age-standardized incidence, prevalence, and DALY rates (ASIR, ASPR, and ASDR) were evaluated using descriptive trend analysis, Sociodemographic Index (SDI) correlation and generalized additive models, Das Gupta decomposition, Bayesian age-period-cohort projection, and age-period-cohort analysis.Results: From 1990 to 2023, incident cases, prevalent cases, and DALYs increased in both sexes, whereas age-standardized rates changed only slightly. In 2023, females had higher ASIR, ASPR, and ASDR than males (16.013 vs 14.240, 218.269 vs 190.726, and 47.161 vs 41.503 per 100,000, respectively). SDI was not significantly correlated with ASIR or ASPR but was modestly correlated with ASDR (R = 0.385, P = 0.0247); non-linear associations were observed for all three standardized indicators. Decomposition showed that population growth mainly drove increases in incident cases, while population growth and aging jointly explained increases in prevalence and DALYs. By 2052, projected both-sex ASIR, ASPR, and ASDR were 38.277, 334.308, and 71.246 per 100,000, respectively. Incidence peaked at 15– 19 years, whereas prevalence and DALYs peaked at 50– 54 and 45– 49 years, respectively.Conclusion: The absolute burden of bipolar disorder in China increased substantially and is projected to remain high. Females, adolescents, and middle-aged adults may require priority attention through earlier identification, sustained management, and long-term service planning, while long-range and cohort-related projections should be interpreted cautiously.Keywords:bipolar disorder, China, epidemiology, global burden of disease study 2023, projection