Global burden of depressive disorders attributable to childhood sexual abuse and bullying victimisation in adolescents and young adults from 1990 to 2021, with years lived with disability projections to 2050: Global Burden of Disease study analysis

BACKGROUND: Depressive disorder is a leading cause of disability, with significant increases among adolescents and young adults. Childhood sexual abuse (CSA) and bullying victimisation are major risk factors, yet their specific contribution remains underexplored. AIMS: To quantify the global burden of depressive disorder attributable to CSA and bullying victimisation among adolescents and young adults, examine temporal trends and project burden to 2050. METHOD: Using Global Burden of Disease 2021 data, years lived with disability (YLD) for depressive disorder related to CSA and bullying victimisation were estimated across 204 countries and 21 regions. Age-standardised YLD rates (ASYR) were calculated, and joinpoint regression was used to assess average annual percentage changes. Bayesian age-period-cohort (BAPC) modelling projected future trends. RESULTS: In 2021, bullying victimisation accounted for a substantially larger proportion of depressive disorder burden (73.31%, ASYR: 87.83 out of 100 000) than CSA (11.81%, ASYR: 14.15 out of 100 000). Both risk factors increased from 1990 to 2021, with bullying victimisation rising faster, particularly in high sociodemographic index regions. Women experienced a substantially higher CSA-related burden (ASYR ratio 1.78:1), whereas men had a slightly higher bullying victimisation-related burden (ASYR ratio 1.02:1). Burden peaked among those aged 20-24 years for both risk factors. BAPC projections suggest that CSA-related depressive disorder will increase through to 2050, whereas bullying victimisation-related depressive disorder may decline, although uncertainty remains regarding future prevention efforts and reporting patterns. CONCLUSIONS: ASYR for depressive disorder due to both CSA and bullying victimisation increased from 1990 to 2021; CSA-related burden is projected to continue rising through to 2050, whereas bullying victimisation-related burden may decline. Gender differences, age-specific peaks and regional disparities highlight the need for gender-sensitive, age-appropriate and region-specific interventions to address depressive disorder related to CSA and bullying victimisation.