全球抑郁症伤残损失寿命年负担及公平性分析

doi:10.12183/j.scjpm.2026.0299

摘要/Abstract

摘要： 目的描述和分析1990—2021年全球抑郁症伤残损失寿命年（year lived with disability,YLD）负担及社会发展水平差异所致的公平性情况,为抑郁症的防治提供参考。方法收集全球疾病负担2021数据库和《2022年人类发展报告》中不同国家和地区抑郁症YLD率和人类发展指数（Human Development Index,HDI）等相关数据,对1990—2021年全球抑郁症年龄标化YLD率的变化趋势进行Joinpoint回归分析,分析年龄标化YLD率与HDI的相关性,并比较不同社会发展水平国家抑郁症年龄标化YLD率差异;采用不平等斜率指数和集中指数进行全球抑郁症年龄标化YLD率的公平性分析。结果 1990—2021年全球抑郁症的年龄标化YLD率整体呈显著上升趋势,全人群、男性、女性的AAPC分别为0.43%（95% CI：0.28%~0.57%）、0.47%（95% CI：0.30%~0.64%）、0.40%（95% CI：0.27%~0.53%）（均P<0.01）。1990—2021年抑郁症年龄标化YLD负担与HDI呈显著负相关（r_s=-0.312,P<0.01）,1990年、2021年不同社会发展水平国家抑郁症年龄标化YLD率的差异具有统计学意义（均P<0.05）。1990年、2021年不平等斜率指数分别为-161.98（95% CI：-268.80~-55.16）、-269.04（95% CI：-361.60~-176.48）,绝对值呈上升趋势;集中指数分别为-0.03（95% CI：-0.05~-0.02）、-0.04（95% CI：-0.05~-0.03）,绝对值呈先上升后下降趋势。结论 1990—2021年全球抑郁症YLD负担加重且存在不公平现象,YLD负担主要集中在低社会发展水平国家,应重视低社会发展水平国家抑郁症的防治,采取积极措施以促进全球抑郁症YLD负担的公平性。

关键词: 抑郁症, 人类发展指数, 伤残损失寿命年, 不平等斜率指数, 集中指数

Abstract: Objective To describe and analyze the global burden of Years Lived with Disability (YLD) attributable to depressive disorders from 1990 to 2021, examining the equity implications associated with varying levels of social development, with the aim of providing a reference for the prevention and control of depressive disorders. Methods Data pertaining to YLD rates for depressive disorders and the Human Development Index (HDI) for various countries and regions were compiled from the Global Burden of Disease 2021 database and the Human Development Report 2022. Joinpoint regression analysis was employed to assess the temporal trends in age-standardized YLD rates for depressive disorders globally between 1990 and 2021. The correlation between age-standardized YLD rates and the HDI was analyzed, and disparities in these rates across nations with different levels of social development were compared. The Slope Index of Inequality (SII) and the Concentration Index (CIX) were utilized to conduct an equity analysis of the global age-standardized YLD rates for depressive disorders. Results A significant upward trend was observed in the global age-standardized YLD rate for depressive disorders from 1990 to 2021. The Average Annual Percent Change (AAPC) for the total population was 0.43% (95% CI: 0.28%-0.57%), for males was 0.47% (95% CI: 0.30%-0.64%), and for females was 0.40% (95% CI: 0.27%-0.53%) (all P<0.01). A significant negative correlation was identified between the age-standardized YLD burden of depressive disorders and the HDI for the period 1990-2021 (rs=-0.312, P<0.01). Statistically significant differences in age-standardized YLD rates for depressive disorders were found among countries with varying levels of social development in both 1990 and 2021 (both P<0.05). The Slope Index of Inequality was -161.98 (95% CI: -268.80 to -55.16) in 1990 and -269.04 (95% CI: -361.60 to -176.48) in 2021, with the absolute value demonstrating an increasing trend. The Concentration Index was -0.03 (95% CI: -0.05 to -0.02) in 1990 and -0.04 (95% CI: -0.05 to -0.03) in 2021, with its absolute value showing an initial increase followed by a subsequent decrease. Conclusion The global burden of YLDs due to depressive disorders increased from 1990 to 2021, and significant inequities persist. The burden is disproportionately concentrated in countries with lower levels of social development. It is imperative to prioritize the prevention and treatment of depressive disorders in these nations and to implement proactive measures to promote equity in the global burden of YLDs from depression.

Key words: Depressive disorders, Human development index, Year lived with disability, Slope index of inequality, Concentration index

中图分类号:

R195.3

王淳, 侯小青, 张乐, 何倩, 邢薇佳. 全球抑郁症伤残损失寿命年负担及公平性分析[J]. 华南预防医学, 2026, 52(3): 299-304.

Wang Chun, Hou Xiaoqing, Zhang Le, He Qian, Xing Weijia. An analysis of the burden and equity of years lived with disability due to depressive disorders globally[J]. South China Journal of Preventive Medicine, 2026, 52(3): 299-304.

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