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. 2025 Mar 19;15(1):9529.
doi: 10.1038/s41598-025-93923-4.

Accelerated global burden of depressive disorders during the COVID-19 pandemic from 2019 to 2021

Jinlei Zhou #  1 , Yuan Zhang #  2 , Shuangshuang He #  3 , Sen Xu  4 , Qice Sun  2 , Tingxiao Zhao  5 , Yaqin Dai  6
Affiliations

Accelerated global burden of depressive disorders during the COVID-19 pandemic from 2019 to 2021

Jinlei Zhou et al. Sci Rep. .

Abstract

A thorough and current analysis of the burden and evolving trends in depressive disorders during the COVID-19 pandemic from 2019 to 2021 remains unavailable. Employing the Global Burden of Disease (GBD) 2021 database, we evaluated the burden of depressive disorders at the global, regional, and national levels, stratifying the analysis by age, gender, and socio-demographic index (SDI). To examine trends in depressive disorders during the epidemic, we calculated the estimated annual percentage change (EAPC) in age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), and age-standardized DALYs rates (ASDR) across all levels from 2019 to 2021. Furthermore, we performed a frontier analysis of depressive disorders across various countries, incorporating risk factor analyses at multiple levels. In 2021, the global incidence of depressive disorders stood at 357.43 million, while the prevalence was recorded at 332.41 million, accompanied by 56.33 million disability-adjusted life years (DALYs). Throughout the COVID-19 pandemic, there was a notable upward trend in ASIR (EAPC = 8.33 [-0.46 to 17.9]), ASPR (EAPC = 6.02 [0.28 to 12.09]), and ASDR (EAPC = 7.13 [-0.18 to 14.97]) for depressive disorders on a global scale. The burden of depressive disorders is most pronounced among females and individuals aged 60 to 64 within their respective subgroups. From 1990 to 2021, the burden of depressive disorders consistently remained highest in the low SDI region; however, it experienced the most significant increase in the high SDI region during the COVID-19 pandemic from 2019 to 2021. In 2021, the burden of depressive disorders was highest in central sub-Saharan Africa, Greenland, and Uganda, while the Andean region of Latin America, along with Bulgaria and Belarus, experienced the most significant increase in depressive disorders during the COVID-19 pandemic. Globally, bullying victimization, intimate partner violence, and childhood sexual abuse contributed to 6.47%, 4.91%, and 2.65% of the ASDR for depressive disorders, respectively. The global burden of depressive disorders has markedly increased during the COVID-19 pandemic, gradually shifting from low to high SDI regions, particularly in North America and Europe.

Keywords: COVID-19 pandemic; Depressive disorders; Estimated annual percentage changes; Global burden of disease; Socio-demographic index.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The number of incidences, prevalence, DALYs, and ASRs for depressive disorder at the global and gender levels from 1990 to 2021. (A) global; (B) gender (ASRs); (C) gender (incidences, prevalence and DALYs).
Fig. 2
Fig. 2
The number of incidences, prevalence, DALYs, and ASRs for depressive disorder at the age and SDI level from 1990 to 2021. (A) age (ASRs); (B) age (incidences, prevalence and DALYs); (C) SDI (ASRs); (D) SDI (incidences, prevalence and DALYs).
Fig. 3
Fig. 3
The number of incidences, prevalence, DALYs, ASRs, and EAPC for depressive disorder in 204 countries and regions from 2019 to 2021. (A) ASIR in 2021; (B) ASPR in 2021; (C) ASDR in 2021; (D) incidences in 2021; (E) prevalences in 2021; (F) DALYs in 2021; (G) EAPC for ASIR from 2019 to 2021; (H) EAPC for ASPR from 2019 to 2021; (I) EAPC for ASDR from 2019 to 2021.
Fig. 4
Fig. 4
Frontier analysis of ASIR, ASPR and ASDR in depressive disorder in 2021. (A) ASIR; (B) ASPR; (C) ASDR.
Fig. 5
Fig. 5
The extent to which the three risk factors influence ASDR for depressive disorder at the global, regional, age, and gender levels.
See this image and copyright information in PMC

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