Global, regional, and national burden of mental disorders among women of reproductive age, 1990-2021: a systematic analysis of the global burden of disease study 2021

Abstract

Background: Women of reproductive age (WRA), a key reproductive group, face mental health issues that impact both their own well-being and that of the next generation. However, research on the burden and trends of mental disorders among WRA remains limited. This study aimed to assess these on a global scale.

Methods: The data from the Global Burden of Disease Study 2021 were utilized to analyze the age-standardized prevalence, age-standardized disability-adjusted life years (DALYs), and annual average percentage change (AAPC) of mental disorders among WRA from 1990 to 2021, examining variations by region, country, Socio-Demographic Index (SDI), and age group, along with DALYs attributable to risk factors.

Results: In 2021, there were 343.22 million cases of mental disorders among WRA, with the highest DALYs among all diseases. From 1990 to 2021, the global burden increased, particularly for anxiety and major depressive disorders during the COVID-19 pandemic. Significant variations were observed across regions and countries. The different age groups showed different distributions of subtypes. High SDI regions showed the highest burdens, and the AAPC and SDI exhibit different correlation patterns before and during the pandemic. The burden of bullying victimization rose both before and during the pandemic, while intimate partner violence significantly increased during the pandemic.

Conclusions: The burden of mental disorders among WRA remained high from 1990 to 2021, exacerbated by the COVID-19 pandemic. Variations exist across regions, countries, age groups, and SDI, indicating a need for the development and adjustment of targeted interventions for WRA.

Keywords: Global burden; Mental disorders; Spatial disparities; Trend analysis; Women of reproductive age.

Fig. 1

The cross-sectional and longitudinal trends of prevalence and DALYs of mental disorders among WRA in global. Distribution of prevalence (A) and DALYs (B) due to the subtypes of mental disorders in 2021. Numbers (C, D) and age-standardized rates (E, F) of prevalence and DALYs due to all mental disorders from 1990 to 2021. The gray dashed line marks 2019. DALYs, disability-adjusted life years

Fig. 2

The cross-sectional and longitudinal trends of prevalence and DALY by 204 countries or territories for mental disorders among WRA. Age-standardised rates of prevalence (A) and DALYs (B) in 2021, and average annual percent changes of age-standardised rates of prevalence (C, E) and DALYs (D, F) during the periods of 1990–2019 and 2019–2021. ASR, Age-standardised rates; DALYs, disability adjusted life-years; AAPC, average annual percent change (%)

Fig. 3

The cross-sectional and longitudinal trends of prevalence and DALY rates by age for all mental disorders among WRA. Numbers and rates of prevalence (A) and DALYs (B) of all mental disorders. Percentage changes of prevalence (C, E) and DALY rates (D, F) of all mental disorders. DALY, disability-adjusted life-years

Fig. 4

The cross-sectional and longitudinal trends of prevalence and DALY by SDI for mental disorders among WRA. Distribution of age-standardized prevalence (A) and DALYs (B) rates due to the subtypes of mental disorders in 2021. The comparison of age-standardized rates (1990, 2019 and 2021) and average annual percent change (1990–2019 and 2019–2021) of prevalence (C, E) and DALYs (D, F). Association between age-standardized prevalence (G) and DALYs (J) in 2021, as well as average annual percent change in age-standardized prevalence (H-I) and DALYs (K-L) rates during the periods of 1990–2019 and 2019–2021, with SDI in 2021, for 204 countries and territories. Each blue dot represents a country or territory, and its size increases with the number of prevalence cases or DALYs. Expected values, based on SDI and ASR (or AAPC) in all countries and territories, are shown as a solid line. The shaded area indicates the 95% CI of the expected values. ASR, age-standardized rate; DALYs, disability adjusted life-years; AAPC, average annual percent change; SDI, socio-demographic index

Fig. 5

The longitudinal trends of risk factors to DALYs of mental disorders among WRA. Numbers and age-standardized rates of prevalence and DALYs of risk factors associated with anxiety disorders, major depressive disorder, and idiopathic developmental intellectual disability among women of reproductive age. The gray dashed line marks 2019. ASR, age-standardized rates; DALYs, disability-adjusted life years