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中国1990与2019年儿童青少年心理疾病负担情况比较

Disease burden of mental disorders among children and adolescents in China from 1990 to 2019: a comparison analysis based on GBD 2019 data

  • 摘要:
    目的 比较1990年与2019年中国儿童青少年心理疾病负担及其变化情况,为中国儿童青少年心理疾病防控策略的改进提供依据。
    方法 基于2019年全球疾病负担数据库,采用患病数、标化患病率、伤残调整生命年(DALY)、标化DALY率、变化率和平均年度变化百分比(AAPC)等指标比较中国1990年与2019年儿童青少年心理疾病负担情况及其变化趋势。
    结果 中国儿童青少年2019年心理疾病的患病数、标化患病率、DALYs和标化DALY率分别为2 600.70万例、8 611.08/10万、210.29万人年、688.12/10万,相较1990年,患病例数、DALYs和标化DALY率分别降低了34.25%、37.25%、1.76%(AAPC = – 1.436%、– 1.575%、– 0.068%),标化患病率则增长了1.64%(AAPC = 0.052%);男性心理疾病的标化患病率和标化DALY率均高于同期女性。中国儿童青少年1990年和2019年心理疾病负担最高的是焦虑症,患病数和标化患病率最高的是注意缺陷多动障碍;标化患病率增长最快的为进食障碍(变化率 = 60.06%,AAPC = 1.647%),下降最快的为先天性智力障碍(变化率 = – 47.15%,AAPC = – 2.176%);标化DALY率增长最快的为进食障碍(变化率 = 59.85%,AAPC = 1.644%),下降最快的是先天性智力障碍(变化率 = – 43.01%,AAPC = – 1.927%)。
    结论 2019年与1990年比较,中国儿童青少年心理疾病负担总体虽有一定程度的改善,但仍处于较高水平,需根据各类心理疾病负担情况进行重点干预与防控。

     

    Abstract:
    Objective To compare the disease burden of mental disorders and its changes among children and adolescents in China between 1990 and 2019 to establish strategies for the prevention and control of mental illnesses.
    Methods The data on mental disorders in children and adolescents (0 – 19 years) were collected from the Global Burden of Disease 2019 (GBD2019) database. The burden of these diseases was assessed using indicators such as the number of cases, standardized prevalence, disability-adjusted life years (DALYs), and standardized DALYs rate. Additionally, the difference in disease burden between 1990 and 2019 was estimated through the rate of change and average annual percentage change (AAPC).
    Results The prevalence, standardized prevalence, DALYs, and standardized DALYs rates of mental disorders in the Chinese population under the age of 20 years in 2019 were recorded as 20.607 million cases, 8611.08/100 000 population, 2.1029 million person-years, and 688.12/100 000 population respectively. In comparison to the data from 1990, there was a reduction of 34.25% in the prevalence rate, a decrease of 37.25% in DALYs rate, and a decline of 1.76% in standardized DALYs rate (AAPC = – 1.436%, – 1.575%, and – 0.068% respectively). However, the standardized prevalence rate increased by 1.64% (AAPC = 0.052%). During the same period under consideration, the male population exhibited higher rates of both standardized prevalence and standardized DALYs for mental disorders compared to the females. Anxiety disorder remained the most burdensome condition among the population in both years (1990 and 2019), while attention deficit hyperactivity disorder had the highest number of cases reported along with its corresponding standardized prevalence rate. Among all psychological disorders analyzed for their change rates over time between 1990 and 2019, eating disorder showed the fastest increase in its standardized prevalence rate (change rate = + 60.06%, AAPC = + 1.647%), whereas congenital intellectual disorder demonstrated the fastest decrease (– 47.15%, AAPC = – 2.176%). Similarly, eating disorders experienced the greatest rise (+ 59.85%) while congenital mental retardation witnessed significant decline (– 43.01%) when considering changes in their standardized DALY rates over this timeframe (AAPC = + 1.644%; AAPC = – 1.927%).
    Conclusion The burden of mental disorders in children and adolescents in China has shown some improvement since 1990, but it still remains relatively high in 2019. Therefore, it is imperative to prioritize intervention, prevention, and control measures based on the various burdens associated with different mental disorders.

     

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