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 (DALY), and standardized DALY 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 = – 1.44%, – 1.58%, and – 0.07% respectively). However, the standardized prevalence rate increased by 1.64% (AAPC = 0.05%). 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 = + 1.65%), whereas congenital intellectual disorder demonstrated the fastest decrease (– 25.42%, AAPC = – 2.18%). Similarly, eating disorders experienced the greatest rise (+ 60.06%) while congenital mental retardation witnessed significant decline (– 43.01%) when considering changes in their standardized DALY rates over this timeframe (AAPC = + 1.64%; AAPC = – 1.93%).

Conclusion The burden of mental illness 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 illnesses.