Aim: Current evidence on the burden of mental disorders in working-age population remains fragmented. This study aimed to comprehensively analyze secular trends, health inequalities, and frontier outcomes in these burdens globally, with the goal of informing resource allocation and public health strategies to reduce disparities and advance global mental health equity.
Methods: Using the Global Burden of Disease 2021 estimates, we systematically assessed the global, regional, and national trends in the burden of mental disorders among working-age population from 1990 to 2021. A comprehensive analytical framework was employed, including health inequality analysis to quantify absolute and relative disparities across countries and territories, frontier analysis to estimate the best attainable health outcomes based on Socio-demographic Index (SDI) levels, and decomposition analysis to identify key drivers of changes in disease burden.
Results: From 1990 to 2021, the prevalence and DALY numbers of mental disorders among working-age population increased substantially, yet the age-standardised prevalence and DALY rates remained stable globally. Anxiety disorders ranking first in prevalence burden, while depressive disorders accounted for the highest DALY burden. High-SDI regions exhibited the highest burden and increasing trends, whereas low-middle and low-SDI regions showed declines. Geographic disparities were pronounced, with Australasia recording the highest age-standardised rates and East Asia the lowest. Population growth was the primary driver of the increased burden, contributing to over 85 % of the rise in prevalent cases and DALYs. Cross-country inequalities widened during the study period, with higher-SDI countries experiencing a heavier burden. Frontier analysis identified significant potential for burden improvement in various countries and territories, with Greenland and Portugal showing the highest deviations from frontier estimates, while Mali and Vietnam had the least.
Conclusion: Mental disorders represent a major public health challenge among working-age population, with significant disparities in burden across regions and nations, driven by demographic and socioeconomic factors. Policymakers must prioritize targeted interventions, optimize resource allocation, and ensure equitable access to mental health care to mitigate these burdens and advance global mental health equity.
Keywords: Frontier analysis; Global burden of disease; Health inequality; Mental disorders; Working-age population.
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