Global, regional, and national trends in incidence of depression among women, 1990-2019: An analysis of the global burden of disease study

Temporal trends in prevalence for depressive disorders among women of childbearing age: Age-period-cohort analysis 2021

BACKGROUND

Depressive disorders (DD) are significant mood disorders with a notable female preference, especially affecting the well-being of women of childbearing age (WCBA). This population with DD was notably associated with severe complications during the perinatal period, leading to unfavourable maternal mortality and morbidity.

METHODS

This study extracted data from the Global Burden of Disease Study (GBD) 2021. We analysed the number of cases, calculated the age-standardized prevalence rate, and performed the age-period-cohort (APC) model to estimate prevalence trends and age, period, and cohort effects from 1992 to 2021.

RESULTS

From 1992 to 2021, the global number of WCBA with DD surged by 59.46 %, reaching 121 million cases up to 2021. India, China, and the USA had over 40 million prevalence cases, accounting for 36.17 % of global prevalence. The global net drift of DD prevalence among WCBA was -0.13 % per year (95 % CI: -0.17 % to -0.09 %). Age effects demonstrated similar patterns that the prevalence risk rose with age. All SDI regions showed unfavourable prevalence risks surging in the period of 2017-2021. The cohort risk of prevalence increased globally in younger generations after the 1987-1996 cohort.

CONCLUSION

Although the overall temporal trend (net drift) presented a downward trend in DD prevalence among WCBA over the past three decades, the prevalence cases had continued to rise with unfavourable period and cohort effects. Since COVID-19 triggered a massive increase in the prevalence of depressive disorders worldwide, there is an urgent need for stakeholders and policy makers to strengthen mental health-care systems.

Global, regional and national burden of depressive disorders and attributable risk factors, from 1990 to 2021: results from the 2021 Global Burden of Disease study

BACKGROUND

Depressive disorders pose a significant global public health challenge, yet evidence on their burden remains insufficient.

AIMS

To report the global, regional and national burden of depressive disorders and their attributable risk factors from 1990 to 2021.

METHODS

Data from the Global Burden of Disease 2021 were analyzed for 204 countries and territories from 1990 to 2021. We explored the age-standardised incidence, prevalence and disability-adjusted life years (DALYs) of depressive disorders by age, gender and sociodemographic index.

RESULTS

In 2021, there were 357.44 million incident cases, 332.41 million prevalent cases and 56.33 million DALYs. Age-standardised rates for incidence, prevalence and DALYs were 4333.62, 4006.82 and 681.14 per 100 000 persons, with annual declines of 0.06%, 0.03% and 0.04%. Uganda, Greenland and Lesotho had the highest prevalence, while Spain, Mexico and Uruguay showed the largest increases. Greenland and Brunei Darussalam had the highest and lowest age-standardised DALYs rates, respectively. DALYs peaked in the 55-59 age group for men and 60-64 for women, with higher rates in women. Regionally, a U-shaped association was found between the sociodemographic index and DALYs rates. Population growth was the main driver for the increase in DALYs cases. Childhood maltreatment was the leading risk factor, with intimate partner violence affecting more females and childhood sexual abuse more males.

CONCLUSIONS

Despite decreasing trends in incidence, prevalence and DALYs rates, absolute case numbers and age-standardised rates continue to increase for depressive disorders. Tackling childhood abuse and improving depressive disorder management are crucial to reducing future burdens.

Global, regional, and national temporal trends in prevalence for depressive disorders in older adults, 1990-2019: An age-period-cohort analysis based on the global burden of disease study 2019

As a severe public health issue, depressive disorders (DD) has caused an increasingly burden of disease, especially in the older adults. To provide an overview and in-depth analysis of temporal trends in prevalence of DD in older adults at global, regional, and national levels over the last 30 years. Here, an age-period-cohort model was adopted to analyze age, period, and cohort effects. We showed that the global prevalence of DD in older adults was increasing. The net drift of the global prevalence of DD was showing an increasing trend in 78 countries, while local drift showing a declining trend in all age groups in high sociodemographic index (SDI) region. Additionally, period and cohort effects exhibited different patterns across regions. Over time, the declining trend was most significant in high SDI regions, while this trend was most significant in middle SDI region. Interestingly, those aged 60-64 years to 70-74 years was increasing globally, while age group aged 75-79 years to 95-99 years was on declining. In high, high-middle, and low SDI regions, individuals born early face higher risks than those born late, while the opposite results were observed in low-middle SDI region. Overall, our findings offer a insight global perspective for studying the temporal trends of DD prevalence, supplementing our evidence and understanding of DD epidemiology, and identifying gaps in DD prevention, management, and intervention plans in different aspects.

Clinical efficacy of adjunctive esketamine anesthesia in electroconvulsive therapy for major depressive disorders: A pragmatic, randomized, controlled trial

Electroconvulsive therapy (ECT) is an effective treatment for depression, and esketamine has been shown to have antidepressant effects. However, it is currently unclear whether adjunctive esketamine can enhance the clinical efficacy of ECT in real-world clinical practice. In this pragmatic clinical trial, patients with major depression were randomly assigned into two groups: patients received 0.25 mg/kg esketamine plus propofol (esketamine group) or the same volume of saline (control group) plus propofol. Results indicated that there was no difference in response and remission rates between the two groups. However, patients receiving esketamine had a higher remission rate of SI and lower psychotic scores. Patients receiving esketamine also required a lower electric dose, but the seizure duration and cognitive function were comparable between the two groups. Diastolic blood pressure increased after esketamine injection, but there was no increased risk of hypertension. Furthermore, incidence of delirium and confusion were comparable between the groups. Conclusively, adjunctive esketamine anesthesia does not provide any advantage in improving the response and remission rates of ECT. However, it can improve remission of SI and alleviate accompanying psychotic symptoms in depressive patients. With adjunctive usage, the adverse cardiovascular and neuropsychiatric events associated with esketamine appear to be tolerable.