Abstract
Background
Mental disorders impose a disproportionate burden on populations in low- to middle-income countries (LMICs) and low-income countries (LICs), yet longitudinal assessments across these settings remain limited.
Methods
Using the Global Burden of Disease Study 2023, we investigated prevalence and disability-adjusted life years (DALYs) for 10 mental disorder subcategories across 76 LMICs and LICs from 1990 to 2023 and projected trends through 2050 via a generalized ensemble modeling approach.
Findings
Age-standardized prevalence rose markedly between 1990 and 2023, from 10,759.9 (95% uncertainty interval, 9,560.1–12,088.6) to 13,929.3 (12,512.5–15,829.0) per 100,000 in LMICs and from 11,723.6 (10,577.7–12,987.5) to 14,979.1 (13,512.9–16,770.7) in LICs, accompanied by corresponding increases in age-standardized DALY rates. The most pronounced increases in both age-standardized prevalence and DALYs were observed during the COVID-19 pandemic. Anxiety disorders (total percentage change: 102.3% in LMICs; 67.3% in LICs), eating disorders (40.7% in LMICs; 4.8% in LICs), depressive disorders (28.6% in LMICs; 29.8% in LICs), and autism spectrum disorders (14.9% in LMICs; 22.5% in LICs) showed the largest increases in prevalence. Under a reference scenario where past trends persist, age-standardized prevalence is projected to reach 17,155.8 (14,449.5–20,212.5) per 100,000 in LMICs and 17,968.4 (15,109.8–21,090.9) in LICs by 2050.
Conclusions
These findings reveal persistent and widening disparities in mental health burden across resource-limited settings, substantially exacerbated by the pandemic. Without targeted, scalable, and sustained policy interventions, the burden in LMICs and LICs will continue to worsen, underscoring the critical need for context-specific public health action.
Funding
This study was funded by the Gates Foundation.
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