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Background <p>Mental disorders constitute a major global public health concern, particularly among the working-age population. Their impact extends beyond reduced productivity and long-term economic loss. This study presents a comprehensive assessment of the global burden of mental disorders among working-age adults and compares trends in the three most populous countries, India, China, and the United States, from 1990 to 2021, with projections through 2045.</p> Aim <p>To evaluate age-, sex-, and country-specific trends in the prevalence, incidence, and disability-adjusted life years (DALYs) of mental disorders among working-age adults, and to forecast future disease burden using advanced modeling techniques.</p> Method <p>Data for individuals aged 15–64&#xa0;years were derived from the Global Burden of Disease Study 2021. The analysis was stratified by sex, age, country, and type of disorder. Age-standardized prevalence and incidence rates were calculated and temporal trends were quantified using the estimated annual percentage change. Significant inflection points were detected using the Joinpoint regression. Future DALYs (2022–2045) were projected using the Nordpred age–period–cohort model based on historical trends and population forecasts. All analyses were conducted using the R software (version 4.4.3).</p> Results <p>Globally, the overall burden of mental disorders remained relatively stable from 1990 to 2021; however, substantial heterogeneity was observed across sex, age groups and countries. Females consistently demonstrated a higher prevalence of depressive and anxiety disorders, whereas males exhibited higher rates of schizophrenia, attention deficit/hyperactivity disorder, and autism spectrum disorders. In the United States, both the prevalence and incidence increased markedly for most mental disorders, whereas China and India showed overall declining trends. Age-stratified analyses revealed a high disease burden among adolescents and young adults, alongside a pronounced and continuing increase in the middle-aged and older populations. Projections through 2045 suggest a further rise in DALYs, particularly among females and individuals aged 50–54&#xa0;years, indicating a worsening global burden of mental disorders.</p> Conclusion <p>This study provides the most detailed, age-stratified evaluation of mental disorder burden among working-age populations to date. The findings highlight persistent gender and regional disparities and demonstrate the urgent need for scalable, culturally sensitive mental health interventions, workforce-based support systems, and the integration of mental health care into primary and occupational health frameworks.</p>

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Burden of mental disorders in working-age populations (15–64 years) from 1990 to 2021 with projections to 2045: a global analysis of India, China and the United States

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月11日

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  • Ruiqi Jiang,
  • Li Wang,
  • Yue Tian,
  • Zhigang Zhao,
  • Alex Kuo,
  • Mingnan Cao

摘要

Background

Mental disorders constitute a major global public health concern, particularly among the working-age population. Their impact extends beyond reduced productivity and long-term economic loss. This study presents a comprehensive assessment of the global burden of mental disorders among working-age adults and compares trends in the three most populous countries, India, China, and the United States, from 1990 to 2021, with projections through 2045.

Aim

To evaluate age-, sex-, and country-specific trends in the prevalence, incidence, and disability-adjusted life years (DALYs) of mental disorders among working-age adults, and to forecast future disease burden using advanced modeling techniques.

Method

Data for individuals aged 15–64 years were derived from the Global Burden of Disease Study 2021. The analysis was stratified by sex, age, country, and type of disorder. Age-standardized prevalence and incidence rates were calculated and temporal trends were quantified using the estimated annual percentage change. Significant inflection points were detected using the Joinpoint regression. Future DALYs (2022–2045) were projected using the Nordpred age–period–cohort model based on historical trends and population forecasts. All analyses were conducted using the R software (version 4.4.3).

Results

Globally, the overall burden of mental disorders remained relatively stable from 1990 to 2021; however, substantial heterogeneity was observed across sex, age groups and countries. Females consistently demonstrated a higher prevalence of depressive and anxiety disorders, whereas males exhibited higher rates of schizophrenia, attention deficit/hyperactivity disorder, and autism spectrum disorders. In the United States, both the prevalence and incidence increased markedly for most mental disorders, whereas China and India showed overall declining trends. Age-stratified analyses revealed a high disease burden among adolescents and young adults, alongside a pronounced and continuing increase in the middle-aged and older populations. Projections through 2045 suggest a further rise in DALYs, particularly among females and individuals aged 50–54 years, indicating a worsening global burden of mental disorders.

Conclusion

This study provides the most detailed, age-stratified evaluation of mental disorder burden among working-age populations to date. The findings highlight persistent gender and regional disparities and demonstrate the urgent need for scalable, culturally sensitive mental health interventions, workforce-based support systems, and the integration of mental health care into primary and occupational health frameworks.