Trends in the epidemiology of anxiety disorders from 1990 to 2021: A global, regional, and national analysis with a focus on the sociodemographic index
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BACKGROUND: Anxiety disorders are widespread across the world. Understanding the global burden of anxiety disorders in the past and future can provide important references for optimizing prevention and control strategies in healthcare systems. METHODS: The estimation of anxiety disorders in the Global Burden of Disease Study 2021 using systematic review was conducted to describe incidence, prevalence and disability adjusted life years (DALYs) in 204 countries and regions from 1990 to 2021. Trends were examined using joinpoint regression analysis and correlation between Sociodemographic Index (SDI) and temporal trends was assessed. RESULTS: In 2021, the global age-standardised prevalence rate (ASPR), age-standardised incidence rate (ASIR), and age-standardised DALYs rates for anxiety disorders were 4421.9 (95 % uncertainty intervals [UIs] 3768.3 to 5182.1), 678.3(565.2 to 832.4), and 524.3(363.1 to 716.3) per 100,000 population, which were 18 %, 20.6 %, and 18.2 % higher than in 1990, respectively. In 2021, Brazil (9007.4), Portugal (9712.4), and Paraguay (8390) had the highest ASPR of anxiety disorders. Brazil (53.2 %), Peru (38.4 %), and Bolivia (42.2 %) showed the largest increases in ASPR across the study period. In women, the global DALY rate of anxiety disorders increased up to age 20-44 years and then decreased with advancing age, whereas for men the rate the same as in women. Regionally, an overall undulating pattern association was found between SDI and the age standardised DALYs rate of anxiety disorders. The global female ASIR slightly increased from 1990 to 2019 (Annual percent change [APC]: 0.02 %). However, from 2019 to 2021, it saw a substantial rise (APC: 10.78 %). CONCLUSIONS: With the development of society, the disease burden of anxiety disorder will become increasingly severe. It is very important to study the accurate epidemiological data on anxiety disorder for clinical diagnosis and treatment and health policy.
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SAD is a globally distributed mental health condition with substantial prevalence across countries and regions.
“Cross-national data showed that SAD is a globally distributed mental health condition, with substantial prevalence across countries and regions [5,6,7].”
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Джаудатович, Т. Р., Кузнецов, В. Н., Александровна, С. К., & Кузнецов, В. Н. (2026) · Психиатрия психотерапия и клиническая психология · doi:10.34883/pi.2026.17.2.001
Fang, Y. D., Xiao, X., Yin, Z., Fang, M., & Lu, P. (2026) · Critical Public Health · doi:10.1080/09581596.2026.2696628
Yuan, M.-L., Liang, X.-Q., Jin, W.-Y., Zheng, M., Feng, S.-Y., Zhao, J.-L., Li, S.-R., Zhu, L.-L., Tan, L., Zeng, Y.-D., et al. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1916777
“The burden of anxiety and depressive disorders among youth followed population-wide temporal trends (26, 27).”
Winkler, C., Koval, P., Phillips, L., & Felmingham, K. L. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.105147
Non-fatal health outcomes of anxiety disorders in Ethiopia, from 1990 to 2023
Tadesse, S., Jemal, M., Sherfa, A., Lahole, B. K., Belay, S., Gebremariam, G., Wodessa, G., Zewudie, A., & Tuke, G. (2026) · SAGE Open Medicine · doi:10.1177/20503121261486073
“11 Moreover, the ASYLDs rates estimated in the current study overlap with the estimates in the Middle East and North Africa region.”
Anxiety disorders in China and G20 countries: A comparative burden study
Wang, Y., Wang, W., Liu, X., Zhou, M., Gu, R., & Lv, F. (2026) · Journal of International Medical Research · doi:10.1177/03000605261485098
Association between sleep paralysis and anxiety: a systematic review and meta-analysis
Garrido, G., Donato, K. O., Gonzalez, J. V. P., Brito, G., Romeo, B. S., Machado, V., Lopes, L. G., & Salles, C. (2026) · Journal of Clinical Sleep Medicine · doi:10.1007/s44470-026-00190-9
Lesmes, Ó. A. G., Ramos, E. S., & Páez, Z. J. V. (2026) · Population Health Metrics · doi:10.1186/s12963-026-00510-4
“Therefore, the impact of anxiety disorders extends beyond the clinical sphere and includes work absenteeism, presenteeism, reduced income, impairment of family caregiving, and substantial indirect costs for households and social systems [4, 27, 31].”
A Random Forest-Based Study on Predicting Anxiety Symptoms Under Psychosocial Stress
Li, K., Niu, Y., Zhan, K., Pi, M., Xiong, Q., Yang, Y., Liu, W. D., Xia, Y., Shu, X., & Huang, M. (2026) · International Conference on Health Big Data · doi:10.1145/3833450.3833472
“Therefore, accurate epidemiological evidence is important for improving prevention, diagnosis, treatment, and mental health policy [5].”
Alonso-Olea, I., Gual-Montolio, P., Díaz-Sanahuja, L., Niño-Ruiz, L., Mira, A., Casteleyn, S., Granell, C., García‐Palacios, A., & Bretón-López, J. M. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-117124
Xiao, S., & Chen, W. (2026) · Child Psychiatry & Human Development · doi:10.1007/s10578-026-02102-7
Liu, J., Yang, L., Qiao, Q., Zhou, J., Zhang, Z., Gao, Y., & Zhang, S. (2026) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-026-02399-4
Late-Life Anxiety and Whether We Should Worry About It
Andreescu, C., Karim, H. T., & Costa, A. P. (2026) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20260015
Zhang, Y.-Y., Hu, M.-T., Xie, S., Yu, C.-X., Xu, Y.-H., Chen, X., Tang, M., Li, C., Zhu, Y., Hu, J.-X., et al. (2026) · Neuron · doi:10.1016/j.neuron.2026.09.032
Chen, Z., Huang, J., Yuying, W., Chen, J., Ke, Z., Chen, T., Chen, X., & Tan, W. (2026) · Brain and Behavior · doi:10.1002/brb3.71843
“Comorbidity is defined as a condition that exists or occurs in the course of a disease other than the one in which the same patient suffers (Y. Wu et al. 2025 ).”
Elmenawi, K. A., Patel, S. V., Aydın, E., Khan, S. T., Villa, J. M., Higuera, C., Deren, M. E., & Piuzzi, N. S. (2026) · MUSCULOSKELETAL SURGERY · doi:10.1007/s12306-026-00988-z
- Authors
- Wu, Y., Li, X., Ji, X., Ren, W., Zhu, Y., Chen, Z., & Du, X.
- Affiliations
- Soochow University (CN)
- Fudan University (CN)
- Corresponding author
- Chen, Ziqiang
- Du, Xiangdong
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2025-03
- Volume
- 373
- Pages
- 166-174
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4405796554
- Cited by
- 57
- References
- 52
- Citations by year
- 2026: 41 · 2025: 16
- FWCI
- 26.87
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- anxiety disorders, global burden of disease, disability-adjusted life years, prevalence trends, incidence trends, socio-demographic index, sex differences, age-standardized rates, regional variation, Brazil, Latin America, women's mental health, Global Burden of Disease 2021, mental health policy, prevention
- MeSH terms
- Global Burden of Disease, Disability-Adjusted Life Years, Sociodemographic Factors, Adult, Anxiety Disorders, Female, Humans, Male, Middle Aged, Socioeconomic Factors, Global Health, Incidence, Prevalence, Young Adult
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