Trends in the epidemiology of anxiety disorders from 1990 to 2021: A global, regional, and national analysis with a focus on the sociodemographic index

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.