Sex Difference in Global Burden of Major Depressive Disorder: Findings From the Global Burden of Disease Study 2019.

Sangzi Li,Yufeng Xu,Leilei Zheng,Qianni Zhang,Hu Pang,Lixia Lou,Xingru Huang

doi:10.3389/fpsyt.2022.789305

Abstract

ObjectivesGlobally, major depressive disorder (MDD) is considered to be a leading cause of disability. In this article, we aim to investigate the sex difference in global burden of MDD by year, age, and socioeconomic development, utilizing disability-adjusted life-years (DALYs).MethodsGlobal and national sex-specific DALY estimates caused by MDD from 1990 to 2019 and in different age groups were obtained from the Global Burden of Disease (GBD) Study 2019. Human development index (HDI) was used as an indicator of national socioeconomic development. Spearman correlation and linear regression analyses were performed to explore the relationship between national socioeconomic development and sex difference in MDD burden.ResultsSex difference in global burden of MDD persisted between 1990 and 2019, with age-standardized DALY rates being 352 among males vs. 593 among females in 1990 and 354 vs. 564 in 2019. Females had higher burden of MDD than males at the same age. Disability-adjusted life-years numbers and rates among both sexes rapidly increased with age for those aged 10–24 years, along with gradually enlarging sex difference. Age-standardized DALY rates among females were higher than that among males for each HDI-based country group (P < 0.001). National age-standardized DALY rates among both sexes were negatively related to HDI. However, female-to-male age-standardized DALY rate ratios were positively associated with HDI (Spearman r = 0.383, P < 0.001; standardized β = 0.300, P < 0.001).ConclusionAlthough some improvement in sex difference in global burden of MDD has been achieved, it still persists in the past three decades, with females bearing more burden than males. To reduce sex difference in global MDD burden, more attention should be paid to young people and people in developed countries. The findings highlight the importance of making sex-specific health policy to manage mental impairment caused by MDD.

Highlights

In 2019, the number of disability-adjusted life-years (DALYs) caused by depression accounted for 1.85% of all DALYs worldwide, with major depressive disorder (MDD) accounting for 1.47% and dysthymia for 0.38% [2]
Disabilityadjusted life years are the sum of years of life lived with disability (YLDs) and years of life lost due to premature death
Sex difference in terms of agestandardized DALY rates was largest in the region of the Americas, followed by Eastern Mediterranean Region, and was smallest in the Western Pacific Region

Summary

Introduction

Depression is a common mental disorder affecting approximately 300 million people of all ages worldwide [1]. It is a leading cause of disability and contributes greatly to the Global Burden of Disease (GBD). Females are more likely to suffer from MDD than males, with global prevalence rate being 3.0% in females and 1.8% in males [2]. Several factors such as biological, affective, cognitive, and sociocultural factors have been suggested to contribute to female vulnerability to MDD [3, 4]

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