Temporal patterns and predictive factors of depressive disorders among adolescents and young people in Asia.

Stroke remains a major global public health challenge, with persistent disparities in its burden across countries, and an increasing burden among young adults aged 15-49 has emerged as a growing concern. However, comprehensive evaluations of stroke and its subtypes among young adults in Asia remain limited. This study utilizes data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), covering the period from 1990 to 2021, to assess the burden of stroke in Asia and provide evidence-based policy and resource allocation. In this study, we extracted GBD 2021 data to estimate the absolute numbers and rates of prevalence, incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) due to stroke and its subtypes among young adults (15-49 years) in Asia from 1990 to 2021, with data stratified by year, age group, and sex. In addition, we analyzed major risk factors and projected future trends through 2050. Our analysis showed that in 2021, stroke accounted for 14.70 million (95% UI 13.39-16.01 million) DALYs and 1.14 million (95% UI 0.99-1.32 million) new cases in Asia, with a DALY rate of 620.24 (95% UI 564.66-675.12) per 100,000 and an incidence rate of 48.22 (95% UI 41.81-55.69) per 100,000. From 1990 to 2021, absolute numbers of prevalence, incidence, mortality, DALYs, YLLs, and YLDs increased by 43.56%, 44.82%, 10.68%, 11.02%, 7.64%, and 38.54%, respectively. Although the rates of prevalence and incidence showed slight increases of 0.07% and 0.96%, the rates of mortality, DALYs, YLLs, and YLDs decreased by 22.84%, 22.61%, 24.96%, and 3.42%, respectively. Among stroke subtypes, both ischemic stroke (IS) and intracerebral hemorrhage (ICH) showed increases in the absolute numbers across six metrics, with IS demonstrating more pronounced growth. Subarachnoid hemorrhage (SAH) showed increases in the incidence, prevalence, and YLDs, while its rates of mortality, DALYs, and YLLs declined. The rates of all six metrics decreased for ICH and SAH, whereas the rates of prevalence, incidence, and YLDs for IS increased, alongside reductions in the rates of mortality, DALYs, and YLLs. The absolute numbers and rates of all six metrics increased with age across both sexes, with males consistently showing higher absolute numbers and the highest burden observed in the 45-49 age group. Apart from the prevalence and YLD rates, males demonstrated higher incidence, mortality, DALYs, and YLL rates across all age groups, peaking at 45-49 years. Moreover, the leading contributors to stroke-related DALYs included high systolic blood pressure, smoking, and air pollution. From 2021 to 2050, the prevalence and incidence of stroke will continue to rise, while mortality and DALYs rates are expected to decline. Overall, from 1990 to 2021, the burden of stroke and its subtypes among young adults in Asia has increased significantly, with notable differences across age groups and sex, and with population growth and demographic changes, this burden is expected to further intensify in the future. Therefore, future research and public health policies should focus more on targeted interventions addressing the specific needs of young adults to effectively control and alleviate the burden of stroke.

Non-Hodgkin lymphoma (NHL) is increasingly prevalent in middle-aged and elderly populations, contributing to the rising global health burden, particularly in high-income countries. This retrospective analysis utilized data from the Global Burden of Disease (GBD) study (1990-2021) to examine temporal trends in age-standardized incidence, mortality, and disability-adjusted life year (DALY) rates of NHL among middle-aged and older adult populations, incorporating age- and sex-stratified comparisons. Furthermore, projections for the subsequent 30 years were generated using Bayesian age-period-cohort (BAPC) modeling. From 1990 to 2021, the number of cases, deaths, and DALYs in middle-aged and older people with NHL had significant increases. Age-standardized incidence rates exhibited an increasing trend (estimated annual percentage change [EAPC] = 0.53), whereas mortality (EAPC = -0.33) and DALY rates (EAPC = -0.52) demonstrated a decreasing trend. The Western European region and high SDI countries are the core burden areas for middle-aged and elderly populations with NHL globally. Lower-middle SDI countries experienced the fastest increase in mortality (EAPC = 0.38) and DALY rates (EAPC = 0.22), while high-SDI countries experienced the steepest decline in all metrics. The DALY burden showed its peak value at 65-69 years among middle-aged and aged adults with NHL, while the morbidity and mortality burden reached their highest point at 70-74 years. When stratified by gender, the overall burden was higher in males than in females. High BMI causes the burden of NHL DALY to rise with increasing SDI, up to 39.14% in High-income North America. By 2050, global NHL incidence is projected to increase modestly by 0.28%, whereas mortality and DALY burdens are expected to decline markedly by 30.67% and 23.02%, respectively. NHL in middle-aged and older adults represents a significant global public health burden, necessitating context-specific interventions due to variations across regions, genders, and age groups.

The global cancer burden is rising, with early-onset cancers becoming more prevalent. We aimed to investigate the burden, trend and population disparity in 33 early-onset cancers from 2012 to 2021. Annual incidence, death, and disability-adjusted life years (DALY) numbers and rates for early-onset (15-49 years) cancer groups were calculated from Global Burden of Diseases (GBD) 2021 dataset, covering 2012-2021 across global, five SDI groupings, and 204 countries and territories. Estimated annual percentage change (EAPC) in the incidence, mortality and DALY rates was calculated to quantify temporal trends, while spearman correlation analysis was used to examine the correlation between rates, EAPC and SDI. In 2021, there were 2.65million new early-onset cancer cases excluding non-melanoma skin cancer (NMSC), resulting in 0.99million deaths and 50.7million DALYs. Breast, tracheal, bronchus and lung (TBL), cervical, colon and stomach cancers were the leading causes of DALYs. The DALY rate for early-onset cancer excluding NMSC changed from 65.7million in 2012 to 67.0million in 2021, with an estimated annual percentage change (EAPC) of -0.49%. While the DALY rate plateaued for females, it decreased by -0.95% for males. Ten of 33 cancer groups exhibited an EAPC > 0. The high SDI quintile had 1,100 DALYs per 100,000 caused by early-onset cancers excluding NMSC, with the highest declining trend in DALY and mortality rates, while the high-middle SDI quintile had the highest early-onset mortality rates. Rising trends in cancer incidence and mortality were especially notable among females in the middle, low-middle, and low SDI quintiles. The global burden of early-onset cancer differs significantly by SDI quintile and gender. The increasing burden across multiple cancer groups poses a significant public health challenge. The rising burden of multiple cancer types is alarming, highlighting the need for increased policy support and targeted medical assistance to address the disparities in their impact.

Global Disease Burden From Acute Glomerulonephritis 1990–2019

Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019

Background Inflammatory bowel disease (IBD) is a significant component of the global disease burden, particularly among adolescents and young adults. This study aimed to investigate the patterns and trends of IBD among adolescents from 1990 to 2021. Methods We retrieved data on the incidence and disability-adjusted life years (DALYs) of IBD in adolescents (aged 15-39 years) from the Global Burden of Disease (GBD) 2021 study, Temporal trends of incidence and DALYs were calculated using the average annual percent change (AAPC). The correlation between age-specific incidence rates and DALYs rates with the Sociodemographic Index (SDI) was performed using Spearman’s correlation analysis. Results From 1990 to 2021, age-specific incidence rates significantly increased while age-specific DALYs rates declined [AAPC: 0.22vs-0.16]. All SDI regions saw a decline in age-specific incidence rates while age-specific DALYs rates in adolescent showed an increasing trend in low and middle SDI regions but a-decrease in high, high-middle and low-middle SDI regions. Incidence rates rose from 1990 to 2021 in 21-GBD regions except for high-income North America. In contrast, DALYs rates increased in regions such as Western Sub-Saharan Africa, Central Latin America, Tropical Latin America, Australasia, Eastern Sub-Saharan Africa, Central Sub-Saharan Africa, Central Asia, and North Africa and the Middle East, while they declined in the remaining 21-GBD regions. Among the 204-countries, China exhibited the fastest-growing age-specific incidence rate among adolescents [AAPC: 2.60], followed by Libya (AAPC: 2.59) and Oman (AAPC: 1.56), while Italy showed the fastest decline [AAPC: -0.76] (Figure-1A). Mauritius experienced the fastest growth in age-specific DALYs rates among adolescents (AAPC: 1.93), followed by Libya (AAPC: 1.79) and Mexico (AAPC: 1.45), while Northern Mariana Islands saw the fastest decline (AAPC: -3.28) (Figure-1B). Moreover, the AAPC of age-specific incidence rates for adolescent IBD exhibited a slight decreasing trend with increasing SDI (Figure-1C), and the AAPC of DALYs rates significantly declined with increasing SDI (Figure-1D). Conclusion The regional disparities in the incidence and DALYs rates of adolescent IBD highlight the urgent need for innovative prevention and healthcare strategies to alleviate the global burden of IBD among adolescents. Early screening could be crucial in mitigating the impact of IBD on adolescents.

Objective: To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly. Methods: Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036. Results: The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95%CI: 3.149%-3.281%, P<0.05), 3.161% (95%CI:3.037%-3.286%, P<0.05), and 3.091%(95%CI: 2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012% (95%CI:-0.031%-0.008%, P>0.05), 0.023% (95%CI:-0.070%-0.116%, P>0.05), and 0.013% (95%CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups (P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions: The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.

Parkinson's disease (PD) ranks as the second most prevalent neurodegenerative disorder; however, its epidemiological characteristics among middle-aged and older adults at global, regional, and national levels remain inadequately documented. This study assessed temporal trends in PD among middle-aged and older adults by extracting incidence rates, disability-adjusted life year (DALY) rates, and corresponding age-specific rates (ASRs) from the Global Burden of Disease (GBD) database spanning 1990 to 2021. Estimated annual percentage change (EAPC) was employed to analyze trends over the past 30 years. The slope index of inequality (SII) and concentration index (CI) were utilized to evaluate disparities in the burden of PD across various countries. Additionally, Bayesian age-period-cohort (BAPC) modeling was applied to project DALY figures for the next 15 years. In 2021, the global incidence and DALY rates for middle-aged and older adults with PD stood at 79.68 and 477.50 cases per 100,000 population, respectively. Both incidence and DALY rates have exhibited an upward trajectory over the past 32 years, with EAPCs of 1.2 (95% UI: 1.1-1.3) and 0.6 (95% UI: 0.5-0.7), respectively. Among the five sociodemographic index (SDI) regions, the high-middle SDI region reported the highest incidence and DALY rates for PD in 2021, at 93.93 and 512.29 cases per 100,000 population, respectively. A positive correlation was observed between the SDI and age-specific incidence rate (ASIR) as well as age-specific DALY rate (ASDR). Disparities in the burden of PD among middle-aged and older adults, associated with SDI, are on the rise and are primarily concentrated in high SDI countries. It is projected that the global incidence and DALY rates for middle-aged and older adults with PD will experience significant increases over the next 15 years. The global burden of PD among middle-aged and older adults has markedly escalated over the past 32 years, particularly in high-middle SDI regions. These findings underscore the necessity for the development of effective interventions and public health policies, contributing to the attainment of the sustainable development goals established by the World Health Organization (WHO).

Background: Depressive disorders are one of the most common mental health diseases, which are associated with adverse life events such as increased risk of self-injury. This study was aimed to measure the epidemiological status and the burden of depressive disorders in the Middle East and North Africa (MENA) countries. Methods: The study population included 21 countries in the MENA region, covering a population of about 600 million. The Global Burden of Disease (GBD) 2019 database was used. The disability-adjusted life years (DALYs) were estimated by the years lived with disability (YLDs) component. The prevalence, incidence, and the DALYs rates per 100000 people by age-standardized rate (ASR) were measured. Results: In 2019, the highest prevalence 6198.95 (95% uncertainty interval [UI], 5402.41- 7108.39), incidence 7864.2 (95% UI, 6719.71-9216.83), and DALYs 1168.68 (95% UI, 802.95- 1624.31) per 100,000 were in Palestine by ASR. Between 1990 and 2019, the depressive disorders-related prevalence, incidence, and DALYs rates in the MENA region increased by 0.004%, 0.006%, and 0.005%. The highest increment of the prevalence, incidence, and DALYs rates was related to Saudi Arabia by 0.05%, 0.064%, and 0.055%. The highest percentage of major depressive disorder (MDD)-related DALYs attributed to intimate partner violence was related to Iran (101.1). Also, the highest percentage of MDD-related DALYs attributed to childhood sexual abuse (34.26) and bullying victimization (49.81) was related to Palestine. Conclusion: Given the increasing trend of depressive disorders in MENA region, mental health programs should be prioritized across the MENA countries, with significant contributions and involvement of the governments.

BackgroundIn recent decades, there has been a global increase in the burden of rheumatoid arthritis (RA) among adolescents and young adults (AYAs), making it a significant public health issue. However, our understanding of the disease burden, harm, and influencing factors of RA in this population remains insufficient. This study aimed to assess the trends in RA burden among AYAs aged 10–24 years from 1990 to 2019 at the global, regional, and national levels.MethodsIncidence, prevalence, and disability-adjusted life years (DALYs) rate per 100,000 population, as well as average annual percentage changes (AAPCs), of RA among individuals aged 10–24 years were reported globally, regionally, and nationally based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). These global trends were further analyzed by age, sex, and Sociodemographic index (SDI). Joinpoint regression analysis was used to determine the year in which the most significant changes in global trends occurred.ResultsGlobally, the incidence of RA among AYAs increased from 4.98 per 100,000 population in 1990 to 5.41 per 100,000 population in 2019, with an AAPCs of 0.29 (95%CI: 0.26, 0.32, p < 0.001). The most significant increase occurred in 2000, while the most significant decrease occurred in 2014. The prevalence increased from 34.11 per 100,000 population in 1990 to 36.34 per 100,000 population in 2019, with an AAPCs of 0.22 (95%CI: 0.19, 0.24, p<0.001); The most significant increase was observed in 2000, and the most significant decrease occurred in 2014. DALYs rate with RA were 5.96 per 100,000 population in 1990 and 5.79 per 100,000 population in 2019 for AYAs, with an average decrease of 0.1 years per year (AAPCs = -0.1, 95%CI: -0.2, -0.01, p = 0.04). In terms of gender, the incidence, prevalence, and DALYs rate were higher for females compared to males during the same period. Regarding age, the incidence, prevalence, and DALYs rate increased with increasing age. Based on the SDI quintile, the incidence, prevalence, and DALYs rate of RA were highest in countries with high SDI and lowest in countries with low SDI from 1990 to 2019. However, the relationship between incidence and SDI is non-linear. In terms of regions, Tropical Latin America exhibited the highest incidence, prevalence, and DALYs rate, while Andean Latin America experienced the most rapid increase in incidence and prevalence. Southern Latin America saw the fastest growth in DALYs rate, whereas Southern Sub-Saharan Africa witnessed the most significant decline.ConclusionIn conclusion, the study revealed an overall increase in the incidence and prevalence of RA among adolescents and young adults (AYAs) over the past three decades, while DALYs rate remained relatively stable. Furthermore, the incidence, prevalence, and DALYs rate of RA were found to increase with age. Fortunately, recent proactive preventive measures and treatment methods have shown promising results. Moving forward, it is crucial to prioritize the female population and AYAs patients in order to further alleviate the global burden of RA.

e16423 Background: Pancreatic cancer (PC) is one of the most aggressive malignancies, disproportionately affecting older adults. Leveraging data from the Global Burden of Disease (GBD), this study investigates gender-specific trends in disability-adjusted life years (DALYs) and mortality rates for PC among adults aged 70 and older from 1990 to 2021. Methods: DALYs and mortality rates associated with PC were extracted for both genders from the GBD-2021 study from 1990 to 2021. The Annual Percentage Change (APC) and the Average Annual Percentage Change (AAPC) were calculated, along with 95% confidence intervals (CI), to assess the statistical significance of the trends using the p-value. Results: In 1990, DALY rates were 837.25 for men and 711.95 for women, increasing to 950.68 and 768.31, respectively, by 2021. Mortality rates followed a similar pattern: men’s rates rose from 52.05 in 1990 to 61.37 in 2021, while women’s increased from 47.31 to 53.40. Men consistently experienced higher burdens than women. The AAPC analysis revealed that men exhibited a steeper rise in both DALYs and mortality rates associated with PC compared to women over the past three decades. Notably, the gender disparity was more evident in DALYs (+0.1929%) than in mortality rates (+0.1358%), with all AAPC values demonstrating statistical significance (p &lt; 0.000001). Following the APC analysis, additional significant trends were identified. Among males, DALY rates demonstrated the most pronounced increase between 1997 and 2021 (APC: 0.5397, 95% CI: 0.5118, 0.5645), whereas in females, the most significant rise occurred from 1990 to 1993 (APC: 0.6593, 95% CI: 0.3608, 1.1016). Conversely, the slowest increase in DALY rates among females was observed between 1993 and 2003 (APC: 0.0925, 95% CI: -0.2053, 0.1641). For mortality rates, the most notable rise in males was observed between 2007 and 2010 (APC: 1.2314, 95% CI: 1.0292, 1.3195), while females experienced their sharpest escalation from 1990 to 1994 (APC: 0.6891, 95% CI: 0.4322, 1.0720). In contrast, the slowest rate of progression in mortality among females occurred between 1993 and 2002 (APC: 0.1736, 95% CI: 0.0180, 0.2368). Conclusions: Over the past three decades, men have experienced a significantly more pronounced rise in DALYs and mortality rates related to PC compared to women.These findings highlight the urgent need for gender-specific interventions to address the growing burden of PC in aging populations. Trends in DALY and mortality rates per 100,000 by gender (1990-2021). Metrics Gender 1990 2021 APC (1990-2021) Daly Rates per 100,000 Male 837.25 950.68 0.4422 Female 711.9 768.31 0.2493 Mortality Rates per 100,000 Male 52.05 61.37 0.5366 Female 47.31 53.40 0.4008

Intracerebral hemorrhage (ICH) in young adults demands greater attention, given its poor prognosis; however, there has been a paucity of epidemiological data. The objective of this study is to estimate the temporal trends and distribution characteristics of the disease burden in 204 countries or territories between 1990 and 2021. The data, including incidence, mortality, prevalence, and disability-adjusted life year (DALY) rates were sourced from the Global Burden of Diseases Study 2021. From 1990 to 2021, there was a significant decline in the global incidence (estimated annual percentage change=-1.05), mortality (estimated annual percentage change=-0.92), and DALY (estimated annual percentage change=-1.00) rates of ICH in young adults. In 2021, the highest incidence, mortality, and DALY rates were observed in Southeast Asia, East Asia, and Oceania. Globally, high systolic blood pressure, smoking, and ambient particulate matter pollution were identified as the primary contributors to the largest proportion of DALYs associated with ICH in young adults. The health inequality of ICH in young adults has been reduced over the past 3 decades. There is a considerable degree of heterogeneity in the global burden of ICH in young adults. A decline in the incidence, mortality, prevalence, and DALY rates has been observed from 1990 to 2021, however, the number of absolute cases has increased. These results will enable health care professionals, policymakers, and researchers to refine the implementation of cost-effective policies, the allocation of health care resources, and the management of patients to further mitigate the burden of ICH in young adults.

Objective: To assess the disease burden of lung cancer associated with occupational exposure to polycyclic aromatic hydrocarbons (PAHs) in China from 1990 to 2021 using the 2021 Global Burden of Disease (GBD) data. Methods: In July 2024, data on occupational PAHs exposure-associated lung cancer from 1990 to 2021 were extracted from the GBD database, including mortality rates, age-standardized mortality rates, number of deaths, disability-adjusted life years (DALYs) rates, age-standardized DALYs rates, and number of DALYs for different genders and ages. Descriptive statistics were used to analyze trends in lung cancer mortality rates, age-standardized mortality rates, DALYs rates, and age-standardized DALYs rates over different years, genders, and ages. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC), and to identify change points and trends in different periods within the data. Results: From 1990 to 2021, the mortality rate of lung cancer associated with occupational PAHs exposure increased from 0.085 per 100000 to 0.259 per 100000, and the age-standardized mortality rate increased from 0.107 per 100000 to 0.162 per 100000. The DALYs rate increased from 2.746 per 100000 to 7.389 per 100000, and the age-standardized DALYs rate increased from 3.330 per 100000 to 4.679 per 100000. The number of lung cancer deaths and DALYs both peaked in the 65-69 age group. Joinpoint regression analysis showed significant upward trends in mortality, age-standardized mortality, DALYs rate, and age-standardized DALYs rate from 1990 to 2021, with AAPCs of 3.655%, 1.382%, 3.256%, and 1.108%, respectively (all P<0.001). From 2016 to 2021, both the mortality rate and age-standardized mortality rate increased, with APCs of 4.163% and 1.735%, respectively. From 2015 to 2021, the DALYs rate increased (APC: 3.137%), and from 2016 to 2021, the age-standardized DALYs rate also rose (APC: 1.578%). For females, both mortality and DALYs rates increased from 2015 to 2021 (APCs: 6.269% and 5.426%, respectively). Among males, the mortality rate increased from 2018 to 2021 (APC: 3.477%) . Conclusion: From 1990 to 2021, the disease burden of lung cancer related to occupational PAHs exposure in China has significantly increased, particularly among the elderly population. Public health policies should enhance screening and prevention efforts targeting the high-risk populations.

Childhood depressive disorders represent a growing mental health concern, yet region-specific evidence in Asia remains limited. Asia hosts more than half of the global child population and has experienced rapid social and environmental changes that may heighten psychosocial stress. This study assessed the burden, temporal trends, geographic variation, and determinants of childhood depressive disorders across Asia from 1990 to 2023. Data for children aged 0-14 years were obtained from the Global Burden of Disease (GBD) 2023 study. Incidence and disability-adjusted life years (DALYs) were analyzed by age, sex, region, and country. Joinpoint regression quantified annual and long-term temporal trends. Bullying victimization was evaluated as a behavioral risk factor. Extreme Gradient Boosting (XGBoost) models with Shapley Additive Explanations (SHAP), which show how each variable influences model predictions, were used to identify the major predictors of incidence and DALYs. In 2023, South Asia showed the highest incidence rate (1099 per 100,000) and DALYs rate (119 per 100,000). Across all regions, children aged 10-14 years and girls had the greatest incidence and DALYs rates. India, China, and Pakistan contributed the largest absolute numbers of cases and DALYs, while Mauritius, Bangladesh, and Pakistan recorded the highest rates. Pakistan demonstrated the steepest long-term increases in both incidence and DALYs. Bullying-attributable DALYs increased across all regions, with the largest growth in South and Southeast Asia. SHAP analyses identified age, sex, calendar year, and population size as the strongest predictors, with older children and girls showing markedly higher predicted burdens. Childhood depressive disorders have increased steadily across Asia over the past three decades, with clear demographic and geographic disparities. These findings highlight the urgency of early detection, school-based mental health programs, antibullying interventions, and gender-responsive services. Strengthening child mental health systems in Asia is critical for improving developmental outcomes.

e23509 Background: Sarcoma is one of the rare malignancies arising from bone or soft tissues, shares a incidence of 1% of all cancers across the world. This study analyzes data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to examine trends and provide a detailed outlook on its global trajectory. Methods: Data was extracted from the GBD 2021 database, focusing on age-standardized death rates (ASDR), Disability Adjusted Life Years (DALYs) and incidence of sarcoma. Analytics conducted using join point regression to determine average annual percentage changes (AAPC). Results: Globally, ASDR for soft tissue and extraosseous sarcomas have continuously declined from 1980-2021. In 1980, the ASDR was 0.77(95% UI: 0.65-0.91) and it declined to 0.60 (AAPC: -0.602; 95% UI: -0.67, -0.53, P&lt;0.001) in 2021. Globally, DALYs rate was 27.4(95% UI: 22.61-33.29) per 100,000 people in 1990 and it decreased to 20.54 (AAPC: -0.0936; 95% CI: -1.02, -0.085, P&lt;0.001) in 2021. The Incidence rate was 27.4(95% UI: 22.61-33.29) in 1990 that decreased to 20.54 (AAPC: -0.131; 95% CI: -0.25 to -0.003, P=0.04) in 2021. Globally, DALYs rate was 27.4(95% UI: 22.61,33.29) per 100,000 people in 1990 and it decreased to 20.54 (AAPC: -.0936; 95% CI: -1.02-to -0.085, P&lt;0.001) in 2021. In geographical analysis, America, Africa and Asia had uniformly declining ASDRs while Europe had a steady rise in ASDR. From 1980 to 2021, America had decreasing death rates with an AAPC of -0.243 (95% CI: -0.48, -0.0050; P=0.04) and nonsignificant decreasing incidence rates with an AAPC of -0.022(95% CI: -0.21, 0.16). Africa and Asia also had declining death rates with AAPC of -0.734 (95% CI: -0.81, -0.65; P&lt;0.001) and AAPC of -1.13 (95%CI: -1.21, -1.06; P&lt;0.01) respectively. Conversely Europe had an increasing trend both in death and incidence rate, with death rate AAPC of 0.33 (95%CI: 0.12,0.55; P&lt;0.001). Per World Bank income levels, high-income countries saw a slight increase in death rates, while others declined. Conclusions: The results show a steady decline in ASDR, DALY and incidence rates from 1980 to 2021. However, regional disparities show declining ASDR in America, Asia, and Africa, while Europe saw a steady rise. Similarly, death rates slightly increased in high-income countries, while lower-income groups saw declines. Sarcoma death rates compared between 1980 and 2021. Location Year Rate Upper Lower Global 1980 0.77 0.90 0.65 2021 0.60 0.73 0.51 America 1980 0.96 1.00 0.93 2021 0.87 0.91 0.81 Europe 1980 0.70 0.74 0.67 2021 0.80 0.85 0.74 Asia 1980 0.67 0.83 0.46 2021 0.42 0.57 0.32 Africa 1980 1.12 1.64 0.89 2021 0.83 1.24 0.64