中国10~24岁青少年1990—2019年抑郁症疾病负担变化趋势及预测

Trends and prediction of the burden of depression among adolescents aged 10 to 24 years in China from 1990 to 2019

目的 分析中国1990—2019年10~24岁青少年抑郁症疾病负担变化趋势及对未来发展进行预测,为青少年抑郁症防治提供理论依据。方法 利用2019年全球疾病负担数据库,通过发病率和伤残调整寿命年(disability-adjusted life years, DALYs)率两个指标,采用Joinpoint回归模型分析中国1990—2019年10~24岁青少年抑郁症疾病负担的变化趋势,利用R软件建立ARIMA时间序列模型,对中国10~24岁青少年抑郁症2020—2029年发展趋势进行预测。结果 1990—2019年中国10~24岁女生抑郁症患者每年发病率和DALYs率均高于总体和男生,20~24岁年龄段每年发病率、DALYs率均高于15~19和10~14岁,差异均有统计学意义(P值均<0.05)。通过Joinpoint回归分析得出10~24岁青少年抑郁症发病率总体呈下降趋势,年均下降速度为1.61%(t=-10.53,P<0.05);10~24岁男生和女生抑郁症发病率总体均呈下降趋势,年均下降速度分别为1.18%(t=-5.79),1.79%(t=-11.84)(P值均<0.05),女生整体下降速度大于总体和男生。1990—2019年中国10~14岁青少年抑郁症发病率总体变化趋势无统计学意义(AAPC=-0.28,P>0.05),15~19岁、20~24岁青少年抑郁症发病率总体均呈下降趋势,年均下降速度分别为1.43%(t=-12.05),1.90%(t=-24.92)(P<0.05)。ARIMA模型预测结果显示,10~24岁青少年抑郁症发病率和DALYs率在2020—2029年继续呈下降趋势。结论 女生和20~24岁是中国10~24岁青少年抑郁症防治重点关注的对象。应从青少年成长的大环境和微环境入手,采取积极有效措施防治青少年抑郁症的发生。

Objective To analyze the trend of the burden of depression among adolescents aged 10-24 years from 1990 to 2019 and predict its future trend,so as to provide a theoretical basis for prevention and treatment.Methods The prevalence and disability-adjusted life years(DALYs)were determined using the 2019 Global Burden of Disease Database.The joinpoint regression model was employed to analyze the changing trend of the burden of depression among adolescents aged 10-24 years in China from 1990 to 2019.The ARIMA time series model was established using R software to predict the development trend of depression among adolescents aged 10-24 years in China from 2020 to 2029.Results From 1990 to 2019,the prevalence and DALYs rate were higher among adolescents aged 10-24 years in comparison to the general population and males.Furthermore,the prevalence and DALYs rate were higher among adolescents aged 20-24 years than among those aged 15-19 and 10-14 years,with statistical significance(P<0.05).The joinpoint regression analysis revealed that the prevalence of depression among adolescents aged 10-24 years showed an overall decreasing trend with an average annual rate of 1.61%(t=-10.53,P<0.05),while the prevalence of depression among male and female adolescents in the same age group also showed a decreasing trend,with an average annual decreasing rate of 1.18%(t=-5.79)and 1.79%(t=-11.84)(P<0.05),and the overall decline rate was greater among women than men.There was no significant change in the prevalence of depression among adolescents aged 10-14 years from 1990 to 2019(AAPC=-0.28,P>0.05),while the prevalence of depression among adolescents aged 15-19 years and 20-24 years also showed a decreasing trend with an average annual rate of 1.43%(t=-12.05)and 1.90%(t=-24.92)(P<0.05).The ARIMA model predicted that the prevalence of depression and the rate of DALYs among adolescents aged 10-24 years would continue to decline from 2020 to 2029.Conclusion The prevention and treatment of depression among adolescents aged 10-24 years in China should focus on females and those aged 20-24 years old.We should start from the environment and micro-environment of adolescent growth and take active and effective measures to prevent the occurrence of adolescent depression.