Effective response: China’s performance and sex-and region-based disparities amid global increase in depressive disorder burden during the COVID-19

Abstract Objective To investigate changes in the depressive disorder burden in China, global, and across socio-demographic index (SDI) regions during the COVID-19(from 2019 to 2021) compared with 1990 to 2019, and to analyze sex-regional disparities. Methods Using depressive disorder data from the Global Burden of Disease (GBD) database (from 1990 to 2021) for China, global populations, and 5 SDI regions, we characterized depressive disorder burden distribution during the pandemic via metrics including age-standardized prevalence rate (ASPR), age-standardized disability-adjusted life years (ASR-DALYs), and estimated annual percentage change (EAPC). Joinpoint regression modeled temporal trends, and the Bayesian age-period-cohort (BAPC) model estimated the excess depressive disorder burden attributable to COVID-19 in 2020—2021. Results China’s depressive disorder ASPR increased to 2 875.68/100 000 person-years (95%CI: 2 589.96 to 3 203.43) in 2021 from 2 825.00/100 000 (95%CI: 2 550.42 to 3 136.08) in 2019; ASR-DALYs rose to 430.61/100 000 (95%CI: 305.24 to 586.21) from 430.14/100 000 person-years (95%CI: 303.92 to 580.82). Joinpoint analysis identified an inflection point for China’s ASPR in 2019, with a significant upward annual percentage change (APC=0.95, P