Burden, trends, and inequalities of anxiety disorders in the Western Pacific region, 1990-2023: A systematic analysis of the Global Burden of Disease Study 2023.

Background

Anxiety disorders (ADs) are a leading non-fatal cause of global disease burden, yet a detailed assessment of their burden, trends, and socioeconomic inequalities in the Western Pacific region is lacking.

Methods

Using data from the Global Burden of Disease (GBD) Study 2023, we estimated prevalence, incidence, and disability-adjusted life years (DALYs) for ADs across 31 countries/territories in the Western Pacific region from 1990 to 2023. We calculated age-standardized rates (ASRs). Temporal trends were analyzed with joinpoint regression, and socioeconomic inequalities were assessed using the slope and concentration indices based on the sociodemographic index (SDI). A Das Gupta decomposition quantified contributions of population growth, aging, and epidemiological change to DALY changes.

Results

In 2023, ADs resulted in 87.1 million prevalent cases, 12.6 million incident cases, and 10.3 million DALYs in the region. The age-standardized DALY rate was 456.8 per 100,000. Burden peaked in ages 10-14 and was consistently higher in females. From 1990-2023, age-standardized rates for prevalence, incidence, and DALYs increased significantly, accelerating after 2010. Population growth accounted for 57.4% of the DALY increase, while epidemiological change contributed 41.7%. Cross-country inequality analyses did not show significant associations with SDI.

Conclusion

The burden of ADs in the Western Pacific has risen substantially, especially since 2010, disproportionately affecting adolescents and females. Epidemiological changes are a major driver. Strengthened prevention, surveillance, and diagnostic capacity are urgently needed to address this growing burden.