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Global burden of diseases attributed to mental and substance use disorders in reproductive-age women: an ecological analysis for the Global Burden of Disease Study 2021

Molecular Psychiatry volume 31, pages 62–74 (2026)Cite this article

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Abstract

A comprehensive analysis of the global burden and trends of mental disorders (MDs) and substance use disorders (SUDs) among reproductive-age women is lacking. This study estimated the burden of disease attributable to MDs and SUDs in reproductive-age women from 1990 to 2021. Using data from the Global Burden of Disease Study 2021, we assessed the prevalence, incidence, and years lived with disability (YLDs) of 12 types of MDs and SUDs among reproductive-age women between 1990 and 2021. Estimates were stratified by age and sex at global, regional, and national levels. Trends were evaluated using the average annual percentage change (AAPC) and total percentage change. In 2021, the global age-standardized prevalence rates per 100,000 population among reproductive-age women were 17,573 (95% uncertainty interval 15,443–19,954) for MDs and 1806 (95% uncertainty interval 484–2191) for SUDs. Among MDs, depressive and anxiety disorders were the leading contributors to YLDs, with age-standardized YLD rates of 1,073.5 (686.73–1,562.48) and 844.05 (532.79–1,232.57) per 100,000 population, respectively. From 1990 to 2021, age-standardized rates of the prevalence, incidence, and YLDs of MDs increased (AAPC: 35%, 55%, and 38%, respectively), while those of SUDs decreased (AAPC: −55%, −62%, and −19%, respectively). The burden of both MDs and SUDs was highest in regions with higher sociodemographic indices. The greatest increases in burden were observed among younger women aged 15–24 years with MDs and 15–34 years with SUDs. MDs and SUDs are substantial contributors to the global disease burden in reproductive-age women. The magnitude and distribution of this burden vary by disorder type, country, age group, and sociodemographic development.

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Fig. 1: Age-standardised rate (ASR) of prevalence, incidence and YLDs for mental and substance use disorders among reproductive age women across 204 countries and territories in 2021.
Fig. 2: Average annual percent change (AAPC) in prevalence, incidence and YLDs of mental and substance use disorders among reproductive age women in 2021 across 204 countries and territories.
Fig. 3: Global burden for the top five specified groups of mental and substance use disorders in reproductive age women from 1990 to 2021.

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Data availability

The datasets generated during and/or analysed during the current study are available in the Global Burden of Disease repository, https://vizhub.healthdata.org/gbd-results/.

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Acknowledgements

We thank BioMed Proofreading LLC for providing English-language editing support. We also would like to thank Professor Chingyu Cheng from the Yong Loo Lin School of Medicine, National University of Singapore, for his valuable guidance in data analysis and critical insights during this study.

Funding

The present project was supported by grants from GDPH Supporting Fund for Talent Program (KY0120220263), the National Natural Science Foundation of China (82271125, 81870663, 82171075, and 82301205), 2024 National Foreign Expert Project (S20240245), Guangdong Basic and Applied Basic Research Foundation (2023B1515120028), the launch fund of Guangdong Provincial People’s Hospital for NSFC (8217040449, 8227040339 and 8217040546), the Science and Technology Program of Guangzhou (20220610092), the Outstanding Young Talent Trainee Program of Guangdong Provincial People’s Hospital (KJ012019087), the GDPH Scientific Research Funds for Leading Medical Talents and Distinguished Young Scholars in Guangdong Province (KJ012019457), and Personalized Medical Incubator Project, The fund for Precision Medicine Research and Industry Development in SIMQ (2023-31). The funder had no role in the design, data collection, data analysis, and reporting of this study.

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  1. These authors contributed equally: Cong Li, Anyi Liang.

Authors and Affiliations

  1. Medical Big Data Center, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

    Cong Li & Lei Liu

  2. Department of ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

    Cong Li, Anyi Liang, Yu Kuang, Shunming Liu, Xiaohong Yang, Lei Liu, Yijun Hu & Honghua Yu

  3. Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Cong Li

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Contributions

CL and AYL are joint first authors. LL, YJH and HHY conceived the design of this paper. CL, SML and LL did analyses of the Global Burden of Disease data. AYL, CL and LL wrote the first draft and contributed to revisions of the draft. AYL, XHY, YK, YJH and HHY commented and edited all versions of the draft. All authors read and approved the final draft. All authors have full access to all the data in the study and accept responsibility to submit for publication.

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Li, C., Liang, A., Kuang, Y. et al. Global burden of diseases attributed to mental and substance use disorders in reproductive-age women: an ecological analysis for the Global Burden of Disease Study 2021. Mol Psychiatry 31, 62–74 (2026). https://doi.org/10.1038/s41380-025-03216-5

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