The burden of mental disorders, substance use disorders and self-harm among adolescents aged 10 to 19 years from 1990 to 2021 and predictions to 2046 in China: A population-based study

The study aims to assess the mental health burden among Chinese adolescents aged 10 to 19 years via the 2021 Global Burden of Diseases Study (GBD). Data on the disease burden owing to mental health conditions of Chinese adolescents aged 10 to 19 years from 1990 to 2021 were obtained from the GBD 2021. Disability-adjusted life of years, years of life lost (YLLs), years lived with disability (YLDs), and the prevalence rates of mental disorders (MDs), substance use disorders (SUDs) and self-harm were plotted against sociodemographic index from 1990 to 2021. Temporal trends in the disease burden were evaluated using the Joinpoint Regression. The Nordpred model was applied to project the disease burden over the next 25 years. The burdens of MDs, SUDs, and self-harm accounted for 31.3% of total YLDs and 7.1% of total YLLs among Chinese adolescents aged 10 to 19 years in 2021. These conditions contributed 1439 YLDs (average annual percentage change [AAPC] = −0.2, 95% CI: −0.3 to −0.1) and 139 YLLs (AAPC = −5.2, 95% CI: −5.6 to −4.8). Significant increases in YLDs were observed for eating disorders (AAPC = 1.3, 95% CI: 1.2 to 1.4), whereas intellectual disabilities and developmental disorders significantly decreased (AAPC = −1.4, 95% CI: −1.5 to −1.3). Differences were evident across age and sex groups. The burden of SUDs reaches to the lowest point with an sociodemographic index value of 0.68. Among GBD-quantified risk factors, bullying victimization was a major contributor to disability. The burden of MDs and SUDs is projected to continue increasing over the next 25 years. The mental health burden among Chinese adolescents is a leading contributor to disability. Model-based projections suggest increasing future burdens of MDs and SUDs, underscoring the need for regularly updated, age- and sex-specific adolescent mental health policies.