Global Burden of Mental Disorders in Women of Reproductive Age from 1990 to 2021: A Comprehensive Analysis and Trend Prediction of Depression, Anxiety, Bipolar Disorder, and Schizophrenia

Background： Mental disorders are a significant global health concern recognized by the World Health Organization (WHO). They contribute substantially to the disease burden and are strongly associated with high suicide rates.Depression, anxiety, bipolar disorder, and schizophrenia are among the most prevalent mental illnesses, severely affecting cognitive function, emotional regulation, and social interaction.Women of reproductive age (15–49 years) encounter distinct physiological and psychological challenges, rendering them more susceptible to stress. This heightened vulnerability elevates their risk of pregnancy-related complications, maternal and infant health issues, and neurodegenerative diseases.Furthermore, socioeconomic stress, gender role expectations, reproductive factors, and restricted access to healthcare collectively exacerbate their vulnerability to mental disorders.However, comprehensive evaluations of the long-term mental health burden in this population remain scarce. Aims： This study aims to quantify the global disease burden of depression, anxiety, bipolar disorder, and schizophrenia in women of reproductive age from 1990 to 2021, using GBD 2021 data. It will analyze their spatiotemporal distribution, assess the impact of the Sociodemographic Index (SDI) on disease burden, and provide evidence to support the development of targeted prevention and control strategies. Methods： Bayesian meta-regression was applied to calculate age-standardized rates (ASIR) and Disability-Adjusted Life Years (DALYs) using GBD 2021 standardized data.The data were stratified based on GBD standards into 7 age subgroups (15–49 years), 21 geographical regions, and 5 SDI levels.The Joinpoint regression model was used to estimate the annual percent change (EAPC, 95% UI).Statistical analysis was performed using R software. Results： From 1990 to 2021, depression and anxiety in women of reproductive age showed a continuous global increase.Anxiety-related DALYs rose from 9.3 million (95% UI: 5.9–13.6) to 16.4 million (95% UI: 10.4–24.0, EAPC = 0.16).In high-income regions, such as North America (EAPC = 0.64), the age-standardized death rate (ASDR) for depression rose from 948.86/100,000 to 1,073.5/100,000.The ASDR for bipolar disorder remained stable, while schizophrenia showed a slight negative trend (EAPC = -0.02).High SDI regions displayed a polarized burden of anxiety and depression, with North America having the highest depression ASDR at 1,929.21/100,000, while low SDI regions saw a significant increase in schizophrenia-related DALYs.Age-stratified analysis revealed that the burden of bipolar disorder was highest in the 15–19 age group, schizophrenia in the 20–24 age group, and depression and anxiety in the 25–34 age group. Conclusions： Depression and anxiety are the primary mental health threats for women of reproductive age, with a particularly pronounced disease polarization effect in high-income regions.Therefore, targeted interventions are urgently needed to reduce socioeconomic disparities, improve perinatal mental health services, and prioritize resource allocation to conflict-affected and low SDI regions.Policymakers should integrate mental health into maternal healthcare systems and use digital tools to reduce the risk of long-term disability.