Global,regional,national burden of schizophrenia from 1990 to 2021,with projections of prevalence to 2035:findings from the Global Burden of Disease Study 2021

Background Schizophrenia (SZ) is a chronic psychiatric disorder affecting approximately 1% of the global population. A comprehensive understanding of its burden is crucial for the development of effective prevention and treatment strategies. In this study,we employ the Global Burden of Disease (GBD) framework to assess global SZ trends from 1990 to 2021 systematically and to project prevalence trajectories through 2035,to provide an evidence-based foundation for policy formulation. Methods Data were obtained from the Global Burden of Disease (GBD) Study 2021 and included schizophrenia (SZ) prevalence,incidence,disability-adjusted life years (DALYs),age-standardized prevalence rate (ASPR),age-standardized incidence rate (ASIR),and age-standardized DALY rate (ASDR) for 204 countries and territories over the period 1990–2021. The Bayesian age-period-cohort model was employed to project trends up to 2035. In this study, projections of SZ-related ASPR for 2022–2035 were generated using the BAPC package. Results Compared with 1990, the global prevalence of SZ in 2021 increased markedly, while incidence declined; over 10 million new cases were recorded, resulting in 14,816,611.18 DALYs. Between 1990 and 2021, the ASPR increased by 0.03% (ranging from 0.02–0.04%), the ASIR decreased by 0.04% (ranging from 0.04–0.03%), and the ASDR increased by 0.04% (ranging from 0.03–0.05%). In 2021, both ASPR and ASDR were highest in the high-SDI quintile, whereas ASIR peaked in high-middle-SDI quintile. Across all three metrics, males exhibited higher ASPR, ASIR, and ASDR than females. From 2022 to 2035, the ASPR will increase moderately. Conclusions The burden of schizophrenia varies by sex, age group, and geographical region. Although incidence has declined slightly, prevalence continues to rise, and schizophrenia remains a substantial contributor to the global disease burden across diverse populations. Scaling up mental health service coverage and enhancing the integration of pharmacological and psychosocial interventions are critical strategies to promote patient recovery and mitigate the worldwide burden of schizophrenia.