Analysis and Projections of the Global Burden of Anxiety, Depression, Bipolar Disorder, and Schizophrenia Among Women of Reproductive Age (1990–2021)

Background and Objective Mental disorders are a leading cause of years lived with disability (YLDs) and disability-adjusted life years (DALYs) worldwide, with high prevalence and severe consequences, including elevated suicide rates. These issues remain a priority for the World Health Organization. Depression, anxiety, bipolar disorder, and schizophrenia are among the most common and impactful mental disorders, and women of reproductive age experience unique physical and psychological stressors, increasing their vulnerability. This study aims to comprehensively analyze the global burden of these four mental disorders in this population, identify potential influencing factors, and project future trends. Methods Data from the Global Burden of Disease (GBD) 2021 database were used to assess the prevalence and DALYs of depression, anxiety, bipolar disorder, and schizophrenia among women of reproductive age. Trends were analyzed across different age groups, Socio-Demographic Index (SDI) regions, GBD regions, and countries. Correlations between disease burden indicators and SDI were examined, along with regional disparities. Decomposition analysis was conducted to assess potential factors contributing to the observed changes in disease burden. Future trends were projected using the Bayesian-Aperiodic-People-Cohort (BAPC) model. Results Between 1990 and 2021, the age-standardized incidence and DALY rates of anxiety, depression, bipolar disorder, and schizophrenia among women of reproductive age remained relatively stable. However, the absolute number of cases and DALYs increased, particularly for anxiety and depression. By 2021, the estimated number of cases and DALYs were 18,962,131 and 16,448,344 for anxiety, 133,248,593 and 21,042,424 for depression, 826,397 and 2,806,894 for bipolar disorder, and 513,255 and 4,836,703 for schizophrenia, respectively. The corresponding ASRs were 976.14/100,000 and 844.05/100,000 for anxiety, 6,808.01/100,000 and 1,073.5/100,000 for depression, 43.16/100,000 and 143.77/100,000 for bipolar disorder, and 26.71/100,000 and 243.46/100,000 for schizophrenia. Adolescents had the highest incidence and DALYs for anxiety, bipolar disorder, and schizophrenia, whereas depression incidence and DALYs increased with age. North America and Latin America exhibited the highest and fastest-growing burdens, while East Asia had the lowest burden, largely influenced by an aging population. Health disparities in mental illness burdens persisted over time. Projections indicate a substantial increase in anxiety and depression cases and DALYs among women of reproductive age in the coming decade. Conclusions The global burden of depression, anxiety, bipolar disorder, and schizophrenia among women of reproductive age continues to rise, particularly for anxiety and depression. Significant health disparities persist, necessitating urgent and targeted interventions.