The epidemiology and burden of ten mental disorders in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021

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Szücs, A., van der Lubbe, S. C. C., Arias de la Torre, J., Valderas, J. M., Hay, S. I., Bisignano, C., Morgan, B. W., Acharya, S., Adnani, Q. E. S., Apostol, G. L. C., Aslam, M. S., Asri, Y., Aung, Z. Z., Aurizki, G. E., Baig, A. A., Bermudez, A. N. C., Cenderadewi, M., Danpanichkul, P., Efendi, F.,..., & Ng, M. (2025). The epidemiology and burden of ten mental disorders in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021. The Lancet Public Health, 10(6), e480-e491. https://doi.org/10.1016/s2468-2667(25)00098-2

Publication date: 27 May 2025 Added to AutiHub: 29 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
62
Publication authors identified as autistic
1 / 62 (1.6%)
  1. Anna Szücs
  2. Stephanie C C van der Lubbe
  3. Jorge Arias de la Torre
  4. Jose M Valderas
  5. Simon I Hay
  6. Catherine Bisignano
  7. Brooks W Morgan
  8. Swetha Acharya
  9. Qorinah Estiningtyas Sakilah Adnani
  10. Geminn Louis Carace Apostol
  11. Muhammad Shahzad Aslam
  12. Yuni Asri
  13. Zaw Zaw Aung
  14. Gading Ekapuja Aurizki
  15. Atif Amin Baig
  16. Amiel Nazer C Bermudez
  17. Muthia Cenderadewi
  18. Pojsakorn Danpanichkul
  19. Ferry Efendi
  20. Crystal Amiel M Estrada
  21. Nelsensius Klau Fauk
  1. Ni Kadek Yuni Fridayani
  2. Fernando Barroga Garcia
  3. Faizul Hasan
  4. Umar Idris Ibrahim
  5. Muhana Fawwazy Ilyas
  6. Nahlah Elkudssiah Ismail
  7. Jazlan Jamaluddin
  8. Roland Dominic G Jamora
  9. Jost B Jonas
  10. Kehinde Kazeem Kanmodi
  11. Kashif Ullah Khan
  12. Fireza Husnul Khotimah
  13. Yun Jin Kim
  14. Maria Dyah Kurniasari
  15. Christina Yeni Kustanti
  16. Dian Kusuma
  17. Tri Laksono
  18. Jerrald Lau
  19. Arianna Maever Loreche
  20. Zheng Feei Ma
  21. Joemer C Maravilla
  1. Roy Rillera Marzo
  2. Richard James Maude
  3. Thantrira Porntaveetus
  4. Setyaningrum Rahmawaty
  5. Alina Rodriguez
  6. Bedanta Roy
  7. Afeez Abolarinwa Salami
  8. Yoseph Leonardo Samodra
  9. Chandrashekhar T Sreeramareddy
  10. Vetriselvan Subramaniyan
  11. Thitiporn Sukaew
  12. Desy Sulistiyorini
  13. Lourdes Bernadette C Sumpaico-Tanchanco
  14. Anggi Lukman Wicaksana
  15. Yen Jun Wong
  16. Mustafa Z Younis
  17. Yves Miel H Zuniga
  18. Christopher J L Murray
  19. Damian Santomauro *
  20. Marie Ng

Abstract

BACKGROUND: The Association of Southeast Asian Nations (ASEAN), a geopolitical and economic network of ten member states, recognises mental disorders as a health priority; however, sparse epidemiological data hinder the development of effective strategies to reduce their prevalence and burden. We aimed to examine the prevalence, morbidity, and disease burden associated with ten mental disorders from 1990 to 2021 in the ASEAN. METHODS: As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2021), we analysed estimates for depressive disorders, anxiety disorders, bipolar disorders, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder (ADHD), eating disorders, idiopathic developmental intellectual disability, and other mental disorders in ten ASEAN member states (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam). Case definitions were based on Diagnostic and Statistical Manual of Mental Disorders or ICD criteria. Prevalence estimates by age, sex, year, and location were derived using DisMod-MR 2.1, a Bayesian meta-regression modelling tool. Disease burden was quantified by estimating years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs). FINDINGS: In 2021, 80·4 million (95% UI 73·8-87·2) cases of mental disorders were reported across ASEAN countries, representing a 70·0% (63·5-77·2) increase since 1990. The age-standardised prevalence of mental disorders was 11·9% (10·9-12·9) in 2021, ranging from 10·1% (9·1-11·3) in Viet Nam to 13·2% (11·6-15·3) in Malaysia, with anxiety and depressive disorders being the most common. The age-standardised prevalence of mental disorders increased by 6·5% (3·7-9·8) between 1990 and 2021. Mental disorders accounted for 11·2 million (8·5-14·3) DALYs in 2021, representing an 87·4% (81·1-94·0) increase since 1990. The 10-14 years age group had the highest disease burden attributable to mental disorders, which accounted for 16·3% (12·7-20·5) of total DALYs in this age group. The largest relative increases in the number of cases of mental disorders between 1990 and 2021 were seen in older adults (182·8% [174·9-192·1] among those aged ≥70 years), despite small relative changes in prevalence in these age groups. INTERPRETATION: The increase in mental disorder prevalence and burden found in this study might partly reflect recent improvements in detection. However, mental disorders now rank among the top ten causes of disease burden in all ASEAN countries except Myanmar, underscoring the urgent need for a comprehensive intersectoral approach to address prevention and treatment gaps across entire populations. FUNDING: Gates Foundation.

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Cited references
50
With a DOI
46
Without a DOI, from raw bibliography text
4
5 / 50 (10.0%) cited references include at least one author identified as autistic.
References with data to complete
2 / 50 (4.0%)
References with detected author names
50 / 50 (100.0%)
Without detected author names
0
Without a structured title
2
Without a stable identifier
4
References with raw author names still to review
0
References with external metadata lookup issues
1
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Author names detected in the cited bibliography
5828
From DOI or external metadata
5828
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
691 / 5828 (11.9%) names are linked to an author already present in AutiHub. 5137 / 5828 (88.1%) names are not yet linked.
Names linked to a person identified as autistic
5 / 5828 (0.1%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 5 / 691 (0.7%). Distinct people identified as autistic: 1 / 3027 (0.0%).
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