Trends and burden in mental disorder death in China from 2009 to 2019: a nationwide longitudinal study

We aimed to elucidate trends in the crude mortality rate (CMR), age-standardized mortality rate (ASMR), and burden of mental disorders (MD) in China.

A longitudinal observational study was performed using the data of MD deaths in the National Disease Surveillance System (DSPs) during 2009-2019. The mortality rates were normalized using the Segis global population. Trends in the mortality of MDs stratified by age, gender, region, and residency, respectively. The burden of MD was evaluated using age-standardized person years of life loss per 100,000 people (SPYLLs) and average years of life lost (AYLL).

A total of 18,178 MD deaths occurred during 2009-2019, accounting for 0.13% of total deaths, and 68.3% of MD deaths occurred in rural areas. The CMR of MD in China was 0.75/100,00 persons (ASMR: 0.62/100,000 persons). The ASMR of all MDs decreased mainly due to the decrease in ASMR in rural residents. Schizophrenia and alcohol use disorder (AUD) were the leading causes of death in MD patients. The ASMR of schizophrenia and AUD was higher in rural residents than in urban residents. The ASMR of MD was highest in the 40-64 age group. As the leading causes of MD burden, the SPYLL and AYLL of schizophrenia were 7.76 person-years and 22.30 years, respectively.

Although the ASMR of all MDs decreased during 2009-2019, schizophrenia and AUD were still the most important causes of death for MDs. Targeted efforts focusing on men, rural residents, and the 40-64 years old population should be strengthened to decrease MD-related premature deaths.