Global, regional and national burden of bipolar disorder: An analysis of trends from 1990 to 2021

To characterize the evolution of the burden of Bipolar disorder (BP) from 1990 to 2021 and to forecast trends.

Based on the Global Burden of Disease (GBD) 2021 study, age-standardized rates (per 100,000 people) of BP incidence, prevalence, and disability-adjusted life years (DALYs) were analyzed from 1990 to 2021, with estimated annual percentage changes (EAPC) calculated. Bayesian age-period-cohort (BAPC) modeling was used to predict incidence trends through 2035. Health inequalities were assessed using the slope index of inequality (SII) and concentration index.

Globally, the incidence, prevalence, and DALYs rates of BP increased in 2021 compared to 1990. Regionally, Australasia had the highest age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized death rate (ASDR) in 2021, with New Zealand leading at the country level. Incidence peaks at 15-19 years of age and is significantly higher in females than in males. The BAPC model predicts continued global increases in incidence, prevalence, and DALYs through 2035. Analysis of health inequalities shows that absolute and relative health inequalities are particularly pronounced in countries and regions with higher levels of development.

Overall trends in the burden of BP from 1990 to 2021 show regional and national variations, and global rates of BP incidence, prevalence, and DALYs are projected to continue to rise through 2035. It's urgent to develop targeted prevention and treatment strategies to address this growing global health challenge at the global level, especially in countries and regions with high levels of development.