Temporal patterns and predictive factors of depressive disorders among adolescents and young people in Asia

Depressive disorders are a leading cause of non-fatal health loss among adolescents and young adults, yet evidence on long-term trends and regional heterogeneity across Asia remains limited. This study assessed the burden and key drivers of depressive disorders among individuals aged 15-39 years across Asia.

Data were obtained from the Global Burden of Disease (GBD) 2023 study for all Asian countries from 1990 to 2023. Temporal trends in incidence and disability-adjusted life years (DALYs) rates were evaluated using log-linear regression and Joinpoint models. Violence-related behavioral risk factors were assessed within the GBD comparative risk assessment framework. Extreme Gradient Boosting (XGBoost) models with Shapley Additive Explanations (SHAP) were used to identify key predictors.

South Asia carried the largest absolute burden of depressive disorders in both incidence and DALYs, whereas Southeast Asia showed the fastest increases in rates. Incidence peaked in late adolescence in South and Southeast Asia, while DALYs rates increased progressively toward early mid-adulthood. Females consistently exhibited higher incidence and DALYs rates than males, and sex was the strongest predictor in machine learning models. Violence-related behavioral risks, including sexual violence against children, bullying, and intimate partner violence, contributed substantially to depression-related DALYs. Incidence increased during 2018-2021 and declined thereafter.

Depressive disorders among adolescents and young adults in Asia show marked heterogeneity by region, sex, and age. Strengthening services in high-burden regions, prioritizing prevention in rapidly increasing regions, and reducing violence exposure are critical to mitigating depression-related disability.