Temporal Patterns and Predictive Factors of Childhood Depressive Disorders Across Asia

Area of Science:

• Child and Adolescent Psychiatry
• Global Mental Health
• Epidemiology

Background:

• Childhood depressive disorders present a significant and increasing global mental health challenge.
• Limited region-specific data exists for Asia, a continent with a large child population and rapid societal changes.
• Psychosocial stress may be heightened in Asian children due to environmental and social shifts.

Purpose of the Study:

• To assess the burden, temporal trends, geographic variations, and determinants of childhood depressive disorders in Asia.
• To analyze data from 1990 to 2023 to understand the evolving landscape of these disorders.
• To identify key predictors influencing the incidence and disability-adjusted life years (DALYs) of childhood depression.

Main Methods:

• Utilized data from the Global Burden of Disease (GBD) 2023 study for children aged 0-14 years.
• Analyzed incidence and DALYs by age, sex, region, and country, employing Joinpoint regression for temporal trend analysis.
• Employed Extreme Gradient Boosting (XGBoost) and Shapley Additive Explanations (SHAP) to identify major predictors, including bullying victimization.

Main Results:

• South Asia exhibited the highest incidence and DALYs rates in 2023. Children aged 10-14 and girls consistently showed higher rates across all regions.
• Pakistan showed the steepest increases in incidence and DALYs over time. Bullying-attributable DALYs increased significantly, particularly in South and Southeast Asia.
• Key predictors identified by SHAP analysis included age, sex, calendar year, and population size, with older children and girls bearing a higher predicted burden.

Conclusions:

• Childhood depressive disorders have shown a steady increase across Asia over three decades, marked by demographic and geographic disparities.
• Urgent need for early detection, school-based mental health programs, anti-bullying initiatives, and gender-responsive services is evident.
• Strengthening child mental health systems in Asia is crucial for improving developmental outcomes and addressing this growing public health issue.