Burden of Depressive and Anxiety Disorders in Nepal, 1990-2017: An Analysis of Global Burden of Disease Data

ABSTRACT Objectives This study aims to describe the burden of depressive and anxiety disorders in Nepal in terms of incidence, prevalence, YLDs, and DALYs by age and sex. Design An ecological study on disease burden. Methods We used the publicly available Global Burden of Disease (GBD) data from 1990 to 2017. The age and sex-specific incidence, prevalence rate, Years Lived with Disability (YLDs), and Disability Adjusted Life Years (DALYs) were examined among per 100,000 populations. Results Females had a higher prevalence of depressive 4094.4 (95% uncertainty interval [UI]: 3761.9-4470.3 per 100,000) and anxiety 4496.8 (95% UI: 4171.9-4837.9 per 100,000) disorders. The prevalence of major depressive disorders was comparatively higher in females (2766.7) than males (1822.9). Females also had higher YLDs for both depressive and anxiety disorders. In 2017, higher DALYs of anxiety disorder were found in the females of 45-49 years (630.1). Childhood sexual abuse was found to be the main risk factor for depressive disorder, contributing to 32.5 DALYs in both sexes. Bullying, victimization had contributed to 26.7 DALYs of anxiety. Conclusions The high burden of disorders in females would support in identifying major mental health challenges in Nepal and develop plans and various preventive, curative, and rehabilitative strategies. Strength and limitations of this study This is one of the few studies that have provided the burden of depressive and anxiety disorders in developing nations such as Nepal. The data used in this study were based on the GBD studies which utilize exhaustive information sources and comprehensive investigations. Estimation of the burden of diseases was restricted to standard epidemiological measures and other financial and social burdens were not considered. Due to use of secondary data and information which were only available publicly this may not representative of the whole nation.