The burden and forecast of major depressive disorder attributed to behavioral risk factors among adolescents and adults at global, regional and national levels from 1990 to 2050: A systematic analysis for GBD 2021.

Bullying victimization (BV), childhood sexual abuse (CSA), and intimate partner violence (IPV) are associated with an increased risk for the development of Major Depressive Disorder (MDD). The aims of this study was to evaluate the disease burden and trends in MDD attributable to behavioral risk factors from 1990 to 2021, and to project the burden over the next 30 years based on the Global Burden of Disease Study 2021 (GBD). Global, regional, and national disability-adjusted life years (DALYs) and annual standardized rates (ASRs) of MDD due to three behavioral risk factor were analyzed, and future trends were projected for the next 30 years. In 2021, the global DALYs for MDD attributable to behavioral risk factors were 5,799,532.86 (95 % UI: 2,707,954.99 - 9,659,862.51), with an ASDR of 147.33 (95 % UI: 147.21 - 147.45). The estimated annual percentage change (EAPC) was 0.38 (95 % UI: 0.24 - 0.52), indicating an overall increasing trend projected to continue until 2050. BV accounted for the highest proportion of MDD burden, with the greatest increase (EAPC: 0.61, 95 % UI: 0.58 - 0.64). BV affected males more, while IPV and CSA had a greater impact on females. From 1990 to 2021, the global MDD burden from the three behavioral risk factors increased, with BV contributing the most. Lower-income countries faced higher health loss risks. Globally, DALYs from MDD attributable to these behavioral risk factors are projected to continue rising over the next 30 years, with IPV having the fastest growth rate.