Adolescence, the stage of development between childhood and adulthood, is characterized by many profound physical, mental, and emotional changes. During this critical stage, young people can experience various difficulties and can develop or show the first signs of mental health disorders, including anxiety disorders, depression, and substance use disorders (SUDs).
Researchers at Ohio State University, Beijing Tiantan Hospital, and other institutes recently set out to explore patterns in recorded mental health disorders experienced by youths worldwide between 1990 and 2021. The findings of their study, published in Molecular Psychiatry, unveiled some common trends in youth mental health, while also reporting a significant rise in mental health disorders after the COVID-19 pandemic.
The prevalence of youth mental disorders since 1990
To carry out their study, the researchers first collected mental health-related data from online sources and global public health records. They specifically focused on a 31-year period starting from 1990 and on young people between the ages of 10 and 24 years old.
“This study quantified global and regional prevalence, disability-adjusted life-years (DALYs), and years lived with disability (YLDs), and temporal trends of mental disorders and SUDs among adolescents and young adults from 1990–2021,” wrote Xiangyu Zhao, Ligang Liu and their colleagues.
To compare mental health trends across different countries and years, the researchers used a disease-modeling tool called DisMod-MR 2.1. In addition, they mapped out trends over time using a statistical technique called Joinpoint regression.
The team found that the most prevalent mental health disorders and neurodevelopmental conditions in adolescents aged 10 to 19 were anxiety disorders, followed by conduct disorders, depressive disorders, and autism spectrum disorder. In young adults, aged 20 to 24 years old, anxiety disorders and depression were also the most prevalent.
“In 2021, the global point prevalence of mental disorders was 15.2% in adolescents, and 16.1% among young adults, with anxiety disorders being the most common condition,” wrote the authors. “Mental disorders were the leading cause of YLDs and DALYs in 2021. High-income regions exhibited the highest rates of mental disorders. Significant sex differences were observed, with a higher prevalence of attention-deficit hyperactivity disorder and autism spectrum disorders in males, and anorexia nervosa was more prevalent in females.”
New youth mental health insights
The findings of this recent study suggest that the COVID-19 pandemic was a critical period for many young people, which prompted a significant rise in anxiety disorders, depression, and some other mental conditions. The main exceptions to this trend were SUDs, which instead appeared to decrease during the pandemic.
“SUDs were the 15th cause of YLDs and 22nd cause of DALYs among adolescents and ranked 8th for YLDs and 11th for DALYs for young adults,” wrote Zhao, Liu and their colleagues.
“During the pandemic, a significant increase in the prevalence of mental disorders and a decline in SUDs was observed. DALYs for mental disorders increased significantly during the pandemic, especially for depressive and anxiety disorders, with higher DALYs in females than males. Mental disorders remain a leading cause of disability in AYAs worldwide, with a marked surge during 2019–2021. Although SUDs declined, the rising burden of depression and anxiety demonstrated urgent needs for age-specific, sex-responsive, and regionally tailored mental health strategies.”
The insights gathered by Zhao, Liu and their colleagues highlight the importance of introducing mental health services designed to best support young people during critical periods, such as that of the COVID-19 pandemic. In the future, they could also help to improve existing prevention and treatment programs for youths, for instance, by highlighting segments of the population that are more likely to experience specific conditions or the disorders that are most and least common across distinct age groups, geographical regions and for the different sexes.
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Publication details
Xiangyu Zhao et al, The global burden of mental and substance use disorders among adolescents and young adults, Molecular Psychiatry (2026). DOI: 10.1038/s41380-026-03503-9.
Journal information:
Molecular Psychiatry
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