Trends in Incidence, Prevalence, and Disability-Adjusted Life Years of Schizophrenia in China from 1990 to 2021, with Projections for 2022-2050

Jiawen Huo¹瑞 李¹Xuan Ren¹Shuyi Zhu¹Xiangdi Hu¹Qiqing Tan¹Yanxin Xu¹Jing Chen¹Junjiao Ping²Jing Wan²Tingyun Jiang^2*Aoxiang Luo^1*

• ¹School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
• ²Third People's Hospital of Zhongshan, Zhongshan, China

Objective: This study assessed trends in schizophrenia (SCZ) burden in China 1990-2021 and projected future trends 2022-2050.We analysed data from the GBD 2021 study, employed the GBD method to integrate epidemiological data on age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age standardized disability adjusted life years rate (ASDR) to accurately assess the global burden of SCZ across various regions, genders, and age groups. Additionally, joint point regression analysis was applied to rigorously examine the time trends of anxiety disorders from 1990 to 2021, calculating the annual percentage change (APC), annual average percentage change (AAPC), and their corresponding 95% confidence intervals (CIs). Finally, a Bayesian age-period-cohort (BAPC) model was employed to predict the prevalence trends of SCZ from 2022 to 2050.From 1990 to 2021, the ASPR and ASDR of SCZ in China increased steadily, with faster growth than global averages (ASPR AAPC: 0.130% vs. 0.021%; ASDR AAPC: 0.141% vs. 0.022%).In contrast, the ASIR remained stable in China (AAPC: 0.038%) but declined globally. Join point regression revealed an ASIR rebound after 2016 and an ASDR acceleration after 2016. In 2021, ASPR and ASIR peaked at ages 35-39 and 20-24, respectively, and burden growth was faster among females. The BAPC model indicates that by 2050, the ASPR of SCZ in China is projected to reach 488.3 per 100,000 population (95% UI: 216.09-760.5), while the ASDR is expected to be 315.37 per 100,000 population (95% UI: 136.88-493.87).GBD 2021 data reveal a rising SCZ burden in China, especially in ASPR and ASDR, posing increasing public health challenges. Males bore a consistently higher burden, but the female burden increased faster than the global average, highlighting gender-specific concerns. Age patterns emphasize young and middle-aged populations as key targets for intervention. Projected increases in incidence and mortality call for enhanced, tailored prevention and treatment strategies, improved resource allocation, and strengthened mental health services to mitigate the societal impact.