Burden, trends, and inequalities of anxiety disorders in the Western Pacific region, 1990-2023: A systematic analysis of the Global Burden of Disease Study 2023.

BACKGROUND: Anxiety disorders (ADs) are a leading non-fatal cause of global disease burden, yet a detailed assessment of their burden, trends, and socioeconomic inequalities in the Western Pacific region is lacking. METHODS: Using data from the Global Burden of Disease (GBD) Study 2023, we estimated prevalence, incidence, and disability-adjusted life years (DALYs) for ADs across 31 countries/territories in the Western Pacific region from 1990 to 2023. We calculated age-standardized rates (ASRs). Temporal trends were analyzed with joinpoint regression, and socioeconomic inequalities were assessed using the slope and concentration indices based on the sociodemographic index (SDI). A Das Gupta decomposition quantified contributions of population growth, aging, and epidemiological change to DALY changes. RESULTS: In 2023, ADs resulted in 87.1 million prevalent cases, 12.6 million incident cases, and 10.3 million DALYs in the region. The age-standardized DALY rate was 456.8 per 100,000. Burden peaked in ages 10-14 and was consistently higher in females. From 1990-2023, age-standardized rates for prevalence, incidence, and DALYs increased significantly, accelerating after 2010. Population growth accounted for 57.4% of the DALY increase, while epidemiological change contributed 41.7%. Cross-country inequality analyses did not show significant associations with SDI. CONCLUSION: The burden of ADs in the Western Pacific has risen substantially, especially since 2010, disproportionately affecting adolescents and females. Epidemiological changes are a major driver. Strengthened prevention, surveillance, and diagnostic capacity are urgently needed to address this growing burden.