Burden of anxiety disorders in Colombia: subnational DALY estimates and territorial inequalities, 2016-2022.

BACKGROUND: Anxiety disorders are among the leading contributors to non-fatal health loss worldwide. However, subnational evidence on their burden and territorial distribution in Colombia remains limited. This study estimated the burden of anxiety disorders across Colombian departments and assessed temporal trends, geographic inequalities, and differences by sex and age between 2016 and 2022. OBJECTIVE: To estimate the subnational burden of anxiety disorders in Colombia between 2016 and 2022 using disability-adjusted life years (DALYs), and to assess temporal trends, territorial inequalities, and differences by sex and age. METHODS: A longitudinal ecological study was conducted using official national administrative databases. Disability-adjusted life years (DALYs) were estimated according to the World Health Organization Global Health Estimates framework using ICD-10 codes F40-F44. Morbidity data were obtained from the Individual Health Service Provision Records (RIPS), mortality data from the Single Registry of Affiliates (RUAF), and population denominators from the National Administrative Department of Statistics (DANE). Crude and age-standardized DALY rates were calculated by department, sex, and age group. Temporal trends were assessed using annual percent change (APC) models. RESULTS: During 2016-2022, 3,055,505 cases and 21 deaths attributable to anxiety disorders were identified, corresponding to an estimated 1,266,489 DALYs. The national age-standardized DALY rate increased from 177.9 per 100,000 population in 2016 to 687.4 per 100,000 in 2022, with an APC of 25.41% (95% CI 19.48-31.63). Women consistently showed higher burden than men throughout the study period. Marked territorial inequalities were identified, with the highest burden concentrated in departments of the Andean region, particularly Risaralda, Caldas, and Bogotá, D.C. whereas lower rates were observed in Amazonian and Orinoquía territories. CONCLUSIONS: Anxiety disorders accounted for a substantial and increasing estimated burden among individuals recorded in the Colombian health system during 2016-2022, with marked territorial heterogeneity and important differences by sex and age. These findings provide subnational evidence to support population health monitoring and burden-of-disease assessment, while recognizing that administrative health records reflect treated morbidity and healthcare utilization rather than population prevalence.