Evidence map›Paper›PMID 41654951›Full record

ArticleInternational journal for equity in health2026

Global and regional quality of care index in major depressive disorder: the global burden of disease study 2021.

Chenyue Xu, Longzhu Zhu, Jianbo Lai, Zeyu Luo, Jiayao Ying, Shaohua Hu, Peige Song, Jianzhong Yang

Abstract read
In one paragraph

Article in International journal for equity in health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Chenyue Xu *Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Longzhu Zhu *Center for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Jianbo Lai *Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Zeyu LuoCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Jiayao YingCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Shaohua HuDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. dorhushaohua@zju.edu.cn.
Peige SongCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China. peigesong@zju.edu.cn.
Jianzhong YangDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. jzhyang2004@163.com.

Funding

Key Research and Development Program of Zhejiang Province 2024C03098, 2025C02109Key Research and Development Program of Zhejiang Province 2025C01104National Key Research and Development Program of China 2023YFC2506200
6 · The paper itself

Abstract

backgroundMajor depressive disorder (MDD) is a leading cause of global disability, yet systematic evaluations of quality of care disparities across regions are sparse. Leveraging data from the Global Burden of Disease (GBD) Study 2021, this study quantified the quality of care for MDD from 1990 to 2021 and examined socio-demographic inequities by age and sex.

methodsData on MDD were extracted from the GBD 2021 study for the globe, 5 socio-demographic index (SDI) regions and 21 GBD regions. The quality of care index (QCI) is a composite, dimensionless index scaling from 0 to 100, with higher values indicating better quality of care. The age-standardized QCI was calculated using the Principal Component Analysis (PCA) method and further stratified by sex, age, and region. The gender disparity ratio (GDR) was used to characterize the sex disparities. The temporal trend of QCI and GDR by sex and age across SDI regions was further calculated.

resultsGlobally, the QCI of MDD increased from 56.26 (1990) to 62.95 (2021), with low SDI regions consistently exhibiting the highest QCI (71.90 in 1990; 71.19 in 2021) and high SDI regions the lowest (40.28 to 51.55). Sex disparities widened as female QCI rose by 14.0% (vs. 7.6% in males) and GDR increased from 1.02 to 1.08. The highest GDR (1.27) persisted in Oceania, while Tropical Latin America had the lowest (0.94 in 2021). Age-specific QCI peaked in adolescents (10-14 years) and declined with age, with notable improvements post-2019. Older adults (> 80 years) in high SDI regions saw higher QCI versus low-middle SDI regions. Trend analysis revealed that high and high-middle SDI regions maintained a lower QCI of MDD than the global average level but narrower sex gaps (GDR 1.04 in 2021) compared to low SDI regions (GDR 1.15).

conclusionsWhile global quality of care for MDD improved, socioeconomic development inversely correlated with QCI, potentially reflecting systemic under-reporting in low-resource settings and overburdened systems in high-income regions. Persistent gender and age disparities necessitate targeted and equal policies, including sex-sensitive care models and geriatric mental health integration.

Indexed as

Global Burden of DiseaseHealthcare DisparitiesMajor Depressive DisorderQuality of Health CareAdolescentAdultAgedFemaleGlobal HealthHumansMaleMiddle AgedYoung AdultGender disparity ratioMajor depressive disorderQuality of care indexRegion

Identifiers

PMID41654951
PMCPMC12977716

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.