{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T09:05:30Z","timestamp":1780909530567,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autism spectrum disorder (ASD) comprises a group of persistent neurodevelopmental conditions characterized by impairments in communication, restricted behavioral patterns, and social dysfunction. In severe cases, ASD can lead to self\u2010injury or suicide, imposing a significant burden on individuals, families, and society. This study aimed to comprehensively assess the temporal, demographic, and regional patterns of ASD burden from 1990 to 2021; project future trends; and provide insights into potential causes and public health strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on the incidence, prevalence, and disability\u2010adjusted life years (DALYs) of ASD were extracted from the Global Burden of Disease (GBD) Study 2021. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Bayesian age\u2010period\u2010cohort (BAPC) modeling. We further examined burden distribution by age, sex, region, and sociodemographic index (SDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, an estimated 61.82 million individuals were living with ASD globally, with 1.16 million new cases and 11.54 million DALYs. The global age\u2010standardized point prevalence, incidence, and DALY rates were 788.3, 18.8, and 147.6 per 100,000 population, respectively\u2014representing increases of 2.0%, 5.2%, and 2.1% since 1990. Regionally, the highest age\u2010standardized prevalence rate was observed in the High\u2010income Asia Pacific region, while tropical Latin America had the lowest. At the national level, Japan recorded the highest age\u2010standardized prevalence, whereas the Republic of Mauritius had the lowest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ASD poses a rising global public health challenge, with persistent regional disparities and underrecognized burden in adults and females. Current gaps in epidemiological surveillance, etiological understanding, and treatment capacity highlight the urgent need for greater governmental investment in ASD\u2010related research, early detection strategies, and inclusive care systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71365","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:31:17Z","timestamp":1775536277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Inequality and Future Burden of Autism Spectrum Disorders: A Frontier and Projection Analysis Based on GBD 2021"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6976-4568","authenticated-orcid":false,"given":"Jiayu","family":"Liu","sequence":"first","affiliation":[{"name":"Senior Department of Neurosurgery Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoxi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine Tsinghua University  Beijing China"},{"name":"Department of General Surgery, the First Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery, the First Medical Center Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Capital Center for Children's Health, Capital Medical University Capital Institute of Pediatrics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Dang","sequence":"additional","affiliation":[{"name":"Senior Department of Neurosurgery Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijing","family":"Liu","sequence":"additional","affiliation":[{"name":"Senior Department of Neurosurgery Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0449-083X","authenticated-orcid":false,"given":"Yuxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Senior Department of Neurosurgery Chinese PLA General Hospital Beijing China"},{"name":"Medical School of Chinese PLA  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hulin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Senior Department of Neurosurgery Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaohua","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Integrated Early Childhood Development Capital Institute of Pediatrics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Senior Department of Neurosurgery Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7413.488"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171400172X"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2010.07.005"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010024\u201053211\u20107"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1362361316683890"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.210"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/60399"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010076885"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000013115"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.3067"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12186"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/s003329170500471x"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0289220"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u2010049437O"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(18)32279\u20107"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468\u20101253(24)00157\u20102"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00757\u20108"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00685\u20108"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00933\u20104"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2023.0039"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/20420188241227295"},{"key":"e_1_2_14_23_1","doi-asserted-by":"crossref","unstructured":"Hao Y. S.Banker J.Trayvick et\u00a0al.2025. \u201cUnderstanding Depression in Autism: The Role of Subjective Perception and Anterior Cingulate Cortex Volume.\u201dMolecular Autism16:9.https:\/\/doi.org\/10.1186\/s13229-025-00638-4.","DOI":"10.1186\/s13229-025-00638-4"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20107610.2004.00215.x"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.02.017"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010020\u201001133\u20105"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2215\u20100366(15)00277\u20101"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3775"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.972809"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010022\u201009923\u20104"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40779\u2010024\u201000551\u20106"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010031816\u2010044318"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v13.i5.174"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488\u2010022\u201001205\u20102"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001\u2010024\u201001916\u20102"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010024\u201001533\u20100"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759\u20107714.14912"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024\u2010067195"},{"key":"e_1_2_14_39_1","first-page":"1068","article-title":"Depressive and Anxiety Disorders Among the Parents of Autism in Bangladesh: A Cross\u2010Sectional Study","volume":"31","author":"Sajib W. H.","year":"2022","journal-title":"Mymensingh Medical Journal: MMJ"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.116150"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2024.102614"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e18624"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2671"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.47102\/annals\u2010acadmedsg.2023307"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jare.2023.07.003"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.04.011"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010024\u201019923\u20107"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40120\u2010024\u201000665\u2010y"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930241246955"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/brb3.71365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T08:29:07Z","timestamp":1780907347000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.71365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/brb3.71365"],"URL":"https:\/\/doi.org\/10.1002\/brb3.71365","archive":["Portico"],"relation":{},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71365"}}