{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:02:23Z","timestamp":1785477743098,"version":"3.56.0"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":210,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Global Health, Epidemiology and Genomics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mental disorders are leading causes of disability worldwide but remain underprioritized in many low\u2010 and middle\u2010income countries, including sub\u2010Saharan Africa (SSA), where access to care, workforce capacity, and mental health infrastructure remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study quantified the burden of mental and substance use disorders (SUDs) in SSA from 1990 to 2023 using Global Burden of Disease (GBD) 2023 estimates, with attention to long\u2010term trends, late\u2010period changes, country\u2010level heterogeneity, sex differences, and risk\u2010factor attribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed GBD 2023 estimates for 46 SSA countries from 1990 to 2023, including prevalence, disability\u2010adjusted life years (DALYs), age\u2010standardized rates, sex\u2010specific estimates, country\u2010level burden, and selected risk factors. Percentage changes were calculated for 1990\u20132023, with sensitivity analyses for 1990\u20132019 and 2019\u20132023 and segmented log\u2010linear trend models using 2019 as the breakpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2023, the age\u2010standardized prevalence rate of mental disorders increased from 11,138.8 to 14,841.0 per 100,000 (+33.24%), while the age\u2010standardized DALY rate increased from 1634.9 to 2218.9 per 100,000 (+35.73%). Anxiety disorders showed the largest relative increases in age\u2010standardized prevalence (+90.99%) and DALY rates (+92.11%). Depressive disorders also increased, while ADHD age\u2010standardized rates remained largely stable. SUDs showed rising absolute burden despite declining age\u2010standardized prevalence and DALY rates. Late\u2010period analyses showed larger increases after 2019, particularly for anxiety disorders. Females had higher age\u2010standardized rates and larger relative increases for anxiety and depressive disorders, whereas males had higher rates of ADHD and SUDs. Among selected risk factors, sexual violence against children had the highest age\u2010standardized attributable DALY rate in 2023, while bullying victimization and intimate partner violence showed the largest relative increases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mental and SUDs represent a growing public health challenge in SSA. Strengthening mental health systems, integrating services into primary and general healthcare platforms, expanding SUD prevention and treatment, addressing violence\u2010related risk factors, and reducing stigma are essential to improving mental health outcomes across the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ghe3\/5570226","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:51:17Z","timestamp":1785477077000},"source":"Crossref","is-referenced-by-count":0,"title":["Over Three Decades of Mental Health in Sub\u2010Saharan Africa: An Analysis of GBD Data From 1990 to 2023"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-4368","authenticated-orcid":false,"given":"Basile","family":"Njei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-4964","authenticated-orcid":false,"given":"Yazan A.","family":"Al-Ajlouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira Y.","family":"Lemos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0227-6425","authenticated-orcid":false,"given":"Nkengafac Villyen","family":"Motaze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-0428","authenticated-orcid":false,"given":"Laurent Cleenewerck de","family":"Kiev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6006-2698","authenticated-orcid":false,"given":"Luchuo E.","family":"Bain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0571-0074","authenticated-orcid":false,"given":"Yauba","family":"Saidu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00395-3"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2020.219"},{"key":"e_1_2_13_3_2","first-page":"1","article-title":"The Burden of Mental Disorders and Substance Abuse in the Middle East and North Africa (MENA) Region: Findings From the Global Burden of Disease Study","volume":"61","author":"Nagi Y.","year":"2025","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2010.tb00305.x"},{"key":"e_1_2_13_5_2","first-page":"751","article-title":"Mental Health Service Delivery in South Africa From 2000 to 2010: One Step Forward, One Step Back","volume":"101","author":"Petersen I.","year":"2011","journal-title":"South African Medical Journal"},{"key":"e_1_2_13_6_2","volume-title":"Mental Health Workforce and System Capacity in Africa","author":"WHO","year":"2023"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2010.61.3.229"},{"key":"e_1_2_13_8_2","first-page":"21","article-title":"Addressing Mental Health Challenges and Non-Communicable Diseases in Sub-Saharan Africa: An Analysis From Health Systems Approach","volume":"1","author":"Amu H.","year":"2024","journal-title":"Preventive Medicine: Research & Reviews"},{"key":"e_1_2_13_9_2","doi-asserted-by":"crossref","DOI":"10.4324\/9781315826455","volume-title":"Culture and Common Mental Disorders in Sub-Saharan Africa","author":"Patel V.","year":"2013"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)00231-h"},{"key":"e_1_2_13_11_2","doi-asserted-by":"crossref","unstructured":"JumbeS. 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