HQ Team
June 5, 2025: Mental disorders have risen 70% across three decades, starting in 1990, in the Association of Southeast Asian Nations (ASEAN), affecting 80 million people in the region, according to a study.
Mental disorders were among the top 10 causes of disease burden in every ASEAN nation except Myanmar, and anxiety disorders were the region’s most common mental disorder, according to a series of scientific papers in The Lancet Public Health.
In 2021, more than 80 million people suffered from one of the 10 mental disorders studied, surging 70% higher than in 1990. That translates to an age-standardised prevalence of 12%, representing a 7% increase from 1990. Malaysia experienced the highest prevalence, which is a 13% rise.
The increase in mental disorders is taking a heavier toll on children, the elderly, and women, according to researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine in Seattle and the National University of Singapore’s (NUS) Yong Loo Lin School of Medicine.
They analysed data from 1990 to 2021 by age, sex, and location across all ASEAN countries.
Greatest burden in Singapore
By age 15–19-year-olds had the steepest climb in prevalence at nearly 11%, while mental disorders accounted for more than a quarter of the total disease burden among 10–19-year-olds.
This was mainly across high-income ASEAN countries, and Singapore had the greatest burden. Although the increase in prevalence was less than 3% among adults 70 and older, the number of cases increased by 183%.
In the ASEAN region, 37 million people suffered from cardiovascular disease, and 1.7 million died from it, making it one of the fastest-growing non-communicable diseases and the leading cause of death.
During the review period, the total number of cardiovascular disease cases increased by 148%, whereas the prevalence increased by about 3%, accounting for nearly 10% of the global cardiovascular disease burden.
Death rates were higher than the global average in Laos, Indonesia, Myanmar, Cambodia, the Philippines, Vietnam, and Malaysia.
11 cigarettes a day
The top three heart diseases with the highest prevalence rates were ischemic heart disease, lower extremity peripheral arterial disease, and stroke, and one of the factors was smoking.
The region’s annual tobacco consumption of 556 billion units was more than the global average. That’s equivalent to 4,131 cigarettes per smoker aged 15 and older, or 11 cigarettes every day.
The number of smokers has increased in every ASEAN country, and by 63% to 137 million regionally, which is 12% of the total number of global smokers. The prevalence of youth taking up smoking has more than doubled in Cambodia and rose by 79% in Indonesia.
Although smoking prevalence has declined in ASEAN, it remains high at 48% among males 15 and older. In Indonesia, that figure was higher at 58%.
While road injuries had the highest mortality and morbidity in most countries in the region, falls were the most common cause of injuries and the second-leading cause of injury mortality, followed by self-harm, drownings, and interpersonal violence.
Death and disability from road were particularly severe in Thailand, which recorded 30 deaths per 100,000 population, primarily from motorcycle accidents. Malaysia reported 24 deaths per 100,000 population, mostly from motor vehicle accidents.
Self-harm
Self-harm was the leading cause of injury-related mortality in Singapore and accounted for nearly half of all injury deaths in the country, mostly males aged between 20 and 24 years old. Self-harm was also among the top three leading causes of death for injuries in Brunei, Malaysia, Thailand, and Vietnam.
“Without immediate action from each of the countries, these preventable health conditions will worsen, causing more death and disability across ASEAN,” said lead author Dr Marie Ng, Affiliate Associate Professor at IHME and Associate Professor at NUS.
“Additionally, the region’s rapid economic growth and ageing population are increasing the burden from non-communicable diseases and the strain on health systems,” she said.
ASEAN comprises Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. The research was part of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021.
