Depression is a leading contributor to the global burden of mental disorders and carries substantial socioeconomic consequences. The authors developed a country-level macroeconomic model to estimate how depression affects economic outcomes across 154 countries during 2025–2050. The model aimed to quantify impacts on output by integrating effects on labor force participation, educational attainment and accumulated work experience, stratified by age and sex.
Model inputs were drawn from the World Bank and the Global Burden of Disease Study 2021. The modelling framework adjusted for age and sex-specific effects of depression on labour market participation, schooling and experience accumulation. The study built on prior epidemiological estimates of prevalence and DALYs for depression to translate health impacts into macroeconomic outcomes.
The modelling projected a total global economic burden of US$12 trillion (2024 US dollars) from 2025 to 2050. This burden was estimated to represent approximately 0.460% of annual global gross domestic product. When suicide-related deaths attributable to depression were included using an assumed 60% attribution rate (an upper-bound value cited from the literature), the overall burden increased to US$14 trillion.
The highest absolute economic burdens were observed in the United States and China. Relative to regional GDP, North America showed the greatest proportional impact.
The analysis identified reduced labor force participation and lost productivity as the primary drivers of the macroeconomic cost of depression. Effects on educational attainment and the resulting reductions in work experience and human capital accumulation also contributed to long-term economic losses. The model emphasises pathways by which health impairments translate into reduced output over time through diminished workforce size and productivity.
Although the largest absolute costs accrued to high-income countries with large economies—the United States and China—the authors report inequitable global distribution of the burden. The relative impact on GDP was most pronounced in North America. Country-level projections were produced to enable cross-country comparability and to inform regional and national policy discussions.
Prior estimates of the economic cost of depression have typically relied on cost-of-illness (COI) analyses, microsimulation models, generalized linear models using survey data, or value-of-statistical-life approaches. The authors note that existing studies are often limited to selected countries or specific settings, which restricts comparability across jurisdictions. By using a unified macroeconomic modelling approach with consistent data inputs across 154 countries, this work addresses that comparability gap.
The paper summarises epidemiological context from recent global studies: about 322 million people were estimated to be living with depression in 2023 (approximately 127 million males and 196 million females), corresponding to an age-standardized prevalence rate of 3,810 per 100,000 population. The COVID-19 pandemic amplified the burden: published analyses cited increases in prevalence of depression and anxiety during the first pandemic year and higher rates of depressive symptoms among children and adolescents in pooled studies. Global DALY rates for depression are projected to rise in GBD forecasting through 2050.
The authors conclude that the macroeconomic burden of depression is substantial and unevenly distributed, and that reducing the health burden could produce economic returns by supporting productivity and capital accumulation. The findings are framed to inform health policy and investment decisions that aim to reduce prevalence, improve access to effective care, and mitigate productivity losses.
The article emphasises that existing evidence has been limited in low- and middle-income countries, where reliable prevalence and key input data are often lacking. The suicide-attributable cost estimate used a 60% attribution assumption described as an upper-bound value from the literature; details on alternative attribution scenarios and sensitivity analyses were not reported in the source summary. Broader limitations typical to macroeconomic projections—such as dependence on input data quality and model assumptions—are implicit in the discussion of comparability and data gaps.
Using a country-level macroeconomic approach with World Bank and GBD inputs, the authors estimate a global economic cost of depression between US$12 trillion and US$14 trillion for 2025–2050 (depending on inclusion of suicide-attributable deaths). The principal drivers are reduced labour participation and productivity, with the largest absolute costs in the United States and China and the largest relative impact in North America. The work addresses the need for comparable cross-country projections and highlights the potential economic benefits of reducing the burden of depression.