BACKGROUND: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. METHODS: Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. FINDINGS: In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. INTERPRETATION: Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. FUNDING: The Bill and Melinda Gates Foundation.

Academic Public Health England London UK

Associated Laboratory for Green Chemistry University of Porto Porto Portugal

Biomedical Research Networking Center for Mental Health Network Barcelona Spain

Biomedical Research Networking Center for Mental Health Network San Juan de Dios Sanitary Park Sant Boi de Llobregat Spain

Cardio Aid Bucharest Romania

Cardiology Department Carol Davila University of Medicine and Pharmacy Bucharest Romania

Carlos 3 Health Institute Biomedical Research Networking Center for Mental Health Network Madrid Spain

Catalan Institution for Research and Advanced Studies Barcelona Spain

Center for Global Mental Health London School of Hygiene and Tropical Medicine London UK

Center for Innovation in Medical Education Pomeranian Medical University Szczecin Poland

Centre for Disease Burden Norwegian Institute of Public Health Bergen Norway

Child and Adolescent Mental Health Services Hospital Garcia de Orta Almada Portugal

CIBERSAM Institute of Health Carlos 3 Madrid Spain

Clinic of Social and Family Medicine University of Crete Heraklion Greece

Clinical and Epidemiological Research in Primary Care Cordoba Spain

Clinical and Experimental Medicine University of Catania Catania Italy

Clinical Epidemiology and Public Health Research Unit Burlo Garofolo Institute for Maternal and Child Health Trieste Italy

Clinical Legal Medicine Department National Institute of Legal Medicine Mina Minovici Bucharest Romania

Clinical Microbiology and Parasitology Unit Dr Zora Profozic Polyclinic Zagreb Croatia

Demographic Change and Aging Research Area Federal Institute for Population Research Wiesbaden Germany

Department of Anatomy and Embryology Romania Bucharest Romania

Department of Applied Social Sciences Sapientia Hungarian University of Transylvania Târgu Mureş Romania

Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Aldo Moro Bari Italy

Department of Biological Sciences University of Porto Porto Portugal

Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy

Department of Cardiovascular Endocrine metabolic Diseases and Aging National Institute of Health Rome Italy

Department of Chemical Sciences University of Porto Porto Portugal

Department of Chemistry University of Porto Porto Portugal

Department of Clinical Research in Neurology Fondazione Cardinale Giovanni Panico Hospital Tricase Italy

Department of Clinical Toxicology Guy's and St Thomas' NHS Foundation Trust London UK

Department of Epidemiology and Prevention IRCCS Neuromed Pozzilli Italy

Department of Epidemiology and Public Health University College London London UK

Department of Family Medicine and Public Health University of Opole Opole Poland

Department of General Surgery Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of General Surgery Emergency Hospital of Bucharest Bucharest Romania

Department of Global Community Health and Behavioral Sciences Tulane University New Orleans LA USA

Department of Global Public Health Karolinska Institute Stockholm Sweden

Department of Health and Behavior Studies Columbia University New York NY USA

Department of Health Care Management Technical University of Berlin Berlin Germany

Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies Famalicão Portugal

Department of Health Sciences University of Leicester Leicester UK

Department of Healthcare University of Vlora Vlora city Albania

Department of Hypertension Medical University of Lodz Lodz Poland

Department of Internal Medicine Catholic University of Rome Rome Italy

Department of International Public Health University of Liverpool Liverpool UK

Department of Legal Medicine and Bioethics Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Medical and Surgical Sciences and Advanced Technologies University of Catania Catania Italy

Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital San Giovanni Rotondo Italy

Department of Medicine University of Porto Porto Portugal

Department of Medicine University of Valencia Valencia Spain

Department of Mental Health and Drug Abuse AUSL Modena Modena Italy

Department of Mental Health AUSL Romagna Ravenna Italy

Department of Molecular Medicine and Surgery Karolinska Institute Stockholm Sweden

Department of Neurology Technical University of Munich Munich Germany

Department of Nursing and Health Promotion Oslo Metropolitan University Oslo Norway

Department of Nursing Debre Berhan University Debre Berhan Ethiopia

Department of Ophthalmology Heidelberg University Mannheim Germany

Department of Pathology and Legal Medicine University of São Paulo Ribeirão Preto Brazil

Department of Pediatrics National Hospital Abuja Nigeria

Department of Pharmacy University of Huddersfield Huddersfield UK

Department of Primary Care and Mental Health University of Liverpool Liverpool UK

Department of Primary Care and Public Health Imperial College London London UK

Department of Primary Care and Public Health University of East Anglia Norwich UK

Department of Psychiatry and Psychotherapy University of Regensburg Regensburg Germany

Department of Psychiatry Universidad Autónoma de Madrid Madrid Spain

Department of Psychiatry University of Nairobi Nairobi Kenya

Department of Psychology Reykjavik University Reykjavik Iceland

Department of Psychosocial Science University of Bergen Bergen Norway

Department of Public Health Aarhus University Aarhus Denmark

Department of Public Health Erasmus University Medical Center Rotterdam Netherlands

Department of Public Health University of Helsinki Helsinki Finland

Department of Public Health University of Naples Federico 2 Naples Italy

Department of Social and Clinical Pharmacy Charles University Hradec Kralova Czech Republic

Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies Bucharest Romania

Department of Statistics and Econometrics Bucharest University of Economic Studies Bucharest Romania

Department of Surgery General University Hospital of Patras Patras Greece

Department of Translational Medicine University of Eastern Piedmont Novara Italy

Division of Psychiatry and Applied Psychology University of Nottingham Nottingham UK

Division of Psychology and Language Sciences University College London London UK

Division of Pulmonary Medicine University of Lausanne Lausanne Switzerland

Epidemiology and Medical Statistics University of Ibadan Ibadan Nigeria

Faculty of Health and Public Administration Semmelweis University Budapest Hungary

Faculty of Health Sciences University Fernando Pessoa Porto Portugal

Faculty of Life Sciences and Medicine King's College London London UK

Faculty of Medical Sciences University of the West Indies St Augustine Trinidad and Tobago

Faculty of Medicine and Health Technology Tampere University Tampere Finland

Family Medicine Department United Arab Emirates University Al Ain United Arab Emirates

Finnish Institute of Occupational Health Helsinki Finland

Functional Neurosurgery Research Center Shahid Beheshti University of Medical Sciences Tehram Iran

Global Health Governance Programme University of Edinburgh Edinburgh UK

Health Policy Research Public Health Foundation of India Gurugram India

Health Services Management Training Centre Semmelweis University Budapest Hungary

Health System and Population Studies Divisions International Centre for Diarrhoeal Disease Research Dhaka Bangladesh

Health Systems and Policy Research Unit Ahmadu Bello University Zaria Nigeria

Heidelberg Institute of Global Health Heidelberg University Heidelberg Germany

Independent Consultant Athens Greece

Institute for Health Metrics and Evaluation Department of Health Metrics Sciences School of Medicine University of Washington Seattle WA USA

Institute for Health Metrics and Evaluation Department of Health Metrics Sciences University of Washington Seattle WA USA

Institute for Research and Advanced Training in Health Sciences and Technologies Instituto Universitário de Ciências da Saúde Gandra Portugal

Institute of Addiction Research Frankfurt University of Applied Sciences Frankfurt Germany

Institute of Applied Health Research University of Birmingham Birmingham UK

Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany

Institute of Health and Society University of Oslo Oslo Norway

Institute of Infection and Immunity St George's University of London London UK

Institute of Molecular and Clinical Ophthalmology Basel Basel Switzerland

Institute of Population Health Sciences University of Liverpool Liverpool UK

Institute of Public Health Charité Universitätsmedizin Berlin Berlin Germany

Institute of Public Health United Arab Emirates University Al Ain United Arab Emirates

Interdisciplinary Centre Psychopathology and Emotion regulation University of Groningen Groningen Netherlands

Laboratory for Process Engineering Environment Biotechnology and Energy University of Porto Porto Portugal

Laboratory of Toxicology University of Porto Porto Portugal

London Institute for Healthcare Engineering King's College London London UK

Medical School University of Thessaly Larissa Greece

Modestum LTD London UK

MRC CSO Social and Public Health Sciences Unit University of Glasgow Glasgow UK

National Center for Disease Prevention and Health Promotion Istituto Superiore di Sanità Italian National Insitute of Health Rome Italy

National Centre for AIDS and STD Control Save the Children Kathmandu Nepal

National Centre for Register based Research Aarhus University Aarhus Denmark

National School of Public Health Institute of Health Carlos 3 Madrid Spain

Outpatient and Inpatient Care Service Central Health Directorate Region Friuli Venezia Giulia Italy

Polish Mothers' Memorial Hospital Research Institute Lodz Poland

Population and Behavioural Sciences University of St Andrews St Andrews UK

Primary Care Department NHS North West London London UK

Privatpraxis Heidelberg Germany

Psychiatry and Medical Psychology Department University of Lisbon Lisbon Portugal

Psychiatry Department Hospital Universitario Doctor Peset Valencia Spain

Public Health England London UK

Queensland Brain Institute School of Public Health The University of Queensland Brisbane QLD Australia

Research Center in Epidemiology and Preventive Medicine University of Insubria Varese Italy

Research Center on Public Health University of Milan Bicocca Monza Italy

Research Unit on Applied Molecular Biosciences University of Porto Porto Portugal

Research Unit University of Barcelona Barcelona Spain

School of Biomedical Sciences and Pharmacy University of Newcastle Newcastle NSW Australia

School of Dentistry University of Leeds Leeds UK

School of Health Polytechnic Institute of Porto Portugal

School of Health Sciences Kristiania University College Oslo Norway

School of Public Health The University of Queensland Brisbane QLD Australia

Surgery Research Unit University of Oulu Oulu Finland

Surgery Sf Pantelimon Emergency Clinical Hospital Bucharest Bucharest Romania

Swiss Research Institute for Public Health and Addiction University of Zürich Zurich Switzerland

T H Chan School of Public Health Harvard University Boston MA USA

UCD Centre for Disability Studies University College Dublin Dublin Ireland

UCL Great Ormond Street Institute of Child Health University College London London UK

UKK Institute Tampere Finland

University Centre Varazdin University North Varazdin Croatia

University College London Hospitals London UK

University Medical Center Groningen School of Economics and Business University of Groningen Groningen Netherlands

University Research Institute National and Kapodistrian University of Athens Athens Greece

Vision and Eye Research Institute Anglia Ruskin University Cambridge UK

WHO Collaborating Centre for Public Health Education and Training Imperial College London London UK

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