학술논문
Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries.
Document Type
Academic Journal
Author
McGrath JJ; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark. Electronic address: j.mcgrath@uq.edu.au.; Al-Hamzawi A; College of Medicine, University of Al-Qadisiya, Al Diwaniya, Iraq.; Alonso J; Health Services Research Unit, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain.; Altwaijri Y; Epidemiology Section, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.; Andrade LH; Section of Psychiatric Epidemiology, Institute of Psychiatry, University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil.; Bromet EJ; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook University, Stony Brook, NY, USA.; Bruffaerts R; Universitair Psychiatrisch Centrum, Katholieke Universiteit Leuven, Leuven, Belgium.; de Almeida JMC; Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.; Chardoul S; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.; Chiu WT; Department of Health Care Policy, Harvard Medical School, Harvard University, Boston, MA, USA.; Degenhardt L; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.; Demler OV; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA, USA; Department of Computer Science, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland.; Ferry F; School of Psychology, Ulster University, Belfast, UK.; Gureje O; Department of Psychiatry, University College Hospital, Ibadan, Nigeria.; Haro JM; Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Centre for Biomedical Research on Mental Health, Madrid, Spain; Departament de Medicine, Universitat de Barcelona, Barcelona, Spain.; Karam EG; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Faculty of Medicine, University of Balamand, Beirut, Lebanon; Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon.; Karam G; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Faculty of Medicine, University of Balamand, Beirut, Lebanon; Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon.; Khaled SM; Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.; Kovess-Masfety V; Institut de Psychologie, Université Paris Cité, Paris, France.; Magno M; Unit of Epidemiological and Evaluation Psychiatry, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.; Medina-Mora ME; National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.; Moskalewicz J; Institute of Psychiatry and Neurology, Warsaw, Poland.; Navarro-Mateu F; Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Gerencia Salud Mental, Servicio Murciano de Salud, Murcia, Spain; Murcia Biomedical Research Institute, Murcia, Spain; Centro de Investigación Biomédica en Red Epidemiology and Public Health-Murcia, Murcia, Spain.; Nishi D; Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.; Plana-Ripoll O; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.; Posada-Villa J; Faculty of Social Sciences, Colegio Mayor de Cundinamarca University, Bogota, Colombia.; Rapsey C; Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.; Sampson NA; Department of Health Care Policy, Harvard Medical School, Harvard University, Boston, MA, USA.; Stagnaro JC; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.; Stein DJ; Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.; Ten Have M; Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.; Torres Y; Center for Excellence on Research in Mental Health, Instituto de Ciencias de la Salud, Medellín, Colombia.; Vladescu C; National Institute for Health Services Management, Bucharest, Romania.; Woodruff PW; Department of Neuroscience, University of Sheffield, Sheffield, UK.; Zarkov Z; Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria.; Kessler RC; Department of Health Care Policy, Harvard Medical School, Harvard University, Boston, MA, USA.
Source
Publisher: Elsevier Country of Publication: England NLM ID: 101638123 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2215-0374 (Electronic) Linking ISSN: 22150366 NLM ISO Abbreviation: Lancet Psychiatry Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-onset distributions, lifetime prevalence, and morbid risk.
Methods: In this cross-national analysis, we analysed data from respondents aged 18 years or older to the World Mental Health surveys, a coordinated series of cross-sectional, face-to-face community epidemiological surveys administered between 2001 and 2022. In the surveys, the WHO Composite International Diagnostic Interview, a fully structured psychiatric diagnostic interview, was used to assess age of onset, lifetime prevalence, and morbid risk of 13 DSM-IV mental disorders until age 75 years across surveys by sex. We did not assess ethnicity. The surveys were geographically clustered and weighted to adjust for selection probability, and standard errors of incidence rates and cumulative incidence curves were calculated using the jackknife repeated replications simulation method, taking weighting and geographical clustering of data into account.
Findings: We included 156 331 respondents from 32 surveys in 29 countries, including 12 low-income and middle-income countries and 17 high-income countries, and including 85 308 (54·5%) female respondents and 71 023 (45·4%) male respondents. The lifetime prevalence of any mental disorder was 28·6% (95% CI 27·9-29·2) for male respondents and 29·8% (29·2-30·3) for female respondents. Morbid risk of any mental disorder by age 75 years was 46·4% (44·9-47·8) for male respondents and 53·1% (51·9-54·3) for female respondents. Conditional probabilities of first onset peaked at approximately age 15 years, with a median age of onset of 19 years (IQR 14-32) for male respondents and 20 years (12-36) for female respondents. The two most prevalent disorders were alcohol use disorder and major depressive disorder for male respondents and major depressive disorder and specific phobia for female respondents.
Interpretation: By age 75 years, approximately half the population can expect to develop one or more of the 13 mental disorders considered in this Article. These disorders typically first emerge in childhood, adolescence, or young adulthood. Services should have the capacity to detect and treat common mental disorders promptly and to optimise care that suits people at these crucial parts of the life course.
Funding: None.
Competing Interests: Declaration of interests LD receives educational grants from Indivior and Seqirus. OVD receives funding from Kowa Research Institute and has been an advisor in the PROMINENT trial. SMK and PWW receive grant funding from Hamad Medical Corporation through the Cambridgeshire and Peterborough National Health Service Foundation trust and from Qatar University. PWW has received financial support from the Qatar National Research Fund and an honorarium from Gresham College. RCK has been a consultant for Cambridge Health Alliance, Canandaigua Veterans Affairs Medical Center, Holmusk, Partners Healthcare, RallyPoint Networks, and Sage Therapeutics. He holds stock options in Cerebral, Mirah, Prepare Your Mind, Roga Sciences, and Verisense Health. DN receives honoraria from AIG General Insurance and Takeda Pharmaceutical and financial support from Startia, En-power, and MD.net. DJS receives royalties from American Psychiatric Press, Cambridge University Press, and Elsevier–Academic Press. He has received honoraria from Discovery Vitality, Johnson & Johnson, Kanna, L'Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda, and Vistagen. He was the president of the African College of Neuropsychopharmacology and is financially supported by the Medical Research Council of South Africa. All other authors declare no competing interests.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Methods: In this cross-national analysis, we analysed data from respondents aged 18 years or older to the World Mental Health surveys, a coordinated series of cross-sectional, face-to-face community epidemiological surveys administered between 2001 and 2022. In the surveys, the WHO Composite International Diagnostic Interview, a fully structured psychiatric diagnostic interview, was used to assess age of onset, lifetime prevalence, and morbid risk of 13 DSM-IV mental disorders until age 75 years across surveys by sex. We did not assess ethnicity. The surveys were geographically clustered and weighted to adjust for selection probability, and standard errors of incidence rates and cumulative incidence curves were calculated using the jackknife repeated replications simulation method, taking weighting and geographical clustering of data into account.
Findings: We included 156 331 respondents from 32 surveys in 29 countries, including 12 low-income and middle-income countries and 17 high-income countries, and including 85 308 (54·5%) female respondents and 71 023 (45·4%) male respondents. The lifetime prevalence of any mental disorder was 28·6% (95% CI 27·9-29·2) for male respondents and 29·8% (29·2-30·3) for female respondents. Morbid risk of any mental disorder by age 75 years was 46·4% (44·9-47·8) for male respondents and 53·1% (51·9-54·3) for female respondents. Conditional probabilities of first onset peaked at approximately age 15 years, with a median age of onset of 19 years (IQR 14-32) for male respondents and 20 years (12-36) for female respondents. The two most prevalent disorders were alcohol use disorder and major depressive disorder for male respondents and major depressive disorder and specific phobia for female respondents.
Interpretation: By age 75 years, approximately half the population can expect to develop one or more of the 13 mental disorders considered in this Article. These disorders typically first emerge in childhood, adolescence, or young adulthood. Services should have the capacity to detect and treat common mental disorders promptly and to optimise care that suits people at these crucial parts of the life course.
Funding: None.
Competing Interests: Declaration of interests LD receives educational grants from Indivior and Seqirus. OVD receives funding from Kowa Research Institute and has been an advisor in the PROMINENT trial. SMK and PWW receive grant funding from Hamad Medical Corporation through the Cambridgeshire and Peterborough National Health Service Foundation trust and from Qatar University. PWW has received financial support from the Qatar National Research Fund and an honorarium from Gresham College. RCK has been a consultant for Cambridge Health Alliance, Canandaigua Veterans Affairs Medical Center, Holmusk, Partners Healthcare, RallyPoint Networks, and Sage Therapeutics. He holds stock options in Cerebral, Mirah, Prepare Your Mind, Roga Sciences, and Verisense Health. DN receives honoraria from AIG General Insurance and Takeda Pharmaceutical and financial support from Startia, En-power, and MD.net. DJS receives royalties from American Psychiatric Press, Cambridge University Press, and Elsevier–Academic Press. He has received honoraria from Discovery Vitality, Johnson & Johnson, Kanna, L'Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda, and Vistagen. He was the president of the African College of Neuropsychopharmacology and is financially supported by the Medical Research Council of South Africa. All other authors declare no competing interests.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)