TY - JOUR
T1 - Age of onset and cumulative risk of mental disorders
T2 - a cross-national analysis of population surveys from 29 countries
AU - McGrath, John J.
AU - Al-Hamzawi, Ali
AU - Alonso, Jordi
AU - Altwaijri, Yasmin A.
AU - Andrade, Laura Helena
AU - Bromet, Evelyn J.
AU - Bruffaerts, Ronny
AU - de Almeida, José Miguel Caldas
AU - Chardoul, Stephanie
AU - Chiu, Wai Tat
AU - Degenhardt, Louisa
AU - Demler, Olga V.
AU - Ferry, Finola
AU - Gureje, Oye
AU - Haro, Josep Maria
AU - Karam, Elie G.
AU - Karam, Georges
AU - Khaled, Salma M.
AU - Kovess-Masfety, Viviane
AU - Magno, Marta
AU - Medina-Mora, Maria Elena
AU - Moskalewicz, Jacek
AU - Navarro-Mateu, Fernando
AU - Nishi, Daisuke
AU - Plana-Ripoll, Oleguer
AU - Posada-Villa, José
AU - Rapsey, Charlene
AU - Sampson, Nancy A.
AU - Stagnaro, Juan Carlos
AU - Stein, Dan J.
AU - ten Have, Margreet
AU - Torres, Yolanda
AU - Vladescu, Cristian
AU - Woodruff, Peter W.
AU - Zarkov, Zahari
AU - Kessler, Ronald C.
AU - Aguilar-Gaxiola, Sergio
AU - Altwaijri, Yasmin A.
AU - Andrade, Laura Helena
AU - Atwoli, Lukoye
AU - Benjet, Corina
AU - Bromet, Evelyn J.
AU - Bunting, Brendan
AU - Caldas-de-Almeida, José Miguel
AU - Cardoso, Graça
AU - Cía, Alfredo H.
AU - De Girolamo, Giovanni
AU - Harris, Meredith G.
AU - Hinkov, Hristo
AU - Xavier, Miguel
N1 - Funding Information:
Access to the cross-national World Mental Health (WMH) data is governed by the organisations responsible for funding and survey data collection in each country. These organisations made data available to the WMH survey consortium through restricted data sharing agreements that do not allow data to be released to third parties. US data are available for secondary analysis via the Inter-University Consortium for Political and Social Research ( http://www.icpsr.umich.edu/icpsrweb/ICPSR/series/00527 ). A complete list of all within-country and cross-national WMH publications is available ( http://www.hcp.med.harvard.edu/wmh/ ). No additional data or materials will be made available.
Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85167985524&partnerID=8YFLogxK
U2 - 10.1016/S2215-0366(23)00193-1
DO - 10.1016/S2215-0366(23)00193-1
M3 - Article
C2 - 37531964
AN - SCOPUS:85167985524
SN - 2215-0366
VL - 10
SP - 668
EP - 681
JO - The Lancet Psychiatry
JF - The Lancet Psychiatry
IS - 9
ER -