Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries.
Por:
McGrath JJ, Al-Hamzawi A, Alonso J, Altwaijri Y, Andrade LH, Bromet EJ, Bruffaerts R, de Almeida JMC, Chardoul S, Chiu WT, Degenhardt L, Demler OV, Ferry F, Gureje O, Haro JM, Karam EG, Karam G, Khaled SM, Kovess-Masfety V, Magno M, Medina-Mora ME, Moskalewicz J, Navarro-Mateu F, Nishi D, Plana-Ripoll O, Posada-Villa J, Rapsey C, Sampson NA, Stagnaro JC, Stein DJ, Ten Have M, Torres Y, Vladescu C, Woodruff PW, Zarkov Z and Kessler RC
Publicada:
1 sep 2023
Ahead of Print:
30 jul 2023
Resumen:
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.
Filiaciones:
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
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
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