Age-of-onset and cumulative risk of mental disorders: A cross-national analysis of population surveys data based on 156,331 respondents from 29 countries

Year: 2023
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Authors

John J McGrath , Ali Al-Hamzawi , Jordi Alonso , Yasmin Altwaijri , Laura H Andrade , Evelyn J Bromet , Ronny Bruffaerts , José Miguel Caldas de Almeida , Stephanie Chardoul , Wai Tat Chiu , Louisa Degenhardt , Olga V Demler , Finola Ferry , Oye Gureje , Josep Maria Haro , Elie G Karam , Georges Karam , Salma M Khaled , Viviane Kovess-Masfety , Marta Magno , Maria Elena Medina-Mora , Jacek Moskalewicz , Fernando Navarro-Mateu , Daisuke Nishi , Oleguer Plana-Ripoll , José Posada-Villa , Charlene Rapsey , Nancy A Sampson , Juan Carlos Stagnaro , Dan J Stein , Margreet Ten Have , Yolanda Torres , Cristian Vladescu , Peter W Woodruff , Zahari Zarkov , Ronald C Kessler ; WHO World Mental Health Survey Collaborators

Abstract

Background:
Information on frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad-based cross-national estimates of this sort from coordinated general population surveys were last updated 15 years ago.

Methods:
Data were analyzed for 156,331 adults (18 years and older) in the World Mental Health surveys, a coordinated series of cross-sectional face-to-face community epidemiological surveys in 29 countries administered between 2001 and 2022. A fully structured layadministered psychiatric diagnostic interview was used to assess age-of-onset, lifetime prevalence, and morbid risk of 13 mental disorders through age 75 across surveys by sex. Ethnicity was not assessed.

Outcomes:
Lifetime prevalence (percent [95% CI]) of any mental disorder was 28ꞏ6% (27ꞏ9- 29ꞏ2%) males and 29ꞏ8% (29ꞏ2-30ꞏ3%) females. Morbid risk by age 75 was substantially higher – 46ꞏ4% (44ꞏ9-47ꞏ8%) for males and 53ꞏ1% (51ꞏ9-54ꞏ3%) for females. Conditional probabilities of first onset peaked at age 15, with median age-of-onset of 19 for males and 20 for females. The two most prevalent disorders were alcohol abuse and major depression for males and major depression and specific phobia disorder for females.

Interpretation:
By age 75, approximately half the population can expect to develop one or more of the mental disorders considered here. These disorders typically first emerge in childhood, adolescence, or young adulthood. Given these findings, services need to have the capacity to detect and treat common mental disorders promptly and to optimize services that suit patients in these critical parts of the life course.

Subject Area

Age-of-onset and cumulative risk of mental disorders: A cross-national analysis of population surveys data based on 156,331 respondents from 29 countries
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