article · The Lancet Psychiatry
This cross-national study updated estimates on the frequency and timing of mental disorder onsets across the lifespan, using data from 156,331 adults in 29 countries. Researchers analysed World Mental Health surveys conducted between 2001 and 2022, employing the WHO Composite International Diagnostic Interview to assess 13 DSM-IV mental disorders. The study found that the lifetime prevalence of any mental disorder was around 29% for both sexes. By age 75, approximately half the population is expected to develop at least one mental disorder. First onsets typically peaked around age 15, with a median onset age of 19 for males and 20 for females. Major depressive disorder was highly prevalent in both sexes, alongside alcohol use disorder for males and specific phobia for females.
Understanding when mental disorders typically emerge and how common they are across different populations is crucial for public health. This research provides updated global statistics, highlighting the significant proportion of people affected and the early age at which these conditions often begin. This information can help in planning more effective and timely mental health services.
The abstract indicates that this research is fundamental for public health planning and suggests that services should be equipped to detect and treat common mental disorders promptly, especially in childhood, adolescence, and young adulthood. It does not indicate a direct commercial application or product. The findings could inform policy makers, healthcare organisations, and public health bodies in optimising mental health service delivery and resource allocation.
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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.
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DOI: 10.1016/s2215-0366(23)00193-1
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