A comprehensive analysis of age of onset and cumulative incidence of mental disorders: A Danish register study.
absolute risk of mental disorders
age‐of‐onset
epidemiology
public mental health
Journal
Acta psychiatrica Scandinavica
ISSN: 1600-0447
Titre abrégé: Acta Psychiatr Scand
Pays: United States
ID NLM: 0370364
Informations de publication
Date de publication:
24 Mar 2024
24 Mar 2024
Historique:
revised:
12
03
2024
received:
08
11
2023
accepted:
13
03
2024
medline:
25
3
2024
pubmed:
25
3
2024
entrez:
25
3
2024
Statut:
aheadofprint
Résumé
The age of onset (AOO), incidence and cumulative incidence of mental disorders are critical epidemiological measures, providing essential insights into the development and course of these disorders across the lifespan. This study aims to provide up-to-date estimates of the AOO, age-specific incidence, and cumulative incidence for a comprehensive range of mental disorders using data from Danish registers. We conducted a follow-up study encompassing all Danish residents from January 1, 2004, to December 31, 2021, totaling 91,613,465 person-years. Data were sourced from the Danish Psychiatric Central Research Register, identifying individuals treated for various mental disorders in psychiatric hospitals, outpatient departments, and accident/emergency departments, that is, treated in secondary care settings. We investigated specific categories of mental disorders, including substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, borderline personality disorders, intellectual disabilities, pervasive developmental disorders, and behavioral and emotional disorders. Age-sex-specific incidence rates were estimated using Poisson generalized linear models, and cumulative incidence was calculated using Aalen-Johansen's competing risks model. The study provides estimates of AOO, incidence, and cumulative incidence for various mental disorders, including their age and sex distributions. The cumulative incidence by age 80 years for any mental disorder was 30.72% (95% confidence interval: 30.62%-30.83%) for males and 34.46% (34.35%-34.57%) for females. The most common types of mental disorders were anxiety-related disorders 16.27% (16.19%-16.36%) for males and 23.39% (23.29%-23.50%) for females, and followed by mood disorder 10.34% (10.27%-10.41%) for males and 16.67% (16.58%-16.77%) for females. For those who develop mental disorder, half will have developed their disorder by approximately age 22 years (median and interquartile range: males 21.37 (11.85-36.00); females 22.55 (16.31-36.08)). Approximately one in three individuals will seek treatment for at least one mental disorder in a secondary care setting by age 80. Given that half of these individuals develop mental disorders before age 22, it is crucial to tailor service planning to meet the specific needs of young individuals. Web-based interactive data-visualization tools are provided for clinical utility.
Sections du résumé
BACKGROUND
BACKGROUND
The age of onset (AOO), incidence and cumulative incidence of mental disorders are critical epidemiological measures, providing essential insights into the development and course of these disorders across the lifespan. This study aims to provide up-to-date estimates of the AOO, age-specific incidence, and cumulative incidence for a comprehensive range of mental disorders using data from Danish registers.
METHODS
METHODS
We conducted a follow-up study encompassing all Danish residents from January 1, 2004, to December 31, 2021, totaling 91,613,465 person-years. Data were sourced from the Danish Psychiatric Central Research Register, identifying individuals treated for various mental disorders in psychiatric hospitals, outpatient departments, and accident/emergency departments, that is, treated in secondary care settings. We investigated specific categories of mental disorders, including substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, borderline personality disorders, intellectual disabilities, pervasive developmental disorders, and behavioral and emotional disorders. Age-sex-specific incidence rates were estimated using Poisson generalized linear models, and cumulative incidence was calculated using Aalen-Johansen's competing risks model. The study provides estimates of AOO, incidence, and cumulative incidence for various mental disorders, including their age and sex distributions.
RESULTS
RESULTS
The cumulative incidence by age 80 years for any mental disorder was 30.72% (95% confidence interval: 30.62%-30.83%) for males and 34.46% (34.35%-34.57%) for females. The most common types of mental disorders were anxiety-related disorders 16.27% (16.19%-16.36%) for males and 23.39% (23.29%-23.50%) for females, and followed by mood disorder 10.34% (10.27%-10.41%) for males and 16.67% (16.58%-16.77%) for females. For those who develop mental disorder, half will have developed their disorder by approximately age 22 years (median and interquartile range: males 21.37 (11.85-36.00); females 22.55 (16.31-36.08)).
CONCLUSIONS
CONCLUSIONS
Approximately one in three individuals will seek treatment for at least one mental disorder in a secondary care setting by age 80. Given that half of these individuals develop mental disorders before age 22, it is crucial to tailor service planning to meet the specific needs of young individuals. Web-based interactive data-visualization tools are provided for clinical utility.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIMH NIH HHS
ID : R01MH120170
Pays : United States
Informations de copyright
© 2024 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
Références
Kessler RC, Angermeyer M, Anthony JC, et al. Lifetime prevalence and age‐of‐onset distributions of mental disorders in the World Health Organization's world mental health survey initiative. World Psychiatry. 2007;6(3):168‐176.
Pedersen CB, Mors O, Bertelsen A, et al. A comprehensive nationwide study of the incidence rate and lifetime risk for treated mental disorders. JAMA Psychiatry. 2014;71(5):573‐581. doi:10.1001/jamapsychiatry.2014.16
Solmi M, Radua J, Olivola M, et al. Age at onset of mental disorders worldwide: large‐scale meta‐analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27(1):281‐295. doi:10.1038/s41380‐021‐01161‐7
Kessler RC, Amminger GP, Aguilar‐Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359‐364. doi:10.1097/YCO.0b013e32816ebc8c
Murray CJ, Lopez AD. The Global Burden of Disease. Harvard School of Public Health; 1996.
Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the global burden of disease study 2010. PLoS One. 2015;10(2):e0116820. doi:10.1371/journal.pone.0116820
McGrath JJ, Al‐Hamzawi A, Alonso J, et al. Age of onset and cumulative risk of mental disorders: a cross‐national analysis of population surveys from 29 countries. Lancet Psychiatry. 2023;10(9):668‐681. doi:10.1016/S2215‐0366(23)00193‐1
Kessing LV, Ziersen SC, Caspi A, Moffitt TE, Andersen PK. Lifetime incidence of treated mental health disorders and psychotropic drug prescriptions and associated socioeconomic functioning. JAMA Psychiatry. 2023;80:1000‐1008. doi:10.1001/jamapsychiatry.2023.2206
Kendler KS, Ohlsson H, Sundquist J, Sundquist K. Family genetic risk scores and the genetic architecture of major affective and psychotic disorders in a Swedish National Sample. JAMA Psychiatry. 2021;78(7):735‐743. doi:10.1001/jamapsychiatry.2021.0336
Pedersen EM, Agerbo E, Plana‐Ripoll O, et al. Accounting for age of onset and family history improves power in genome‐wide association studies. Am J Hum Genet. 2022;109(3):417‐432. doi:10.1016/j.ajhg.2022.01.009
Pedersen CB, Gotzsche H, Moller JO, Mortensen PB. The Danish civil registration system. A cohort of eight million persons. Dan Med Bull. 2006;53(4):441‐449.
Pedersen CB. The Danish civil registration system. Scand J Public Health. 2011;39(7 Suppl):22‐25. doi:10.1177/1403494810387965
Mors O, Perto GP, Mortensen PB. The Danish psychiatric central research register. Scand J Public Health. 2011;39(7 Suppl):54‐57. doi:10.1177/1403494810395825
Munk‐Jorgensen P, Mortensen PB. The Danish psychiatric central register. Dan Med Bull. 1997;44(1):82‐84.
Andersen PK, Borgan Ø, Gill RD, Keiding N. Model specification and censoring. In: Andersen PK, Borgan Ø, Gill RD, Keiding N, eds. Statistical Models Based on Counting Processes. US; 1993:121‐175.
Carstensen B. Parametrization and prediction of rates. Epidemiology With R. Oxford University Press; 2020:119‐158 chap 6.
Andersen PK, Perme MP, van Houwelingen HC, et al. Analysis of time‐to‐event for observational studies: guidance to the use of intensity models. Stat Med. 2021;40(1):185‐211. doi:10.1002/sim.8757
Mozumder SI, Rutherford MJ, Lambert PC. Estimating restricted mean survival time and expected life‐years lost in the presence of competing risks within flexible parametric survival models. BMC Med Res Methodol. 2021;21(1):52. doi:10.1186/s12874‐021‐01213‐0
Andersen PK, Keiding N. Interpretability and importance of functionals in competing risks and multistate models. Stat Med. 2012;31(11–12):1074‐1088. doi:10.1002/sim.4385
McGrath J, Agerbo E, Beck C, et al. A comprehensive analysis of age of onset and cumulative incidence of mental disorders: A Danish register study. 2023. doi:10.17605/OSF.IO/QT9CR
McGorry PD, Purcell R, Hickie IB, Jorm AF. Investing in youth mental health is a best buy. Med J Aust. 2007;187(7 Suppl):S5‐S7.
Hay SI, Abajobir AA, Abate KH, et al. Global, regional, and national disability‐adjusted life‐years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990‐2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1260‐1344.
Eranti SV, MacCabe JH, Bundy H, Murray RM. Gender difference in age at onset of schizophrenia: a meta‐analysis. Psychol Med. 2013;43(1):155‐167. doi:10.1017/S003329171200089X
Venkatesh BK, Thirthalli J, Naveen MN, et al. Sex difference in age of onset of schizophrenia: findings from a community‐based study in India. World Psychiatry. 2008;7(3):173‐176. doi:10.1002/j.2051‐5545.2008.tb00191.x
Kessing L. Validity of diagnoses and other clinical register data in patients with affective disorder. Eur Psychiatry. 1998;13(8):392‐398. doi:10.1016/S0924‐9338(99)80685‐3
Lauritsen MB, Jorgensen M, Madsen KM, et al. Validity of childhood autism in the Danish psychiatric central register: findings from a cohort sample born 1990‐1999. J Autism Dev Disord. 2010;40(2):139‐148. doi:10.1007/s10803‐009‐0818‐0
Bock C, Bukh JD, Vinberg M, Gether U, Kessing LV. Validity of the diagnosis of a single depressive episode in a case register. Clin Pract Epidemiol Ment Health. 2009;5:4. doi:10.1186/1745‐0179‐5‐4
Mohr‐Jensen C, Vinkel Koch S, Briciet Lauritsen M, Steinhausen HC. The validity and reliability of the diagnosis of hyperkinetic disorders in the Danish psychiatric central research registry. Eur Psychiatry. 2016;35:16‐24. doi:10.1016/j.eurpsy.2016.01.2427
Jakobsen KD, Frederiksen JN, Hansen T, Jansson LB, Parnas J, Werge T. Reliability of clinical ICD‐10 schizophrenia diagnoses. Nord J Psychiatry. 2005;59(3):209‐212. doi:10.1080/08039480510027698
Musliner KL, Liu X, Gasse C, Christensen KS, Wimberley T, Munk‐Olsen T. Incidence of medically treated depression in Denmark among individuals 15‐44 years old: a comprehensive overview based on population registers. Acta Psychiatr Scand. 2019;139(6):548‐557. doi:10.1111/acps.13028
Agerbo E, Byrne M, Eaton WW, Mortensen PB. Marital and labor market status in the long run in schizophrenia. Arch Gen Psychiatry. 2004;61(1):28‐33. doi:10.1001/archpsyc.61.1.28
Álvarez‐Cadenas L, García‐Vázquez P, Ezquerra B, et al. Detection of bipolar disorder in the prodromal phase: a systematic review of assessment instruments. J Affect Disord. 2023;325:399‐412. doi:10.1016/j.jad.2023.01.012
Thompson EM, Torres AR, Albertella L, et al. The speed of progression towards obsessive‐compulsive disorder. J Affect Disord. 2020;264:181‐186. doi:10.1016/j.jad.2019.12.016
Weye N, McGrath JJ, Lasgaard M, et al. Agreement between survey‐ and register‐based measures of depression in Denmark. Acta Psychiatr Scand. 2023;147(6):581‐592. doi:10.1111/acps.13555
Plana‐Ripoll O, Momen NC, McGrath JJ, et al. Temporal changes in sex‐ and age‐specific incidence profiles of mental disorders: a nationwide study from 1970 to 2016. Acta Psychiatr Scand. 2022;145(6):604‐614. doi:10.1111/acps.13410
Lyall K, Croen L, Daniels J, et al. The changing epidemiology of autism Spectrum disorders. Annu Rev Public Health. 2016;38:81‐102. doi:10.1146/annurev‐publhealth‐031816‐044318
Hansen SN, Overgaard M, Andersen PK, Parner ET. Estimating a population cumulative incidence under calendar time trends. BMC Med Res Methodol. 2017;17(1):7. doi:10.1186/s12874‐016‐0280‐6
Pedersen EM, Agerbo E, Plana‐Ripoll O, et al. Accounting for age‐of‐onset and family history improves power in genome‐wide association studies. bioRxiv. Preprint posted online April 20, 2021. 2021. doi:10.1101/2021.04.20.440585
Whiteford HA, Degenhardt L, Rehm J, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet. 2013;382(9904):1575‐1586. doi:10.1016/S0140‐6736(13)61611‐6