Scientists who examined data from more than 150 000 adults across 29 countries found a high prevalence of mental health disorders, the results showing that 50% of the population can possibly expect to develop at least one of about 13 disorders by the age of 75.
The global study between 2001 and 2022 was co-led by researchers from the University of Queensland (UQ) and Harvard Medical School.
Professor John McGrath from UQ’s Queensland Brain Institute, Professor Ronald Kessler from Harvard Medical School, and their colleagues from 27 other countries, analysed data taken from the largest ever co-ordinated series of face-to-face interviews – the World Health Organisation’s World Mental Health Survey initiative.
Lead author McGrath said the results demonstrate the high prevalence of mental health disorders, the most common being mood disorders like major depression or anxiety.
“We also found the risk of certain mental disorders differed by sex,” he said.
The three most common mental health disorders among women were: depression; specific phobia (a disabling anxiety that interferes with daily life); and post-traumatic stress (PTSD).
The three most common mental health disorders among men were alcohol abuse; depression, and specific phobia.
The research also found mental health disorders typically first emerge in childhood, adolescence or young adulthood.
“The peak age of first onset was at 15, with a median age of onset of 19 for men and 20 for women,” McGrath said.
“This lends weight to the need to invest in basic neuroscience to understand why these disorders develop.”
Kessler said investment was also needed in mental health services, with a particular focus on young people.
“Services need to be able to detect and treat common mental disorders promptly, and be optimised to suit patients in these critical parts of their lives.”
The study is published in The Lancet Psychiatry.
Study details
Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries
John McGrath, Ali Al-Hamzawi, Ronald Kessler, et al.
Published in The Lancet Psychiatry on 30 July 2023.
Summary
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 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 jack-knife 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, with a median age of onset of 19 (IQR 14–32) for male respondents and 20 (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, 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.
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