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dc.contributor.authorSolmi, Marco
dc.contributor.authorRadua, Joaquim
dc.contributor.authorOlivola, Miriam
dc.contributor.authorCroce, Enrico
dc.contributor.authorSoardo, Livia
dc.contributor.authorSalazar de Pablo, Gonzalo
dc.contributor.authorIl Shin, Jae
dc.contributor.authorKirkbride, James B
dc.contributor.authorJones, Peter
dc.contributor.authorKim, Jae Han
dc.contributor.authorKim, Jong Yeob
dc.contributor.authorCarvalho, Andrè F
dc.contributor.authorSeeman, Mary V
dc.contributor.authorCorrell, Christoph U
dc.contributor.authorFusar-Poli, Paolo
dc.date.accessioned2022-03-31T18:00:47Z
dc.date.available2022-03-31T18:00:47Z
dc.date.issued2022-01
dc.date.submitted2021-03-06
dc.identifier.issn1359-4184
dc.identifier.others41380-021-01161-7
dc.identifier.other1161
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335601
dc.description.abstractPromotion of good mental health, prevention, and early intervention before/at the onset of mental disorders improve outcomes. However, the range and peak ages at onset for mental disorders are not fully established. To provide robust, global epidemiological estimates of age at onset for mental disorders, we conducted a PRISMA/MOOSE-compliant systematic review with meta-analysis of birth cohort/cross-sectional/cohort studies, representative of the general population, reporting age at onset for any ICD/DSM-mental disorders, identified in PubMed/Web of Science (up to 16/05/2020) (PROSPERO:CRD42019143015). Co-primary outcomes were the proportion of individuals with onset of mental disorders before age 14, 18, 25, and peak age at onset, for any mental disorder and across International Classification of Diseases 11 diagnostic blocks. Median age at onset of specific disorders was additionally investigated. Across 192 studies (n = 708,561) included, the proportion of individuals with onset of any mental disorders before the ages of 14, 18, 25 were 34.6%, 48.4%, 62.5%, and peak age was 14.5 years (k = 14, median = 18, interquartile range (IQR) = 11-34). For diagnostic blocks, the proportion of individuals with onset of disorder before the age of 14, 18, 25 and peak age were as follows: neurodevelopmental disorders: 61.5%, 83.2%, 95.8%, 5.5 years (k = 21, median=12, IQR = 7-16), anxiety/fear-related disorders: 38.1%, 51.8%, 73.3%, 5.5 years (k = 73, median = 17, IQR = 9-25), obsessive-compulsive/related disorders: 24.6%, 45.1%, 64.0%, 14.5 years (k = 20, median = 19, IQR = 14-29), feeding/eating disorders/problems: 15.8%, 48.1%, 82.4%, 15.5 years (k = 11, median = 18, IQR = 15-23), conditions specifically associated with stress disorders: 16.9%, 27.6%, 43.1%, 15.5 years (k = 16, median = 30, IQR = 17-48), substance use disorders/addictive behaviours: 2.9%, 15.2%, 48.8%, 19.5 years (k = 58, median = 25, IQR = 20-41), schizophrenia-spectrum disorders/primary psychotic states: 3%, 12.3%, 47.8%, 20.5 years (k = 36, median = 25, IQR = 20-34), personality disorders/related traits: 1.9%, 9.6%, 47.7%, 20.5 years (k = 6, median = 25, IQR = 20-33), and mood disorders: 2.5%, 11.5%, 34.5%, 20.5 years (k = 79, median = 31, IQR = 21-46). No significant difference emerged by sex, or definition of age of onset. Median age at onset for specific mental disorders mapped on a time continuum, from phobias/separation anxiety/autism spectrum disorder/attention deficit hyperactivity disorder/social anxiety (8-13 years) to anorexia nervosa/bulimia nervosa/obsessive-compulsive/binge eating/cannabis use disorders (17-22 years), followed by schizophrenia, personality, panic and alcohol use disorders (25-27 years), and finally post-traumatic/depressive/generalized anxiety/bipolar/acute and transient psychotic disorders (30-35 years), with overlap among groups and no significant clustering. These results inform the timing of good mental health promotion/preventive/early intervention, updating the current mental health system structured around a child/adult service schism at age 18.
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.subjectReview Article
dc.subject/692/699/476
dc.subject/692/699/476/1799
dc.subject/692/699/476/1333
dc.subject/692/699/476/1414
dc.subjectreview-article
dc.titleAge at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies.
dc.typeArticle
dc.date.updated2022-03-31T18:00:46Z
prism.endingPage295
prism.issueIdentifier1
prism.publicationNameMol Psychiatry
prism.startingPage281
prism.volume27
dc.identifier.doi10.17863/CAM.83032
dcterms.dateAccepted2021-05-05
rioxxterms.versionofrecord10.1038/s41380-021-01161-7
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidSolmi, Marco [0000-0003-4877-7233]
dc.contributor.orcidSoardo, Livia [0000-0002-6735-0561]
dc.contributor.orcidKirkbride, James B [0000-0003-3401-0824]
dc.contributor.orcidJones, Peter [0000-0002-0387-880X]
dc.contributor.orcidSeeman, Mary V [0000-0001-6797-3382]
dc.contributor.orcidFusar-Poli, Paolo [0000-0003-3582-6788]
dc.identifier.eissn1476-5578
cam.issuedOnline2021-06-02


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