Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies.
Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies.
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DOI：
10.1038/s41380-021-01161-7
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发表时间：
2022-01
影响因子：
11
通讯作者：
Fusar-Poli P
中科院分区：
文献类型：
--
作者：
Solmi M;Radua J;Olivola M;Croce E;Soardo L;Salazar de Pablo G;Il Shin J;Kirkbride JB;Jones P;Kim JH;Kim JY;Carvalho AF;Seeman MV;Correll CU;Fusar-Poli P
促进良好的心理健康、预防和在精神障碍发作前/发作时的早期干预可改善结果。然而，精神障碍发病的范围和高峰年龄尚未完全确定。为了提供精神障碍发病年龄的稳健的全球流行病学估计，我们进行了一项符合PRISMA/MOOSE标准的系统性综述，对出生队列/横断面/队列研究进行了荟萃分析，代表了一般人群，报告了PubMed/Web of Science中确定的任何ICD/DSM-精神障碍的发病年龄（截至2020年5月16日）（PROSPERO：CRD 42019143015）。共同主要结局是14岁、18岁、25岁之前精神障碍发作的个体比例，以及任何精神障碍和国际疾病分类11个诊断块的发病高峰年龄。另外还调查了特定疾病发病的中位年龄。在14岁、18岁、25岁以前有精神障碍者分别占34.6%、48.4%、62.5%，高峰年龄为14.5岁（k = 14，中位数= 18，四分位距（IQR）= 11-34）。对于诊断块，在14岁、18岁、25岁和高峰年龄之前发病的个体比例如下：神经发育障碍：61.5%、83.2%、95.8%、5.5岁（k = 21，中位数=12，IQR = 7-16），焦虑/恐惧相关疾病：38.1%，51.8%，73.3%，5.5年（k = 73，中位数= 17，IQR = 9-25），强迫症/相关疾病：24.6%，45.1%，64.0%，14.5年（k = 20，中位数= 19，IQR = 14-29），喂养/进食障碍/问题：15.8%，48.1%，82.4%，15.5年（k = 11，中位数= 18，IQR = 15-23），与应激障碍特别相关的疾病：16.9%，27.6%，43.1%，15.5年（k = 16，中位数= 30，IQR = 17-48），物质使用障碍/成瘾行为：2.9%、15.2%、48.8%、19.5年（k = 58，中位数= 25，IQR = 20-41），精神分裂症谱系障碍/原发性精神病状态：3%、12.3%、47.8%、20.5年（k = 36，中位数= 25，IQR = 20-34），人格障碍/相关特质：1.9%，9.6%，47.7%，20.5年（k = 6，中位数= 25，IQR = 20-33）和情绪障碍：2.5%，11.5%，34.5%，20.5年（k = 79，中位数= 31，IQR = 21-46）。按性别或发病年龄的定义，无显著差异。特定精神障碍的中位发病年龄映射到时间连续体上，从恐惧症/分离焦虑症/自闭症谱系障碍/注意缺陷多动障碍/社交焦虑症（8-13岁）至神经性厌食症/神经性贪食症/强迫症/暴饮暴食/大麻使用障碍（17-22岁），其次是精神分裂症、人格、恐慌和酒精使用障碍（25-27岁），最后是创伤后/抑郁/广泛性焦虑/双相/急性和短暂性精神障碍（30-35岁），组间重叠，无显著聚类。这些结果告知良好的心理健康促进/预防/早期干预的时机，更新目前的心理健康系统结构周围的儿童/成人服务分裂在18岁。
Promotion 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.
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South-London（OASIS）2001 - 2020年的外展和支持：针对患有精神病风险的年轻人进行二十年的早期发现，预后和预防性护理。
DOI：
10.1016/j.euroneuro.2020.08.002
发表时间：
2020-10
期刊：
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
影响因子：
--
作者：
Fusar-Poli P;Spencer T;De Micheli A;Curzi V;Nandha S;McGuire P
通讯作者：
McGuire P
影响因子：
6.6
作者：
Fusar-Poli, Paolo
通讯作者：
Fusar-Poli, Paolo
影响因子：
7.8
作者：
Fusar-Poli, P.;Byrne, M.;McGuire, P. K.
通讯作者：
McGuire, P. K.
DOI：
10.1016/j.pnpbp.2017.05.023
发表时间：
2018-01-03
影响因子：
5.6
作者：
Galecki, Piotr;Talarowska, Monika
通讯作者：
Talarowska, Monika
影响因子：
25.8
作者：
de Pablo, Gonzalo Salazar;Radua, Joaquim;Fusar-Poli, Paolo
通讯作者：
Fusar-Poli, Paolo