Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
Curr Opin Psychiatry. 2011 Jul;24(4):301-6. doi: 10.1097/YCO.0b013e3283477a09.
To provide an update of the recent studies on the age of onset of the major mental illnesses, with a special focus on the prospects for prevention and early intervention.
The studies reviewed here confirm previous reports on the age of onset of the major mental disorders. While the behaviour disorders, and certain anxiety disorders, emerge during childhood, most of the high prevalence disorders (anxiety, mood and substance use) emerge during adolescence and early adulthood, as do the psychotic disorders. Early age of onset has been shown to be associated with a longer duration of untreated illness and poorer clinical and functional outcomes.
Although the onset of most mental disorders usually occurs during the first three decades of life, effective treatment is typically not initiated until a number of years later. Although there is increasing evidence to suggest that intervention during the early stages of a disorder may help reduce the severity and/or the persistence of the initial or primary disorder and prevent secondary disorders, additional research is needed into appropriate treatment for early stage cases as well as the long-term effects of early intervention, and to appropriate service design for those in the early stages of a mental illness. This will mean not only the strengthening and re-engineering of existing systems but also, crucially, the construction of new streams of care for young people in transition to adulthood.
提供最近关于主要精神疾病发病年龄的研究进展，特别关注预防和早期干预的前景。
本文回顾的研究证实了先前关于主要精神障碍发病年龄的报告。行为障碍和某些焦虑障碍在儿童期出现，而大多数高患病率障碍（焦虑、情绪和物质使用障碍）以及精神病障碍则在青春期和成年早期出现。发病年龄早与未治疗疾病的持续时间更长以及临床和功能结局更差有关。
尽管大多数精神障碍的发病通常发生在生命的头三十年，但通常要在数年之后才开始有效治疗。尽管越来越多的证据表明，在疾病的早期阶段进行干预可能有助于减轻初始或原发性疾病的严重程度和/或持续性，并预防继发性疾病，但仍需要进一步研究早期病例的适当治疗以及早期干预的长期效果，并为处于精神疾病早期阶段的人设计适当的服务。这不仅意味着加强和重新设计现有系统，而且还需要为即将成年的年轻人构建新的护理渠道。
