Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
J Affect Disord. 2013 Jul;149(1-3):100-7. doi: 10.1016/j.jad.2013.01.009. Epub 2013 Feb 9.
Prospective studies measuring first-incidence of DSM-IV mood, anxiety and substance use disorders in the general population are rare. We assessed these incidence rates in the Dutch population; and identified baseline sociodemographic, physical and psychopathological variables, and negative changes in sociodemographics and physical health between baseline and follow-up, as determinants of first-onset main categories of disorders.
Data are from NEMESIS-2, a representative face-to-face survey including 5303 subjects aged 18-64 interviewed twice (2007-2009; 2010-2012) with the CIDI 3.0.
In three years, 8.86% of adults without prior psychopathology experienced any mental disorder, corresponding with 3.09 cases per 100 person-years. Incidence was highest for anxiety (1.69 per 100 person-years) and mood disorder (1.65), and lowest for substance use disorder (0.97). For the separate disorders, incidence was highest for major depression (1.58), specific phobia (0.79) and alcohol abuse (0.73). For mood and anxiety disorder, incidence rate was higher among women and for substance use disorder it was higher among men. Age was inversely related to all disorder categories. Changes in sociodemographics, like no longer living with a partner and decrease in income, were stronger determinants than the corresponding sociodemographics. Incident mood disorder was predicted by baseline anxiety and substance use disorder, incident anxiety disorder by mood and substance use disorder, and incident substance use disorder by adult ADHD.
Validity of lifetime diagnoses can be questioned because of difficulty of accurate recall. Only determinants of categories of disorders were studied, due to low numbers of incident cases of most separate disorders.
First-onset of mental disorders in a 3-year period is not an uncommon phenomenon. Results about determinants of incident disorders are important for prevention and early intervention initiatives aimed at reducing burden of mental disorders.
在普通人群中，前瞻性研究测量 DSM-IV 情绪、焦虑和物质使用障碍的首次发作较为罕见。我们评估了荷兰人群中的这些发病率，并确定了基线社会人口统计学、身体和心理病理学变量，以及基线和随访之间社会人口统计学和身体健康的负面变化，这些都是首发主要障碍类别的决定因素。
数据来自 NEMESIS-2，这是一项代表性的面对面调查，包括 5303 名年龄在 18-64 岁之间的受访者，他们在 2007-2009 年和 2010-2012 年接受了两次 CIDI 3.0 访谈。
在三年内，8.86%没有先前精神病理学的成年人经历了任何精神障碍，对应的发病率为每 100 人年 3.09 例。发病率最高的是焦虑症（1.69/100 人年）和情绪障碍（1.65），最低的是物质使用障碍（0.97）。对于单独的障碍，发病率最高的是重度抑郁症（1.58）、特定恐惧症（0.79）和酒精滥用（0.73）。对于情绪和焦虑障碍，女性的发病率更高，而对于物质使用障碍，男性的发病率更高。年龄与所有障碍类别呈负相关。社会人口统计学的变化，如不再与伴侣生活在一起和收入减少，比相应的社会人口统计学因素更能决定发病。首发心境障碍预测首发焦虑障碍和物质使用障碍，首发焦虑障碍预测首发心境障碍和物质使用障碍，首发物质使用障碍预测成人 ADHD。
由于难以准确回忆，终生诊断的有效性可能受到质疑。由于大多数单独障碍的发病例数较少，因此仅研究了障碍类别的决定因素。
在 3 年内首次出现精神障碍并非罕见现象。关于首发障碍决定因素的结果对于旨在减轻精神障碍负担的预防和早期干预措施非常重要。
