Department of Child and Adolescent Psychiatry, University of Zurich, Neumünsterallee 9, CH-8032 Zurich, Switzerland.
Centre for Child and Adolescent Mental Health, Capital Region Psychiatry, Copenhagen, Denmark.
J Clin Psychiatry. 2019 Apr 23;80(3):17m12012. doi: 10.4088/JCP.17m12012.
To investigate incidences, cumulative incidence rates, and risk factors of diagnosed mental disorders in a complete nationwide birth cohort across the entire period of childhood and adolescence.
Based on nationwide Danish registries, the entire cohort of all children born in 1995 was followed up to December 31, 2013. Data for children who migrated during the period were censored in the time analyses, and death before age 18 years was considered a competing risk. Incidence rates and cumulative incidence rates for any first-time-diagnosed mental disorder and 10 major categories of mental disorders according to ICD-10 criteria were calculated for 68,982 individuals. In addition, the effects of age, sex, and further child- and family-related risk factors on mental disorders were analyzed.
The incidences of any mental disorder, substance use disorders, depression, and anxiety disorders showed an increase in adolescence, whereas those for autism spectrum disorders, attention-deficit/hyperactivity disorder, conduct disorder, and tic disorder increased during childhood and decreased thereafter. Males had higher incidence rates of any mental disorders, substance use disorders, autism spectrum disorders, ADHD, conduct disorder, and tic disorder. Females had higher risks for depressive, anxiety, obsessive-compulsive, and eating disorders. Several other risk and protective factors for any mental disorder were identified. The cumulative incidence rate at age 18 years amounted to 11.02% for any mental disorder.
These findings provide the most comprehensive estimates of the development, incidence rates, and contributing risk factors of registered mental disorders for the entire period of childhood and adolescence that have been calculated so far.
调查整个儿童期和青春期确诊精神障碍的发病率、累积发病率及危险因素。
基于全国性丹麦注册中心,对所有 1995 年出生的儿童进行了队列随访,随访至 2013 年 12 月 31 日。在此期间迁移的儿童的数据在时间分析中被删失,并且 18 岁前死亡被视为竞争风险。为 68982 例个体计算了任何首次确诊的精神障碍以及根据 ICD-10 标准的 10 种主要类别的精神障碍的发病率和累积发病率。此外,还分析了年龄、性别以及其他儿童和家庭相关危险因素对精神障碍的影响。
任何精神障碍、物质使用障碍、抑郁和焦虑障碍的发病率在青春期呈上升趋势,而自闭症谱系障碍、注意缺陷多动障碍、品行障碍和抽动障碍的发病率在儿童期呈上升趋势,随后下降。男性任何精神障碍、物质使用障碍、自闭症谱系障碍、ADHD、品行障碍和抽动障碍的发病率较高。女性患抑郁、焦虑、强迫症和饮食障碍的风险较高。还确定了其他一些任何精神障碍的风险和保护因素。18 岁时任何精神障碍的累积发病率为 11.02%。
这些发现提供了迄今为止最全面的关于整个儿童期和青春期登记的精神障碍发展、发病率和发病风险因素的估计。