二十年来英国常见精神障碍记录发病率的时间模式:一项初级保健队列研究。
Temporal patterns in the recorded annual incidence of common mental disorders over two decades in the United Kingdom: a primary care cohort study.
机构信息
Department of Primary Care and Population Health, UCL, London, UK.
Division of Psychiatry, UCL, London, UK.
出版信息
Psychol Med. 2024 Mar;54(4):663-674. doi: 10.1017/S0033291723002349. Epub 2023 Aug 22.
BACKGROUND
Common mental disorders (CMDs) including depression, anxiety, and stress are very common, but it is unclear whether the last decades of social, economic, and political change have impacted incidence of CMD. This study explored temporal trends in the recorded incidence of CMD in the United Kingdom.
METHODS
We used data from general practices in the United Kingdom (Clinical Practice Research Datalink) to estimate the annual recorded incidence of CMD for 2000-2020, including symptoms, diagnosis, or pharmaceutical treatment. Trends were explored by sex, age, ethnicity, region, deprivation, and comorbidity.
RESULTS
We included 29 480 164 individuals who were followed up for 12.5 years on average (s.d. = 6.4 years). The recorded incidence of CMD episodes was 55.9 per 1000 person-years in 2000 [95% confidence interval (CI) 55.8-56.1], increasing to 79.6 per 1000 person-years in 2019 (95% CI 79.5-79.8). Females had higher recorded incidence rates, as did those living in more deprived areas. We observed striking patterns by age over time, with rates in ages 16-24 increasing from 40.2 per 1000 in 2000 (95% CI 39.8-40.5), to 107.8 per 1000 in 2019 (95% CI 107.0-108.6). In contrast, the rates in those aged ≥55 years decreased since 2014. There were differing patterns of incidence by ethnic group, with a steeper increase in Asian, Black, and mixed groups in recent years.
CONCLUSIONS
Overall, the incidence of recorded CMD in the UK general practice increased between 2000 and 2019 with a small decrease in 2020. The overall trends obscured important differences across population subgroups, which may have implications for prevention.
背景
常见精神障碍(CMD)包括抑郁、焦虑和压力等,非常普遍,但尚不清楚过去几十年的社会、经济和政治变化是否对 CMD 的发病率产生了影响。本研究探讨了英国 CMD 记录发病率的时间趋势。
方法
我们使用英国普通实践(临床实践研究数据链接)的数据,估算了 2000-2020 年 CMD 的年记录发病率,包括症状、诊断或药物治疗。通过性别、年龄、族裔、地区、贫困程度和合并症来探讨趋势。
结果
我们纳入了 29480164 名平均随访 12.5 年(标准差=6.4 年)的个体。2000 年 CMD 发作的记录发病率为 55.9/1000人年(95%置信区间[CI]为 55.8-56.1),到 2019 年增加至 79.6/1000 人年(95%CI 为 79.5-79.8)。女性的记录发病率较高,生活在贫困程度较高地区的人也是如此。我们观察到随时间推移年龄的显著模式,16-24 岁年龄组的发病率从 2000 年的 40.2/1000 (95%CI 为 39.8-40.5)增加到 2019 年的 107.8/1000 (95%CI 为 107.0-108.6)。相比之下,≥55 岁年龄组的发病率自 2014 年以来有所下降。族裔群体的发病率模式不同,近年来亚洲、黑人、混血人群的发病率增长更为陡峭。
结论
总体而言,英国普通实践中记录的 CMD 发病率在 2000 年至 2019 年之间有所增加,2020 年略有下降。总体趋势掩盖了人群亚组之间的重要差异,这可能对预防产生影响。