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全球儿童和青少年期精神障碍的患病率和残疾负担:来自全球疾病负担研究的证据。

Worldwide Prevalence and Disability From Mental Disorders Across Childhood and Adolescence: Evidence From the Global Burden of Disease Study.

机构信息

Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.

Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.

出版信息

JAMA Psychiatry. 2024 Apr 1;81(4):347-356. doi: 10.1001/jamapsychiatry.2023.5051.

Abstract

IMPORTANCE

The period from childhood to early adulthood involves increased susceptibility to the onset of mental disorders, with implications for policy making that may be better appreciated by disaggregated analyses of narrow age groups.

OBJECTIVE

To estimate the global prevalence and years lived with disability (YLDs) associated with mental disorders and substance use disorders (SUDs) across 4 age groups using data from the 2019 Global Burden of Disease (GBD) study.

DESIGN, SETTING, AND PARTICIPANTS: Data from the 2019 GBD study were used for analysis of mental disorders and SUDs. Results were stratified by age group (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and sex. Data for the 2019 GBD study were collected up to 2018, and data were analyzed for this article from April 2022 to September 2023.

EXPOSURE

Age 5 to 9 years, 10 to 14 years, 15 to 19 years, and 20 to 24 years.

MAIN OUTCOMES AND MEASURES

Prevalence rates with 95% uncertainty intervals (95% UIs) and number of YLDs.

RESULTS

Globally in 2019, 293 million of 2516 million individuals aged 5 to 24 years had at least 1 mental disorder, and 31 million had an SUD. The mean prevalence was 11.63% for mental disorders and 1.22% for SUDs. For the narrower age groups, the prevalence of mental disorders was 6.80% (95% UI, 5.58-8.03) for those aged 5 to 9 years, 12.40% (95% UI, 10.62-14.59) for those aged 10 to 14 years, 13.96% (95% UI, 12.36-15.78) for those aged 15 to 19 years, and 13.63% (95% UI, 11.90-15.53) for those aged 20 to 24 years. The prevalence of each individual disorder also varied by age groups; sex-specific patterns varied to some extent by age. Mental disorders accounted for 31.14 million of 153.59 million YLDs (20.27% of YLDs from all causes). SUDs accounted for 4.30 million YLDs (2.80% of YLDs from all causes). Over the entire life course, 24.85% of all YLDs attributable to mental disorders were recorded before age 25 years.

CONCLUSIONS AND RELEVANCE

An analytical framework that relies on stratified age groups should be adopted for examination of mental disorders and SUDs from childhood to early adulthood. Given the implications of the early onset and lifetime burden of mental disorders and SUDs, age-disaggregated data are essential for the understanding of vulnerability and effective prevention and intervention initiatives.

摘要

重要性

从儿童期到成年早期,人们更容易患上精神障碍,这对政策制定有影响,而对年龄组进行细分分析可能会更好地理解这一影响。

目的

使用来自 2019 年全球疾病负担(GBD)研究的数据,估计 4 个年龄组中与精神障碍和物质使用障碍(SUD)相关的全球患病率和残疾调整生命年(YLDs)。

设计、设置和参与者:使用 2019 年 GBD 研究的数据对精神障碍和 SUD 进行了分析。结果按年龄组(5 至 9 岁、10 至 14 岁、15 至 19 岁和 20 至 24 岁)和性别进行分层。2019 年 GBD 研究的数据收集截至 2018 年,本文的数据分析于 2022 年 4 月至 2023 年 9 月进行。

暴露情况

5 至 9 岁、10 至 14 岁、15 至 19 岁和 20 至 24 岁。

主要结果和措施

95%置信区间(95%UI)的患病率和 YLDs 数量。

结果

2019 年,全球 2516 万 5 至 24 岁的人中,有 2930 万人至少患有 1 种精神障碍,有 3100 万人患有 SUD。精神障碍的平均患病率为 11.63%,SUD 的患病率为 1.22%。对于更窄的年龄组,精神障碍的患病率为 5 至 9 岁者 6.80%(95%UI,5.58-8.03),10 至 14 岁者 12.40%(95%UI,10.62-14.59),15 至 19 岁者 13.96%(95%UI,12.36-15.78),20 至 24 岁者 13.63%(95%UI,11.90-15.53)。每种疾病的患病率也因年龄组而异;性别特异性模式在一定程度上因年龄而异。精神障碍导致 15359 万 YLDs 中的 3114 万(所有病因 YLDs 的 20.27%)。SUD 导致 430 万 YLDs(所有病因 YLDs 的 2.80%)。在整个生命周期中,归因于精神障碍的所有 YLDs 中有 24.85%发生在 25 岁之前。

结论和相关性

应该采用基于分层年龄组的分析框架来检查从儿童期到成年早期的精神障碍和 SUD。鉴于精神障碍和 SUD 的早期发病和终生负担的影响,按年龄划分的数据对于了解脆弱性以及有效预防和干预措施至关重要。

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