Yang Yihui, Fang Fang, Arnberg Filip K, Kuja-Halkola Ralf, D'Onofrio Brian M, Larsson Henrik, Brikell Isabell, Chang Zheng, Andreassen Ole A, Lichtenstein Paul, Valdimarsdóttir Unnur A, Lu Donghao
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
National Centre for Disaster Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Lancet Reg Health Eur. 2024 Oct 21;47:101105. doi: 10.1016/j.lanepe.2024.101105. eCollection 2024 Dec.
Limited studies exist on sex differences in incidence rates of psychiatric disorders across the lifespan. This study aims to analyze sex differences in the incidence rates of clinically diagnosed psychiatric disorders over the lifespan.
We conducted a nationwide register-based cohort study, including all individuals who were born in Sweden and lived in Sweden between 2003 and 2019, including 4,818,071 females and 4,837,829 males. We calculated sex- and age-specific standardized incidence rates for any and 10 major types of psychiatric disorders. Multivariable-adjusted incidence rate differences (IRDs) for diagnosed psychiatric disorders between females and males were estimated.
During a follow-up of 119,420,908 person-years, males showed a higher incidence rate of any diagnosed psychiatric disorder than females at age 5-9 (IRD = -8.93; 95% CI: -9.08 to -8.79; per 1000 person-years), whereas females showed a higher rate than males at age 15-19 (IRD = 9.33; 95% CI: 9.12-9.54) and onwards (except age 60-69). Specifically, among females, excess rates were apparent for depressive, anxiety, eating, stress-related and bipolar disorders at age 10-54, whereas among males, excess rates were pronounced for autism and attention deficit hyperactivity disorders before age 14, drug use disorders at age 15-54, and alcohol use disorders in adulthood. For schizophrenia, the male excess at age 15-49 shifted to female excess at age 60-79. The magnitude of IRDs were greater in recent years and individuals with lower socioeconomic status.
Knowledge about the lifespan and socioeconomic variations in the sex differences in rates of diagnosed psychiatric disorders may inform targeted screening/intervention strategies.
Vetenskapsrådet, FORTE, Karolinska Institutet Strategic Research Area in Epidemiology and Biostatistics, and Icelandic Research Fund.
关于精神疾病发病率在整个生命周期中的性别差异的研究有限。本研究旨在分析临床诊断的精神疾病在整个生命周期中的发病率的性别差异。
我们进行了一项基于全国登记册的队列研究，纳入了所有2003年至2019年在瑞典出生并居住在瑞典的个体，包括4818071名女性和4837829名男性。我们计算了任何一种及10种主要精神疾病类型的性别和年龄特异性标准化发病率。估计了女性和男性之间诊断出的精神疾病的多变量调整发病率差异（IRDs）。
在119420908人年的随访期间，5至9岁时，男性任何诊断出的精神疾病的发病率高于女性（IRD = -8.93；95% CI：-9.08至-8.79；每1000人年），而15至19岁及之后（60至69岁除外）女性的发病率高于男性。具体而言，在女性中，10至54岁时抑郁、焦虑、饮食、应激相关和双相情感障碍的发病率过高，而在男性中，14岁之前自闭症和注意力缺陷多动障碍的发病率过高，15至54岁时药物使用障碍的发病率过高，成年期酒精使用障碍的发病率过高。对于精神分裂症，15至49岁时男性发病率过高在60至79岁时转变为女性发病率过高。近年来以及社会经济地位较低者中IRDs的幅度更大。
关于诊断出的精神疾病发病率性别差异在整个生命周期和社会经济方面的变化的知识可能为有针对性的筛查/干预策略提供信息。
瑞典研究理事会、瑞典健康、工作与福利研究理事会、卡罗林斯卡学院流行病学和生物统计学战略研究领域以及冰岛研究基金。
