Dykxhoorn Jennifer, Solmi Francesca, Walters Kate, Gnani Shamini, Lazzarino Antonio, Kidger Judi, Kirkbride James B, Osborn David P J
UCL Division of Psychiatry, London, UK
UCL Research Department of Primary Care and Population Health, London, UK.
BMJ Ment Health. 2025 May 13;28(1):e301457. doi: 10.1136/bmjment-2024-301457.
Rates of common mental disorders (CMDs) including anxiety, depression and stress, treated in primary care have increased among young adults, but it is unclear if this reflects more help-seeking and/or an increase in symptoms, and if there are differences across sociodemographic groups.
This study examined trends in primary care-recorded CMD and self-reported psychological distress symptoms in young adults over time.
We used data from participants born between 1980 and 2003 in two datasets: UK primary care records and longitudinal cohort data. Participants were followed from age 16 to age 39 (maximum) or the end of the follow-up (2019-2020). Annual incidence rates of recorded CMD overall and by sociodemographic group were calculated for 2009-2019, using incidence rate ratios to explore changes. We calculated annual self-reported psychological distress symptoms from cohort data, calculating ratios to explore changes over time.
Between 2009 and 2019, recorded CMD increased by 9.90%, while average psychological distress symptoms rose by 19.33%. The sharpest increases for both recorded CMD and average psychological distress symptoms were observed in older adolescents (ages 16-19) and those born after 1995. Recorded CMD increased more in males (20.61%) than in females (7.65%), despite similar symptom increases. Recorded CMD increased the most in the least deprived areas (16.34%) compared with the most deprived areas (3.55%), despite comparable rises in psychological distress symptoms.
Both recorded CMD and psychological distress symptoms in young adults increased between 2009 and 2019, which may indicate that the rising primary care-recorded CMD reflects increased symptom burden.
Differences between recorded CMD and psychological distress symptoms across sociodemographic groups highlight potential misalignment in mental healthcare with underlying population need, indicating that the most affected groups may not be those receiving the most care.
在初级保健机构接受治疗的包括焦虑、抑郁和压力在内的常见精神障碍（CMD）在年轻人中的发病率有所上升，但尚不清楚这是反映了更多的求助行为和/或症状增加，以及社会人口学群体之间是否存在差异。
本研究调查了年轻人中初级保健记录的CMD和自我报告的心理困扰症状随时间的变化趋势。
我们使用了来自两个数据集（英国初级保健记录和纵向队列数据）中1980年至2003年出生的参与者的数据。参与者从16岁开始随访至39岁（最大年龄）或随访结束（2019 - 2020年）。计算2009 - 2019年记录的CMD总体发病率以及按社会人口学群体划分的发病率，并使用发病率比来探讨变化情况。我们从队列数据中计算年度自我报告的心理困扰症状，并计算比率以探讨随时间的变化。
2009年至2019年期间，记录的CMD增加了9.90%，而平均心理困扰症状上升了19.33%。记录的CMD和平均心理困扰症状增幅最大的是年龄较大的青少年（16 - 19岁）和1995年以后出生的人。记录的CMD在男性中增加（20.61%）比女性（7.65%）更多，尽管症状增加情况相似。与最贫困地区（3.55%）相比，记录的CMD在最不贫困地区增加最多（16.34%），尽管心理困扰症状的上升幅度相当。
2009年至2019年期间，年轻人中记录的CMD和心理困扰症状均有所增加，这可能表明初级保健记录的CMD上升反映了症状负担增加。
社会人口学群体之间记录的CMD和心理困扰症状的差异凸显了精神卫生保健与潜在人群需求之间可能存在的不一致，表明受影响最大的群体可能并非接受最多护理的群体。
