Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative.
Data are presented on the lifetime prevalence, projected lifetime risk, and age-of-onset distributions of mental disorders in the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Face-to-face community surveys were conducted in seventeen countries in Africa, Asia, the Americas, Europe, and the Middle East. The combined numbers of respondents were 85,052. Lifetime prevalence, projected lifetime risk, and age of onset of DSM-IV disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI), a fully-structured lay administered diagnostic interview. Survival analysis was used to estimate lifetime risk. Median and inter-quartile range (IQR) of age of onset is very early for some anxiety disorders (7-14, IQR: 8-11) and impulse control disorders (7-15, IQR: 11-12). The age-of-onset distribution is later for mood disorders (29-43, IQR: 35-40), other anxiety disorders (24-50, IQR: 31-41), and substance use disorders (18-29, IQR: 21-26). Median and IQR lifetime prevalence estimates are: anxiety disorders 4.8-31.0% (IQR: 9.9-16.7%), mood disorders 3.3-21.4% (IQR: 9.8-15.8%), impulse control disorders 0.3-25.0% (IQR: 3.1-5.7%), substance use disorders 1.3-15.0% (IQR: 4.8-9.6%), and any disorder 12.0-47.4% (IQR: 18.1-36.1%). Projected lifetime risk is proportionally between 17% and 69% higher than estimated lifetime prevalence (IQR: 28-44%), with the highest ratios in countries exposed to sectarian violence (Israel, Nigeria, and South Africa), and a general tendency for projected risk to be highest in recent cohorts in all countries. These results document clearly that mental disorders are commonly occurring. As many mental disorders begin in childhood or adolescents, interventions aimed at early detection and treatment might help reduce the persistence or severity of primary disorders and prevent the subsequent onset of secondary disorders.
Kessler
Ronald C
RC
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA;
Angermeyer
Matthias
M
Anthony
James C
JC
DE Graaf
Ron
R
Demyttenaere
Koen
K
Gasquet
Isabelle
I
DE Girolamo
Giovanni
G
Gluzman
Semyon
S
Gureje
Oye
O
Haro
Josep Maria
JM
Kawakami
Norito
N
Karam
Aimee
A
Levinson
Daphna
D
Medina Mora
Maria Elena
ME
Oakley Browne
Mark A
MA
Posada-Villa
José
J
Stein
Dan J
DJ
Adley Tsang
Cheuk Him
CH
Aguilar-Gaxiola
Sergio
S
Alonso
Jordi
J
Lee
Sing
S
Heeringa
Steven
S
Pennell
Beth-Ellen
BE
Berglund
Patricia
P
Gruber
Michael J
MJ
Petukhova
Maria
M
Chatterji
Somnath
S
Ustün
T Bedirhan
TB