Conclusions: From the Study of the Age of Onset to the Development of Age-Specific Interventions in Mental Health

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

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Addressing the mental health needs of adolescents in South African communities: a protocol for a feasibility randomized controlled trial

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00803-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

K. Sorsdahl ◽

C. van der Westhuizen ◽

M. Neuman ◽

H. A. Weiss ◽

B. Myers

Keyword(s):

Mental Health ◽

At Risk ◽

South African ◽

Mental Health Problems ◽

Age Of Onset ◽

Common Mental Disorders ◽

Controlled Trial ◽

Feasibility Trial ◽

Counselling Intervention ◽

Health Counselling

Abstract Background Like many low- and middle-income countries, almost half of the proportion of the South African population is under the age of 25. Given the peak age of onset for most mental health problems is in adolescence, it is vital that adolescents have access to mental health counselling. There are several initiatives to increase access to mental health counselling in South Africa, primarily through the integration of counselling for common mental disorders (CMD) into primary health care services, but adolescents (15–18 years of age) generally do not utilize these services. To address this gap, we will undertake a study to explore the feasibility of conducting a trial of the effectiveness of a community-based mental health counselling intervention for adolescents at-risk for a CMD. Methods The study is a feasibility trial of the ASPIRE intervention, a four-session blended multi-component counselling intervention adapted for South African adolescents at risk for depression and alcohol use disorders. We will enrol 100 adolescents from community settings and randomly assign them to the ASPIRE intervention or a comparison condition. Feasibility measures, such as rates of recruitment, consent to participate in the trial and retention, will be calculated. Qualitative interviews with participants and counsellors will explore the acceptability of the intervention. The primary outcomes for a subsequent trial would be reductions in symptoms of depression and days of heavy drinking which will be measured at baseline, 6 weeks, and 3 months post-randomization. Discussion This feasibility trial using a mixed-methods design will allow us to determine whether we can move forward to a larger effectiveness trial of the ASPIRE intervention. Trial registration The trial is registered with the Pan African Clinical Trials Registry (PACTR20200352214510). Registered 28 February 2020—retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9795

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The epidemiology of blood-injection-injury phobia

Psychological Medicine ◽

10.1017/s0033291798007144 ◽

1998 ◽

Vol 28 (5) ◽

pp. 1129-1136 ◽

Cited By ~ 137

Author(s):

O. JOSEPH BIENVENU ◽

WILLIAM W. EATON

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

General Health ◽

Age Of Onset ◽

Health Treatment ◽

Compulsive Disorder ◽

Injection Injury ◽

Blood Injection ◽

Psychiatric Conditions ◽

Blood Injection Injury Phobia

Background. We report the prevalence, clinical characteristics, frequency of mental health treatment, demographic correlates, frequency of co-morbid psychiatric conditions, and general health ramifications of DSM-IV blood-injection-injury phobia in the general population.Method. The Diagnostic Interview Schedule (version III-R), which included questions on blood-injection-injury phobia, was administered to 1920 subjects in the Baltimore ECA Follow-up Study.Results. The estimated unweighted lifetime prevalence of blood-injection-injury phobia was 3·5%. The median age of onset was 5·5 years; 78% had had symptoms within the last 6 months. Subjects with blood-injection-injury phobia (cases) had higher lifetime histories of fainting and seizures than those without (non-cases). None reported seeking mental health treatment specifically for phobia. Prevalences were lower in the elderly and higher in females and persons with less education. Cases had significantly higher than expected lifetime prevalences of other psychiatric conditions, including marijuana abuse/dependence, major depression, obsessive–compulsive disorder, panic disorder, agoraphobia, social phobia and other simple phobia. Cases and non-cases did not differ with regard to usual health-care settings, regular care for specific medical conditions, numbers of out-patient visits or hospitalizations, or previous general anaesthesia or live births. However, diabetics with blood-injection-injury phobia had higher than expected rates of macrovascular complications.Conclusion. Blood-injection-injury phobia is common, especially in females and those with less education, and it is associated with several co-morbid psychiatric conditions. No strong, broad general health ramifications of this phobia are apparent. However, diabetics with this phobia appear at particular risk for complications; this deserves further study.

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Impact of Child Sexual Abuse on Females: Toward a Developmental, Psychobiological Integration

Psychological Science ◽

10.1111/j.1467-9280.1993.tb00465.x ◽

1993 ◽

Vol 4 (2) ◽

pp. 81-87 ◽

Cited By ~ 94

Author(s):

Penelope K. Trickett ◽

Frank W. Putnam

Keyword(s):

Mental Health ◽

Sexual Abuse ◽

Age Of Onset ◽

Average Duration ◽

Pubertal Development ◽

Biological Processes ◽

Basic Theme ◽

Long Term Impact ◽

The Impact

In the last decade, it has become clear that the sexual abuse of children is much more prevalent than previously realized and that such abuse has extensive mental health sequelae. Females are reported victims of sexual abuse much more often than males. The peak age of onset of sexual abuse for females is prepubertal—7 or 8 years of age—and the average duration fends to be about 2 years. The basic theme of this article is that there may be directly traceable mechanistic relationships between the impact of sexual abuse on specific psychological and biological developmental processes for females and some of the adult outcomes of that abuse. Specifically, it is proposed that, to understand the long-term impact of sexual abuse, it is necessary to investigate how it may interfere with both the psychological and the biological processes of pubertal development.

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The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS)

Psychological Medicine ◽

10.1017/s0033291717001878 ◽

2017 ◽

Vol 48 (3) ◽

pp. 473-487 ◽

Cited By ~ 14

Author(s):

H. Yin ◽

G. Xu ◽

H. Tian ◽

G. Yang ◽

K. J. Wardenaar ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Mental Disorders ◽

Mental Disorder ◽

Mood Disorders ◽

Age Of Onset ◽

Male Gender ◽

Immigrant Status ◽

Sociodemographic Correlates ◽

Mental Health Survey

BackgroundTo effectively shape mental healthcare policy in modern-day China, up-to-date epidemiological data on mental disorders is needed. The objective was to estimate the prevalence, age-of-onset (AOO) and sociodemographic correlates of mental disorders in a representative household sample of the general population (age ⩾ 18) in the Tianjin Municipality in China.MethodsData came from the Tianjin Mental health Survey (TJMHS), which was conducted between July 2011 and March 2012 using a two-phase design. 11 748 individuals were screened with an expanded version of the General Health Questionnaire and 4438 subjects were selected for a diagnostic interview by a psychiatrist, using the Structured Clinical Interview for the Diagnostic and Statistical Manual – fourth edition (SCID).ResultsThe lifetime and 1-month prevalence of any mental disorder were 23.6% and 12.8%, respectively. Mood disorders (lifetime: 9.3%; 1-month: 3.9%), anxiety disorders (lifetime: 4.5% 1-month: 3.1%) and substance-use disorders (lifetime: 8.8%; 1-month: 3.5%) were most prevalent. The median AOO ranged from 25 years [interquartile range (IQR): 23–32] for substance-use disorders to 36 years (IQR: 24–50) for mood disorders. Not being married, non-immigrant status (i.e. local ‘Hukou’), being a farmer, having <6 years of education and male gender were associated with a higher lifetime prevalence of any mental disorder.ConclusionResults from the current survey indicate that mental disorders are steadily reported more commonly in rapidly-developing urban China. Several interesting sociodemographic correlates were observed (e.g. male gender and non-immigrant status) that warrant further investigation and could be used to profile persons in need of preventive intervention.

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Non-suicidal self-injury in United States adults: prevalence, sociodemographics, topography and functions

Psychological Medicine ◽

10.1017/s0033291710002497 ◽

2011 ◽

Vol 41 (9) ◽

pp. 1981-1986 ◽

Cited By ~ 293

Author(s):

E. D. Klonsky

Keyword(s):

Mental Health ◽

United States ◽

Mental Health Treatment ◽

Large Scale ◽

Age Of Onset ◽

Adult Population ◽

The United States ◽

Epidemiological Studies ◽

Adolescent And Young Adult ◽

Self Injury

BackgroundNon-suicidal self-injury (NSSI) has received increased attention in the mental health literature and has been proposed as a diagnostic entity for DSM-5. However, data on NSSI in the United States adult population are lacking.MethodThe prevalence and nature of NSSI were examined in a random-digit dialing sample of 439 adults in the United States. Participants were recruited during July and August of 2008.ResultsLifetime prevalence of NSSI was 5.9%, including 2.7% who had self-injured five or more times. The 12-month prevalence was 0.9%. Methods of NSSI reported included cutting/carving, burning, biting, scraping/scratching skin, hitting, interfering with wound healing and skin picking. Half of self-injurers reported multiple methods. The average age of onset was 16 years (median 14 years). Instances of NSSI infrequently co-occurred with suicidal thoughts and with use of alcohol or drugs and rarely required medical treatment. Most injurers reported that NSSI functioned to alleviate negative emotions. Fewer reported that they self-injured to punish themselves, to communicate with others/get attention or to escape a situation or responsibility. NSSI was associated with younger age, being unmarried and a history of mental health treatment, but not with gender, ethnicity, educational history or household income.ConclusionsResults are largely consistent with previous research in adolescent and young adult samples. Study limitations notwithstanding, this study provides the most definitive and detailed information to date regarding the prevalence and characteristics of NSSI in US adults. In the future, it will be important for large-scale epidemiological studies of psychopathology to include questions about NSSI.

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Lifetime Prevalence, Age and Gender Distribution and Age-of-Onset of Psychiatric Disorders in the São Paulo Metropolitan Area, Brazil: Results from the São Paulo Megacity Mental Health Survey

Brazilian Journal of Psychiatry ◽

10.1016/j.rbp.2012.03.001 ◽

2012 ◽

Vol 34 (3) ◽

pp. 249-260 ◽

Cited By ~ 67

Author(s):

Maria Carmen Viana ◽

Laura Helena Andrade

Keyword(s):

Mental Health ◽

Psychiatric Disorders ◽

Health Survey ◽

Metropolitan Area ◽

Age Of Onset ◽

Sao Paulo ◽

São Paulo ◽

Age And Gender ◽

Mental Health Survey ◽

And Gender

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Association between psychological distress trajectories from adolescence to midlife and mental health during the pandemic: Evidence from two British birth cohorts

10.1101/2021.09.30.21264342 ◽

2021 ◽

Author(s):

Vanessa Moulton ◽

Alice Sullivan ◽

Praveetha Patalay ◽

Emla Fitzsimons ◽

Morag Henderson ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Health Outcomes ◽

Latent Variable ◽

Age Of Onset ◽

Secondary Analysis ◽

Poisson Model ◽

Poor Mental Health ◽

Mental Health Outcomes ◽

Birth Cohorts

Abstract Background Some studies suggest worsening mental health in the early stages of the pandemic, for individuals with pre-existing mental health conditions the evidence is mixed. We examined whether different life-course trajectories of psychological distress from adolescence to midlife were associated with psychological distress, lower life satisfaction and feelings of loneliness at different stages during the pandemic. Methods This study is a secondary analysis of two nationally representative British Birth cohorts, the National Child Development Study (1958) and 1970 British Cohort Study, from birth to later mid-life. We used latent variable mixture models to identify pre-pandemic longitudinal trajectories of psychological distress and a modified poisson model with robust standard errors to estimate associations with mental health outcomes during the pandemic from May 2020 to March 2021. Findings Our analysis identified five distinct pre-pandemic trajectories of psychological distress in both cohorts. All trajectories with prior symptoms of psychological distress were associated with a greater relative risk of mental health outcomes during the pandemic. This was the case irrespective of age of onset, severity, longevity and proximal occurrence. Those who had experienced more than one prior episode of high psychological distress, and more recent occurrences, faced the greatest risk of poor mental health during the pandemic. Interpretation Whilst any prior episode of poor mental health put individuals at greater risk of severe mental health symptoms, those with chronic and more recent occurrence are likely to require greater mental health support.

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