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Cited by 511Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessHealth and Medical Studies

Incidence rates and cumulative incidences of the full spectrum of diagnosed mental disorders in childhood and adolescence

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Dalsgaard, Søren, Thorsteinsson, Erla, Trabjerg, Betina B., Schullehner, Jörg, Plana-Ripoll, Oleguer, Brikell, Isabell, Wimberley, Theresa, Thygesen, Malene +6 more·2020·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2019.3523PMC PMC6902162
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Abstract

Importance: Knowledge about the epidemiology of mental disorders in children and adolescents is essential for research and planning of health services. Surveys can provide prevalence rates, whereas population-based registers are instrumental to obtain precise estimates of incidence rates and risks. Objective: To estimate age- and sex-specific incidence rates and risks of being diagnosed with any mental disorder during childhood and adolescence. Design: This cohort study included all individuals born in Denmark from January 1, 1995, through December 31, 2016 (1.3 million), and followed up from birth until December 31, 2016, or the date of death, emigration, disappearance, or diagnosis of 1 of the mental disorders examined (14.4 million person-years of follow-up). Data were analyzed from September 14, 2018, through June 11, 2019. Exposures: Age and sex. Main Outcomes and Measures: Incidence rates and cumulative incidences of all mental disorders according to the ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research, diagnosed before 18 years of age during the study period. Results: A total of 99 926 individuals (15.01%; 95% CI, 14.98%-15.17%), including 41 350 girls (14.63%; 95% CI, 14.48%-14.77%) and 58 576 boys (15.51%; 95% CI, 15.18%-15.84%), were diagnosed with a mental disorder before 18 years of age. Anxiety disorder was the most common diagnosis in girls (7.85%; 95% CI, 7.74%-7.97%); attention-deficit/hyperactivity disorder (ADHD) was the most common in boys (5.90%; 95% CI, 5.76%-6.03%). Girls had a higher risk than boys of schizophrenia (0.76% [95% CI, 0.72%-0.80%] vs 0.48% [95% CI, 0.39%-0.59%]), obsessive-compulsive disorder (0.96% [95% CI, 0.92%-1.00%] vs 0.63% [95% CI, 0.56%-0.72%]), and mood disorders (2.54% [95% CI, 2.47%-2.61%] vs 1.10% [95% CI, 0.84%-1.21%]). Incidence peaked earlier in boys than girls in ADHD (8 vs 17 years of age), intellectual disability (5 vs 14 years of age), and other developmental disorders (5 vs 16 years of age). The overall risk of being diagnosed with a mental disorder before 6 years of age was 2.13% (95% CI, 2.11%-2.16%) and was higher in boys (2.78% [95% CI, 2.44%-3.15%]) than in girls (1.45% [95% CI, 1.42%-1.49%]). Conclusions and Relevance: This nationwide population-based cohort study provides a first comprehensive assessment of the incidence and risks of mental disorders in childhood and adolescence. By 18 years of age, 15.01% of children and adolescents in this study were diagnosed with a mental disorder. The incidence of several neurodevelopmental disorders peaked in late adolescence in girls, suggesting possible delayed detection. The distinct signatures of the different mental disorders with respect to sex and age may have important implications for service planning and etiological research.

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  • A recent nationally comprehensive survey of the Danish registry data noted that, by age 18, the cumulative incidence of ID diagnoses in males (1.5%) is lower than the cumulative incidence of ASD diagnoses in females (1.9%).

    “A recent nationally comprehensive survey of the Danish registry data noted that, by age 18, the cumulative incidence of ID diagnoses in males (1.5%) is lower than the cumulative incidence of ASD diagnoses in females (1.9%).32”

    From The female protective effect against autism spectrum disorder (2022) · cites this paper as [32]

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  1. Rothman KJ, Greenland S, Lash TL. Modern Epidemiology. 3rd ed. Philidelphia, PA: Lippincott Williams & Wilkins; 2008.

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Authors
Dalsgaard, S., Thorsteinsson, E., Trabjerg, B. B., Schullehner, J., Plana-Ripoll, O., Brikell, I., Wimberley, T., Thygesen, M., Madsen, K. B., Timmerman, A., Schendel, D., McGrath, J. J., Mortensen, P. B., & Pedersen, C. B.
Affiliations
  • Aarhus University (DK)
  • National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
  • The University of Queensland (AU)
Corresponding author
Dalsgaard, Søren
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2020-02-01
Volume
77
Issue
2
Pages
155
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2019.3523
PMC
PMC6902162
OpenAlex
W2989638817
Cited by
510
References
72
Citations by year
2026: 70 · 2025: 92 · 2024: 99 · 2023: 86 · 2022: 80 · 2021: 52 · 2020: 29 · 2019: 2
FWCI
47.59
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • European Commission (837180, 667302)
  • Danmarks Grundforskningsfond (APP1056929)
  • Lundbeckfonden (R155-2014-1724, R248‐2017‐2003)
  • Helsefonden
  • TrygFonden
  • Novo Nordisk Fonden (NNF 16OC0022018)
  • National Institutes of Health
  • National Health and Medical Research Council
  • National Institute of Environmental Health Sciences (R01ES026993)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
Keywords
child psychopathology, adolescent mental disorders, incidence rates, cumulative incidence, sex differences, anxiety disorders, attention deficit hyperactivity disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorder, bipolar disorder, ICD-10, Denmark, mental health service planning, mental health funding, mental health service utilization
MeSH terms
Adolescent, Age Factors, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Child, Preschool, Denmark, Female, Humans, Infant, Male, Intellectual Disability, Obsessive-Compulsive Disorder, Risk Factors, Schizophrenia, Sex Factors, Incidence, Mood Disorders

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