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

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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, Madsen, Kathrine Bang, Timmerman, Allan, Schendel, Diana, McGrath, John J., Mortensen, Preben Bo, Pedersen, Carsten B.·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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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: Dalsgaard, Søren
Trabjerg, Betina B.
Schullehner, Jörg
Brikell, Isabell
Wimberley, Theresa
Thygesen, Malene
Madsen, Kathrine Bang
Schendel, Diana
McGrath, John J.
Mortensen, Preben Bo
Pedersen, Carsten B.
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
FWCI: 47.59
Type: journal article
Language: en
Open access: bronze
doi.org
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
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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Incidence Rates and Cumulative Incidences of the Full Spectrum of Diagnosed Mental Disorders in Childhood and Adolescence

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