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Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018
Open accessAbstract
Background: There has been growing concern in the UK over recent years that a perceived mental health crisis is affecting children and adolescents, although published epidemiological evidence is limited. Methods: Two population-based UK primary care cohorts were delineated in the Aurum and GOLD datasets of the Clinical Practice Research Datalink (CPRD). We included data from 9,133,246 individuals aged 1–20 who contributed 117,682,651 person-years of observation time. Sex- and age-stratified annual incidence rates were estimated for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) (age groups: 1–5, 6–9, 10–12, 13–16, 17–19), depression, anxiety disorders (6–9, 10–12, 13–16, 17–19), eating disorders and self-harm (10–12, 13–16, 17–19) during 2003–2018. We fitted negative binomial regressions to estimate incidence rate ratios (IRRs) to examine change in incidence between the first (2003) and final year (2018) year of observation and to examine sex-specific incidence. Results: The results indicated that the overall incidence has increased substantially in both boys and girls in between 2003 and 2018 for anxiety disorders (IRR 3.51 95% CI 3.18–3.89), depression (2.37; 2.03–2.77), ASD (2.36; 1.72–3.26), ADHD (2.3; 1.73–3.25), and self-harm (2.25; 1.82–2.79). The incidence for eating disorders also increased (IRR 1.3 95% CI 1.06–1.61), but less sharply. The incidence of anxiety disorders, depression, self-harm and eating disorders was in absolute terms higher in girls, whereas the opposite was true for the incidence of ADHD and ASD, which were higher among boys. The largest relative increases in incidence were observed for neurodevelopmental disorders, particularly among girls diagnosed with ADHD or ASD. However, in absolute terms, the incidence was much higher for depression and anxiety disorders. Conclusion: The number of young people seeking help for psychological distress appears to have increased in recent years. Changes to diagnostic criteria, reduced stigma, and increased awareness may partly explain our results, but we cannot rule out true increases in incidence occurring in the population. Whatever the explanation, the marked rise in demand for healthcare services means that it may be more challenging for affected young people to promptly access the care and support that they need.
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“This issue is increasingly observed in youth seeking psychiatric care [29, 45, 46].”
From Scrolling through adolescence: a systematic review of the impact of TikTok on adolescent mental health (2025) · cites this paper as [46]
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Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa
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“This issue is increasingly observed in youth seeking psychiatric care [ 29 , 45, 46].”
Metadata
- Authors
- Cybulski, L., Ashcroft, D. M., Carr, M. J., Garg, S., Chew-Graham, C. A., Kapur, N., & Webb, R. T.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Keele University (GB)
- Venue
- BMC Psychiatry
- Published
- 2021-05-03
- Volume
- 21
- Issue
- 1
- Pages
- 229-229
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC8092997
- OpenAlex
- W3159798238
- Cited by
- 170
- References
- 40
- Citations by year
- 2026: 29 · 2025: 46 · 2024: 40 · 2023: 31 · 2022: 19 · 2021: 5
- FWCI
- 16.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (acceptedVersion, cc-by)
- Keele Research Repository (Keele University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute for Health and Care Research (NIHR-INF-0701)
- Department of Health and Social Care
- Patient Safety Translational Research Centre
- 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
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- mental illness, children and adolescents, incidence trends, attention deficit hyperactivity disorder, autism spectrum disorder, depression, anxiety disorders, eating disorders, self-harm, sex differences, mental health crisis, primary care, Clinical Practice Research Datalink, neurodevelopmental disorders, incidence rate ratio, United Kingdom
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Anxiety Disorders, Child, Child, Preschool, Female, United Kingdom, Humans, Infant, Male, Incidence, Self-Injurious Behavior, Young Adult
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