“The idea is to really advance in research in both basic and applied neurobiology, in order to understand the underlying intimate mechanisms in the different pictures,” said Dr. Enrique De Rosa Alabaster (Getty Images).
The announcement that half the world’s population will have a psychiatric illness may seem like a catastrophic exaggeration, consistent with a series about a dystopian future. However, it is the finding, beyond the empirical perceptions that we are progressively collecting in this regard, of an international study carried out in centers in 29 countries and recently published.
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The research is titled “Age of Onset and Cumulative Risk of Mental Disorders: A Cross-National Analysis of Population Surveys from 29 Countries” and was published in The Lancet on July 30, 2023.
The object of the work was to determine the age of onset and the frequency of a predetermined group of mental illnesses throughout life and to see the evolution over time. In this way, we sought to obtain updated and improved estimates of the distributions of age at onset, lifetime prevalence, and morbid risk, all of which are of fundamental importance for public health planning.
The most frequent pathologies among women are depression, different phobias and post-traumatic stress, according to the study
In this temporary variable they add the factor of the accumulation of mental disorders and reach the conclusion that, by the age of approximately 75 years, 50% of the world population will have suffered from at least one mental illness.
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The global study was co-led by researchers at the University of Queensland, and led by Professor John McGrath of the Queensland Brain Institute and Professor Ronald Kessler of Harvard Medical School.
The analysis was carried out on surveys in several countries, over 18 to 21 years. These were community mental health epidemiological surveys, administered between 2001 and 2022. The World Health Organization (WHO) Composite International Diagnostic Interview, a fully structured psychiatric diagnostic interview, was used to assess age of onset, sex , lifetime prevalence, and morbid risk of 13 DSM-IV mental disorders up to age 75. The surveys were clustered geographically.
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In that period and among all the centers they managed to analyze a population of more than 150,000 adults (156,331) in personalized and standardized interviews. The sample was taken in 12 low-income countries and 17 medium- and high-income countries, so diversity also makes it relevant.
The most frequent pathologies among men are alcohol abuse, depression and phobias (Getty)
They excel in three areas in particular:
1. Differences according to gender
2. Most frequent pathologies
3. Ages of onset and accumulation of pathology risk
In the first case, a different prevalence of mental disorders was found between genders and depression, different phobias and post-traumatic stress (PTSD) were identified among women; while in men alcohol abuse was in first place, followed by depression and phobias.
For the second point, the experts indicated that the most frequent pathologies correspond to what other studies indicate: the increase and prevalence of major depression and anxiety.
Finally, regarding the times of life and the beginning or detection of pathologies, it was found that they arise more frequently in the stages of adolescence and youth. The age of maximum frequency of the first onset of any condition was 15 years, with a median age of onset of 19 for men and 20 for women.
The report confirmed the need for investment in mental health services with a particular focus on children, adolescents and youth
The conclusions of this study, which has purposes eminently linked to health planning, confirm, based on certain data, what we understand to be essential today and which was already pointed out, even in a recent report, by Dr. Vivek Murthy, surgeon general of the United States : the need to put mental health in its rightful place.
This report also indicates in particular the adolescent population as the most at risk. The need to raise awareness must go hand in hand with investment in both clinical and epidemiological research (as in this case) as well as basic science research. The idea is to really advance in research in both basic and applied neurobiology, in order to understand the underlying intimate mechanisms in the different pictures and get out of a stage of speculative obscurantism, but basically to better understand the functioning of our nervous system and especially the unit mind-body.
In the healthcare area, the need for investment in mental health services is evident, with a particular focus on children, adolescents and young people. We must be able to detect and treat mental disorders in their early manifestations and understand the complexity to adapt in critical stages of life, much more so in moments of intense social and cultural changes.
The study highlighted the different prevalence of mental disorders between genders and the importance of early diagnosis.
Early detection in an adequate manner can redound in benefits, as we have already pointed out, and in economic aspects for society as well. Apart from material resources, professional training and standardization of appropriate management guides for the understanding of the different tables, it is reflected in this study in which the societies studied are diverse, and even so they present similar results.
Disclosure for all types of personnel who are in contact with these age groups, such as teachers, for example, and their accompaniment, seem to be an unavoidable need. On the other hand, and we have a long way to go in our environment, it is not only necessary to administer material resources, but also legal ones that understand the reality of mental illness; without ideologies, but on the basis of data, such as those provided in this case.
In conclusion, this study will undoubtedly be referential. In addition, it points out something that should make us reflect and act accordingly: at the age of 75, approximately half of the population can expect to develop one or more of the 13 mental disorders considered in this study.
These disorders appear for the first time in childhood, adolescence, or early adulthood, but if they are not actively searched for, they very often go undetected until a clinical outbreak in adult life. The implementation of measures should give the possibility of detecting and treating common mental disorders promptly, and optimizing care that suits people at different stages of the life course.
* Dr. Enrique De Rosa Alabaster specializes in mental health issues. He is a psychiatrist, neurologist, sexologist and forensic doctor
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