Lukasz Cybulski1,2, Darren M Ashcroft3,4, Matthew J Carr3,4, Shruti Garg5, Carolyn A Chew-Graham6, Nav Kapur7,3,8, Roger T Webb7,3. 1. Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, M13 9PL, UK. lukeznder@gmail.com. 2. NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK. lukeznder@gmail.com. 3. NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK. 4. Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. 5. Neuroscience & Experimental Psychology, Manchester Academic Health Science Centre, University of Manchester and Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation, Manchester, UK. 6. School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffs, ST5 5BG, UK. 7. Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, M13 9PL, UK. 8. Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
Abstract
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.
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.
Authors: S Skurtveit; J G Bramness; V Hjellvik; I Hartz; R Nesvåg; L J Hauge; M Handal Journal: Acta Psychiatr Scand Date: 2018-04-05 Impact factor: 6.392
Authors: K Kosidou; C Magnusson; E Mittendorfer-Rutz; J Hallqvist; C Hellner Gumpert; S Idrizbegovic; H Dal; C Dalman Journal: Acta Psychiatr Scand Date: 2009-10-13 Impact factor: 6.392
Authors: Jane Sarginson; Roger T Webb; S Jill Stocks; Aneez Esmail; Shruti Garg; Darren M Ashcroft Journal: J Affect Disord Date: 2017-01-02 Impact factor: 4.839
Authors: A John; A L Marchant; J I McGregor; J O A Tan; H A Hutchings; V Kovess; S Choppin; J Macleod; M S Dennis; K Lloyd Journal: J Affect Disord Date: 2015-05-12 Impact factor: 4.839
Authors: Tyra Lagerberg; Y Molero; B M D'Onofrio; L Fernández de la Cruz; P Lichtenstein; D Mataix-Cols; C Rück; C Hellner; Z Chang Journal: Eur Child Adolesc Psychiatry Date: 2019-01-19 Impact factor: 4.785
Authors: Evangelos Kontopantelis; Mamas A Mamas; Harm van Marwijk; Iain Buchan; Andrew M Ryan; Tim Doran Journal: J Epidemiol Community Health Date: 2018-03-19 Impact factor: 3.710
Authors: Louise Birrell; Ainsley Furneaux-Bate; Jennifer Debenham; Sophia Spallek; Nicola Newton; Catherine Chapman Journal: JMIR Form Res Date: 2022-05-27
Authors: Leire Leache; Olast Arrizibita; Marta Gutiérrez-Valencia; Luis Carlos Saiz; Juan Erviti; Julián Librero Journal: Int J Environ Res Public Health Date: 2021-08-31 Impact factor: 3.390