Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles

Epidemiol Psychiatr Sci. 2012 Mar;21(1):47-57. doi: 10.1017/s2045796011000746.

Abstract

Purpose of review: In this review, we provide an update of recent studies on the age of onset (AOO) of the major mental disorders, with a special focus on the availability and use of services providing prevention and early intervention.

Recent findings: The studies reviewed here confirm previous reports on the AOO of the major mental disorders. Although the behaviour disorders and specific anxiety disorders emerge during childhood, most of the high-prevalence disorders (mood, anxiety and substance use) emerge during adolescence and early adulthood, as do the psychotic disorders. Early AOO has been shown to be associated with a longer duration of untreated illness, and poorer clinical and functional outcomes.

Summary: Although the onset of most mental disorders usually occurs during the first three decades of life, effective treatment is typically not initiated until a number of years later. There is increasing evidence that intervention during the early stages of disorder may help reduce the severity and/or the persistence of the initial or primary disorder, and prevent secondary disorders. However, additional research is needed on effective interventions in early-stage cases, as well as on the long-term effects of early intervention, and for an appropriate service design for those with emerging mental disorders. This will mean not only the strengthening and re-engineering of existing systems, but is also crucial the construction of new streams of care for young people in transition to adulthood.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Age of Onset
  • Aged
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / therapy
  • Child
  • Cross-Sectional Studies
  • Early Medical Intervention
  • Female
  • Follow-Up Studies
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / therapy
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / therapy
  • Risk Factors
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / therapy
  • Young Adult