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Original Investigation
May 2014

A Comprehensive Nationwide Study of the Incidence Rate and Lifetime Risk for Treated Mental Disorders

Author Affiliations
  • 1National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
  • 2Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
  • 3The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
  • 4Research Department P, Aarhus University Hospital, Risskov, Denmark
  • 5Queensland Brain Institute, The University of Queensland, St Lucia, Australia
  • 6Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Richlands, Australia
  • 7Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Psychiatry. 2014;71(5):573-581. doi:10.1001/jamapsychiatry.2014.16

Importance  Understanding the epidemiologic profile of the life course of mental disorders is fundamental for research and planning for health care. Although previous studies have used population surveys, informative and complementary estimates can be derived from population-based registers.

Objective  To derive comprehensive and precise estimates of the incidence rate of and lifetime risk for any mental disorder and a range of specific mental disorders.

Design, Setting, and Participants  We conducted a follow-up study of all Danish residents (5.6 million persons), to whom all treatment is provided by the government health care system without charge to the patient, from January 1, 2000, through December 31, 2012 (total follow-up, 59.5 million person-years). During the study period, 320 543 persons received first lifetime treatment in a psychiatric setting for any mental disorder; 489 006 persons were censored owing to death; and 69 987 persons were censored owing to emigration. Specific categories of mental disorders investigated included organic mental disorders, substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, personality disorders, mental retardation, pervasive developmental disorders, and behavioral and emotional disorders.

Exposures  Age and sex.

Main Outcomes and Measures  Sex- and age-specific incidence rates and cumulative incidences and sex-specific lifetime risks.

Results  During the course of life, 37.66% of females (95% CI, 37.52%-37.80%) and 32.05% of males (31.91%-32.19%) received their first treatment in a psychiatric setting for any mental disorder. The occurrence of mental disorders varied markedly between diagnostic categories and by sex and age. The sex- and age-specific incidence rates for many mental disorders had a single peak incidence rate during the second and third decades of life. Some disorders had a second peak in the sex- and age-specific incidence rate later in life.

Conclusions and Relevance  This nationwide study provides a first comprehensive assessment of the lifetime risks for treated mental disorders. Approximately one-third of the Danish population received treatment for mental disorders. The distinct signatures of the different mental disorders with respect to sex and age have important implications for service planning and etiologic research.