ImportanceResearch suggests an increase in mental disorder incidence in recent years, but this trend remains unexplained, and there is a lack of large studies based on a representative sample that investigate mental disorders over the full spectrum.ObjectiveTo explore sex- and age-specific incidence of any mental disorder and 19 specific disorders according to birth cohort and calendar period.Design, Setting, and ParticipantsThis was a population-based cohort study among 5 936 202 individuals aged 1 to 80 years living in Denmark at some point between January 1, 2004, and December 31, 2021. Data were derived from the Danish Civil Registration System and analyzed from February to August 2024.ExposuresBirth cohort (8 categories from 1924 to 2011) and calendar period (six 3-year categories from 2004 to 2021).Main Outcomes and MeasuresIncidence rates of mental disorders from 2004 to 2021 by sex and age, according to birth cohort and calendar period, including the first years of the COVID-19 pandemic, using Danish health register data.ResultsThe population comprised 2 933 857 female individuals and 3 002 345 male individuals, who were followed up for 83.8 million person-years, with median ages at start and end of follow-up of 30.2 and 46.2 years, respectively. There was an overall mental disorder incidence rate of 55.27 every 10 000 person-years. For diagnoses of any mental disorder, higher incidence rates were observed for more recent birth cohorts and calendar periods in the younger ages. Over older ages, incidence rates did not vary so greatly. An increase was observed in rates of most types of mental disorders, especially among young people, and decreases for other types (eg, substance use disorders). Prominent sex differences were also observed. For example, for schizophrenia, a large increase was seen in incidence rates for female individuals in more recent birth cohorts at younger ages, but no change for male individuals, leading to a higher peak incidence for female individuals than for male individuals in the most recent periods. For personality disorders, a large increase was observed in incidence for female individuals over time and a slight decrease for male individuals.Conclusions and RelevanceThis comprehensive investigation of mental disorders incidence in Denmark indicates sex- and age-specific patterns according to birth cohorts and calendar periods. While trends may partly be explained by increases in incidence, several other factors may contribute, such as diagnostic practices, health sector capacity, and risk factors for mental disorders.

中文翻译：

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丹麦 心理健康障碍趋势 按年龄、日历周期和出生队列


重要性研究表明，近年来精神障碍的发病率有所增加，但这一趋势仍未得到解释，并且缺乏基于代表性样本的大型研究来调查所有范围的精神障碍。目的探讨任何精神障碍的性别和年龄特异性发病率，以及根据出生队列和日历周期的 19 种特定障碍。设计、设置和参与者这是一项基于人群的队列研究，对象为 5 936 202 名年龄在 2004 年 1 月 1 日至 2021 年 12 月 31 日期间居住在丹麦的 1 至 80 岁个体。数据来自丹麦民事登记系统，并于 2024 年 2 月至 8 月进行分析。主要结果和措施使用丹麦健康登记数据，根据出生队列和日历时期，包括 COVID-19 大流行的最初几年，按性别和年龄划分的 2004 年至 2021 年精神障碍发病率。结果人群包括 2 933 857 名女性和 3 002 345 名男性，随访 8380 万人年，随访开始和结束时的中位年龄分别为 30.2 岁和 46.2 岁。总体精神障碍发病率为 55.27/10 000 人年。对于任何精神障碍的诊断，在较近的出生队列和较年轻的日历期间观察到更高的发病率。在老年人中，发病率没有太大变化。观察到大多数类型精神障碍的发病率增加，尤其是在年轻人中，而其他类型的（例如，物质使用障碍）的发病率有所下降。还观察到显着的性别差异。 例如，对于精神分裂症，在较年轻的近期出生队列中，女性个体的发病率大幅增加，但男性个体没有变化，导致女性个体的发病率峰值高于最近一段时间的男性个体。对于人格障碍，随着时间的推移，女性个体的发病率大幅增加，而男性个体的发病率略有下降。结论和相关性这项对丹麦精神障碍发病率的全面调查表明，根据出生队列和日历时期，存在性别和年龄特异性模式。虽然趋势可能部分由发病率增加来解释，但其他几个因素也可能有所影响，例如诊断实践、卫生部门能力和精神障碍的危险因素。