Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study

作者：Avshalom Caspi, Renate Houts, Antony Ambler, Andrea Danese, Maxwell L. Elliott, Ahmad R. Hariri, HonaLee Harrington, Sean Hogan, Richie Poulton, Sandhya Ramrakha, Line Jee Hartmann Rasmussen, Aaron Reuben, Leah S. Richmond‐Rakerd, Karen Sugden, Jasmin Wertz, Benjamin Williams, Terrie E. Moffitt · 发表于：JAMA Network Open · 年份：2020 · DOI：10.1001/jamanetworkopen.2020.3221 · 被引用次数：662 · 研究领域：Mental Health Treatment and Access、Treatment of Major Depression、Digital Mental Health Interventions

Importance: Mental health professionals typically encounter patients at 1 point in patients' lives. This cross-sectional window understandably fosters focus on the current presenting diagnosis. Research programs, treatment protocols, specialist clinics, and specialist journals are oriented to presenting diagnoses, on the assumption that diagnosis informs about causes and prognosis. This study tests an alternative hypothesis: people with mental disorders experience many different kinds of disorders across diagnostic families, when followed for 4 decades. Objective: To describe mental disorder life histories across the first half of the life course. Design, Setting, and Participants: This cohort study involved participants born in New Zealand from 1972 to 1973 who were enrolled in the population-representative Dunedin Study. Participants were observed from birth to age 45 years (until April 2019). Data were analyzed from May 2019 to January 2020. Main Outcomes and Measures: Diagnosed impairing disorders were assessed 9 times from ages 11 to 45 years. Brain function was assessed through neurocognitive examinations conducted at age 3 years, neuropsychological testing during childhood and adulthood, and midlife neuroimaging-based brain age. Results: Of 1037 original participants (535 male [51.6%]), 1013 had mental health data available. The proportions of participants meeting the criteria for a mental disorder were as follows: 35% (346 of 975) at ages 11 to 15 years, 50% (473 of 9...