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Early age of onset of mood, anxiety and alcohol use disorders is associated with sociodemographic characteristics and health outcomes in adults: results from a cross-sectional national survey

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Abstract

Purpose

This cross-sectional study investigated distribution, sociodemographic correlates, and health outcomes in early versus late age of onset (AOO) of mood, anxiety, and alcohol use disorders in Singapore.

Methods

The Composite International Diagnostic Interview established lifetime diagnoses of major depressive, bipolar, generalized anxiety, obsessive compulsive and alcohol use disorders in a representative sample of residents aged 18 years and over (n = 6126). The AOO of the individual and any mental disorders were classified into early and late onset using median values as cut-offs. Data included socio-demographic and health background, health utility score, and productivity losses. Multivariable logistic regression analysis was conducted to assess sociodemographic correlates of early versus late AOO of any mental disorder while linear regression analysis investigated the associations between AOO of individual disorders with health utility score and productivity loss.

Results

Respondents’ mean (SD) age was 45.6 (16.5) years, comprising 50.5% women and majority of Chinese ethnicity (75.8%). The median AOO for any of the five studied disorders was 21 years (IQR: 15–29). Lowest AOO was observed for obsessive compulsive disorder (Median: 14, IQR: 11–26). Those aged 35 years and over (versus 18–34) were less likely to have earlier AOO [35–49 years (OR: 0.287; 95% CI: 0.154–0.534); 50–64 years (OR:0.156; 95% CI: 0.068–0.361) and 65 and over (OR:0.112; 95% CI:0.027–0.461)], while Malay ethnicity (versus Chinese) (OR: 2.319; 95% CI: 1.384–3.885) and being never married (versus married) (OR: 2.731; 95% CI: 1.493–4.993) were more likely to have early AOO for any mental disorder. Sample with early (versus late) AOO had a lower health utility score (β =  − 0.06,95% CI: − 0.08 to − 0.03) and higher number of days cut down on the type of work (β = 1.61,95% CI: 0.12–3.10) in those with any mental disorders.

Conclusion

This study showed that half of the adults with mood, anxiety or alcohol use disorders in Singapore experienced their illness onset by 21 years of age. Early AOO is associated with sociodemographic background and poor health outcomes. Prevention, early detection, and interventions to improve health outcomes in mental disorders should consider the sociodemographic profile and age at first onset of symptoms in the population.

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Data availability

Study data and materials are not available due to funding guidelines. However, part of the data/aggregate data can be available upon reasonable request from the corresponding author.

Code availability

These are available from the corresponding author upon reasonable request.

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Funding

The study was funded by the Ministry of Health Singapore and Temasek Foundation.

Author information

Authors and Affiliations

  1. Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore

    Janhavi Ajit Vaingankar, Siow Ann Chong, Edimansyah Abdin, Saleha Shafie, Boon Yiang Chua, Shazana Shahwan & Mythily Subramaniam

  2. Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore

    Swapna Verma

  3. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore

    Swapna Verma

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  1. Janhavi Ajit Vaingankar
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Correspondence to Janhavi Ajit Vaingankar.

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Authors do not have any competing or conflicts of interest to declare.

Ethical standards

The study was approved by the National Healthcare Group’s Domain Specific Review Board and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Relevant national laws on research on human research subjects have been observed.

Informed consent

Written informed consent was obtained from all respondents and their parents or legal guardians for those aged under 21 years.

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Vaingankar, J.A., Chong, S.A., Abdin, E. et al. Early age of onset of mood, anxiety and alcohol use disorders is associated with sociodemographic characteristics and health outcomes in adults: results from a cross-sectional national survey. Soc Psychiatry Psychiatr Epidemiol 56, 1835–1846 (2021). https://doi.org/10.1007/s00127-021-02070-4

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