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However, the range and peak ages at onset for mental disorders are not fully established. To provide robust, global epidemiological estimates of age at onset for mental disorders, we conducted a PRISMA\/MOOSE-compliant systematic review with meta-analysis of birth cohort\/cross-sectional\/cohort studies, representative of the general population, reporting age at onset for any ICD\/DSM-mental disorders, identified in PubMed\/Web of Science (up to 16\/05\/2020) (PROSPERO:CRD42019143015). Co-primary outcomes were the proportion of individuals with onset of mental disorders before age 14, 18, 25, and peak age at onset, for any mental disorder and across International\u00a0Classification of\u00a0Diseases\u00a011 diagnostic\u00a0blocks.\u00a0Median age at onset of\u00a0specific\u00a0disorders was additionally investigated.\u00a0Across 192 studies (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009708,561)\u00a0included, the proportion of individuals with onset of any mental disorders before the\u00a0ages of\u00a014, 18, 25\u00a0were 34.6%, 48.4%, 62.5%, and peak age was\u00a014.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200914, median\u2009=\u200918, interquartile range (IQR)\u2009=\u200911\u201334). For diagnostic blocks, the proportion of individuals with onset of disorder before the age of 14, 18, 25 and peak age were as follows: neurodevelopmental disorders: 61.5%, 83.2%, 95.8%, 5.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200921, median=12, IQR\u2009=\u20097\u201316), anxiety\/fear-related disorders: 38.1%, 51.8%, 73.3%, 5.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200973, median\u2009=\u200917, IQR\u2009=\u20099\u201325), obsessive-compulsive\/related disorders: 24.6%, 45.1%, 64.0%, 14.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200920, median\u2009=\u200919, IQR\u2009=\u200914\u201329), feeding\/eating disorders\/problems: 15.8%, 48.1%, 82.4%, 15.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200911, median\u2009=\u200918, IQR\u2009=\u200915\u201323), conditions specifically associated with stress disorders: 16.9%, 27.6%, 43.1%, 15.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200916, median\u2009=\u200930, IQR\u2009=\u200917\u201348), substance use disorders\/addictive behaviours: 2.9%, 15.2%, 48.8%, 19.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200958, median\u2009=\u200925, IQR\u2009=\u200920\u201341), schizophrenia-spectrum disorders\/primary psychotic states: 3%, 12.3%, 47.8%, 20.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200936, median\u2009=\u200925, IQR\u2009=\u200920\u201334), personality disorders\/related traits: 1.9%, 9.6%, 47.7%, 20.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u20096, median\u2009=\u200925, IQR\u2009=\u200920\u201333), and mood disorders: 2.5%, 11.5%, 34.5%, 20.5 years (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200979, median\u2009=\u200931, IQR\u2009=\u200921\u201346). No significant difference emerged by sex, or definition of age of onset. Median age at onset for specific mental disorders\u00a0mapped\u00a0on a time continuum, from phobias\/separation anxiety\/autism spectrum disorder\/attention deficit hyperactivity disorder\/social anxiety (8-13 years) to anorexia nervosa\/bulimia nervosa\/obsessive-compulsive\/binge eating\/cannabis use disorders\u00a0(17-22 years), followed by schizophrenia, personality, panic and\u00a0alcohol use disorders\u00a0(25-27 years), and finally\u00a0post-traumatic\/depressive\/generalized anxiety\/bipolar\/acute and transient psychotic disorders (30-35 years), with overlap among groups and no\u00a0significant clustering. These results inform the timing of good mental health promotion\/preventive\/early intervention, updating the current mental health system structured around a child\/adult service schism at age 18.\n                  <\/jats:p>","DOI":"10.1038\/s41380-021-01161-7","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T05:06:08Z","timestamp":1622610368000},"page":"281-295","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3607,"title":["Age at onset of mental disorders worldwide: large-scale meta-analysis of\u00a0192 epidemiological studies"],"prefix":"10.1038","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4877-7233","authenticated-orcid":false,"given":"Marco","family":"Solmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Radua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Olivola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Croce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6735-0561","authenticated-orcid":false,"given":"Livia","family":"Soardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Salazar de Pablo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae","family":"Il Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3401-0824","authenticated-orcid":false,"given":"James B.","family":"Kirkbride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0387-880X","authenticated-orcid":false,"given":"Peter","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Han","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Yeob","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e8 F.","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6797-3382","authenticated-orcid":false,"given":"Mary V.","family":"Seeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph U.","family":"Correll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-6788","authenticated-orcid":false,"given":"Paolo","family":"Fusar-Poli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"1161_CR1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/S2215-0366(17)30078-0","volume":"4","author":"C Hjorth\u00f8j","year":"2017","unstructured":"Hjorth\u00f8j C, St\u00fcrup AE, McGrath JJ, Nordentoft M. 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