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Incidence of psychiatric disorders on the rise among Finnish teens

The overall incidence of psychiatric and neurodevelopmental disorders increased by 5.2% from 1987 to 1997 among adolescent girls, and by 2.6% among adolescent boys, according to data from two national birth cohorts in Finland.

“According to a 2015 review, diagnosis and treatment of a wide range of psychiatric and neurodevelopmental disorders have been increasing among adolescents in several high-income countries,” David Gyllenberg, MD, from the Research Centre for Child Psychiatry, University of Turku, Finland, and colleagues wrote. “To reduce the burden associated with adolescent psychiatric and neurodevelopmental disorders, optimal allocation of services is of high importance.”

Using data from two national cohorts born in 1987 and 1997, researchers examined the absolute and relative temporal changes in use of specialized services for psychiatric and neurodevelopmental diagnoses among Finnish adolescents. They compared the nationwide register-based incidence of specialized service use for any psychiatric or neurodevelopmental disorder, and for 17 specific diagnostic classes, among adolescents aged between 12 and 18 years. Researchers also examined whether adolescents who died by suicide had accessed specialized services before their deaths.

The analyses included 29,240 teens from the 1987 cohort and 29,884 from the 1997 cohort. The results showed that the incidence of psychiatric or neurodevelopmental disorders increased from 9.8 in 1987 to 14.9 in 1997 (difference 5.2 percentage points; 95% CI = 4.8-5.5) among teenaged girls, and from 6.2 to 8.8 (2.6 percentage points; 95% CI = 2.4-2.9) among teenaged boys. The adjusted HR for the relative increase of any neurodevelopment and psychiatric disorders in the 1997 group vs. the 1987 group was 1.6 (95% CI = 1.5-1.8) among girls and 1.5 (95% CI = 1.4-1.6) among boys. Significant relative increases occurred for 10 of 17 specific diagnostic classes among girls and 11 among boys (P < .001).

Notably, more participants in the 1997 cohort accessed specialized services. In the 1987 cohort, 1,383 girls used outpatient or inpatient specialized services for any psychiatric or neurodevelopmental disorder during follow-up, compared with 2,198 in the 1997 cohort. Among boys, the numbers were 908 in the 1987 cohort and 1,306 in the 1997 cohort. Of 16 adolescents in the 1987 cohort and 12 in the 1997 cohort who committed suicide, only 5 in the first cohort and 2 in the second used specialized services for psychiatric disorders 6 months prior to death.

“The large absolute increase in diagnosed psychiatric and neurodevelopmental disorders in specialized services will necessitate the allocation of financial resources to services to ensure adequate treatment,” Gyllenberg and colleagues wrote. “The increased number of adolescents with depression and anxiety disorders poses a challenge, because psychotherapy is the first-line treatment, and the availability of therapists is limited. Identification of adolescents at risk of suicide remains a challenge for suicide prevention.”

These findings highlight the fact that only some children who need access to mental health services receive support, and resources should adapt to provide patient-centered care, according to a related comment published in The Lancet Psychiatry by Marie Korhonen, MD, from Tampere University, Finland, and Laura Korhonen, MD, PhD, from University of Helsinki, Finland.

“The challenge is to fit supply with demand. Not everyone who needs support can be cared for in specialized health care, which emphasizes the need for other measures, such as early-access services,” they wrote. “Every effort should be made to disseminate community-based preventive interventions like those described for early behavior problems. Additionally, digital services ... could be flexible, feasible, and cost-effective alternatives.” – by Savannah Demko

Disclosures: Gyllenberg and colleagues report no relevant financial disclosures. Marie Korhonen reports grant support from Lastentautien tutkimussäätiö.