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Introduction
While there have been studies of mental disorders in community settings (McConnell et al. 2002) and representative studies of general mental well-being in Northern Ireland (NI) (Department of Health and Social Services and Public Safety, 2007), we are aware of no previous report providing representative estimates of mental disorders in NI based on validated diagnostic criteria.
One of the most significant advancements in the epidemiology of mental disorders was the development of the Composite International Diagnostic Interview (CIDI) (Kessler et al. 2008) and establishment of the World Mental Health (WMH) Survey Initiative in 1998. This initiative was established to coordinate a series of epidemiological studies using standardized methods in 28 countries. The aim was to obtain valid information about: (a) the prevalence and correlates of mental disorders; (b) levels of unmet need; (c) treatment adequacy; (d) the societal burden of mental disorders. These surveys reveal that anxiety disorders was the most prevalent disorder category in 10 of 17 countries, with lifetime prevalence estimates ranging from 4.8% in China to 31% in the US. Mood disorders were the most prevalent in all other but one of the remaining countries with overall estimates ranging from 3.3% in Nigeria to 21.4% in the US (Kessler et al. 2008).
Examination of age-at-onset distributions for disorders may inform the timing of service provision and interventions. Estimates of age-at-onset distributions from WMH studies show broadly consistent results. Impulse control disorders had the earliest median age at onset and a narrow range of onset risk. For anxiety disorders, the pattern varied with disorder type while mood disorders displayed a later age-at-onset range (29-43 years). While the onset of substance use generally increased from adolescence to early adulthood, the rate of this increase varied substantially across countries (Kessler et al. 2008).
Given the impairment associated with mental disorders, early treatment-seeking following disorder onset is desirable. The National Institute of Clinical Excellence highlights the key role of the general practitioner, as the initial point of contact for the majority of individuals with mental health problems, in the identification, assessment and subsequent treatment management of individuals with mental health disorders (National Collaborating Centre for Mental Health, 2010). NI, as part...