Skip to main content
SpringerLink
Log in
Book cover

Age of Onset of Mental Disorders pp 125–147Cite as

The Age of Onset of Anxiety Disorders

  • Chapter
  • First Online:

  • 1434 Accesses

Abstract

Anxiety disorders are highly prevalent and debilitating psychiatric conditions, which often remain unrecognised and untreated. However, left untreated, anxiety disorders often persist and can contribute to the development of other psychiatric disorders. Therefore, early detection and subsequent intervention are important. Information on the age of onset (AOO) of anxiety disorders could be informative for the timing of prevention strategies.

The aim of this chapter is to review and quantitatively synthesise previous findings on the AOO of anxiety disorders. We extended data of a previous meta-analysis of our research group (de Lijster et al. 2017) with a literature search of studies published between October 2014 and June 2017.

Anxiety disorders in general were found to have their mean onset at 21 years, which is earlier than the average onset of mood disorders and substance use disorders. However, the age period in which anxiety disorders develops is relatively broad. Separation anxiety disorder, specific phobia and social phobia have their onset in childhood and adolescence, whereas agoraphobia, obsessive–compulsive disorder, post-traumatic stress disorder and panic disorder have their onset in early adulthood. Generalised anxiety disorder had the latest mean onset at almost 35 years.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Ajdacic-Gross V, Aleksandrowicz A, Rodgers S, Muller M, Kawohl W, Rossler W, et al. Social phobia is associated with delayed onset of chickenpox, measles, and mumps infections. Front Psychiatry. 2016;7:203.

    Article  Google Scholar 

  • Albert U, Manchia M, Tortorella A, Volpe U, Rosso G, Carpiniello B, et al. Admixture analysis of age at symptom onset and age at disorder onset in a large sample of patients with obsessive-compulsive disorder. J Affect Disord. 2015;187:188–96.

    Article  Google Scholar 

  • Alhasnawi S, Sadik S, Rasheed M, Baban A, Al-Alak MM, Othman AY, et al. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS). World Psychiatry. 2009;8(2):97–109.

    PubMed  PubMed Central  Google Scholar 

  • Angst J, Gamma A, Endrass J, et al. Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course. Eur Arch Psychiatry Clin Neurosci. 2004;254(3):156–64.

    Article  Google Scholar 

  • Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Degenhardt L, Whiteford HA. The global burden of mental and substance use disorders: changes in estimating burden between GBD1990 and GBD2010. Epidemiol Psychiatr Sci. 2014;23(3):239–49.

    Article  CAS  Google Scholar 

  • Becker ES, Rinck M, Turke V, Kause P, Goodwin R, Neumer S, et al. Epidemiology of specific phobia subtypes: findings from the Dresden Mental Health Study. Eur Psychiatry. 2007;22(2):69–74.

    Article  Google Scholar 

  • Bienvenu OJ, Onyike CU, Stein MB, Chen LS, Samuels J, Nestadt G, et al. Agoraphobia in adults: incidence and longitudinal relationship with panic. Br J Psychiatry. 2006;188:432–8.

    Article  Google Scholar 

  • Bittner A, Goodwin RD, Wittchen HU, Beesdo K, Höfler M, Lieb R. What characteristics of primary anxiety disorders predict subsequent major depressive disorder. J Clin Psychiatry. 2004;65:618–26.

    Article  Google Scholar 

  • Bonnewyn A, Bruffaerts R, Vilagut G, Almansa J, Demyttenaere K. Lifetime risk and age-of-onset of mental disorders in the Belgian general population. Soc Psychiatry Psychiatr Epidemiol. 2007;42(7):522–9.

    Article  Google Scholar 

  • Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive meta-analysis version 2. Engelwood: Biostat; 2005.

    Google Scholar 

  • Broeren S, Muris P. The relation between cognitive development and anxiety phenomena in children. J Child Fam Stud. 2009;18:702–9.

    Article  Google Scholar 

  • Caraveo-Anduaga JJ, Colmenares Bermudez E. The epidemiology of obsessive-compulsive disorder in Mexico City. Salud Ment. 2004;27(2):1–6.

    Google Scholar 

  • Chapman C, Mills K, Slade T, et al. Remission from posttraumatic stress disorder in the general population. Psychol Med. 2012;42(8):1695–703.

    Article  CAS  Google Scholar 

  • Chartier MJ, Walker JR, Stein MB. Considering comorbidity in social phobia. Soc Psychiatry Psychiatr Epidemiol. 2003;38(12):728–34.

    Article  Google Scholar 

  • Cho MJ, Chang SM, Hahm BJ, Chung IW, Bae A, Lee YM, et al. Lifetime risk and age of onset distributions of psychiatric disorders: analysis of national sample survey in South Korea. Soc Psychiatry Psychiatr Epidemiol. 2012;47(5):671–81.

    Article  Google Scholar 

  • Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2006;67(2):247–57.

    Article  CAS  Google Scholar 

  • Dadds MR, Spence SH, Holland DE, Barrett PM, Laurens KR. Prevention and early intervention for anxiety disorders: a controlled trial. J Consult Clin Psychol. 1997;65(4):627–35.

    Article  CAS  Google Scholar 

  • de Jonge P, Roest AM, Lim CCW, Florescu SE, Bromet EJ, Stein DJ, et al. Cross-national epidemiology of panic disorder and panic attacks in the World Mental Health surveys. Depress Anxiety. 2016;33(12):1155–77.

    Article  Google Scholar 

  • de Lijster JM, Dierckx B, Utens EM, Verhulst FC, Zieldorff C, Dieleman GC, et al. The age of onset of anxiety disorders: a meta-analysis. Can J Psychiatry. 2017;62(4):237–46.

    Article  Google Scholar 

  • de Lijster J, Dieleman GC, Utens EMWJ, Dierckx B, Wierenga M, Verhulst FC, et al. Social and academic functioning in adolescents with anxiety disorders: a systematic review. J Affect Disord. 2018;230:108–17.

    Article  Google Scholar 

  • Essau CA, Lewinsohn PM, Olaya B, Seeley JR. Anxiety disorders in adolescents and psychosocial outcomes at age 30. J Affect Disord. 2014;163:125–32.

    Article  Google Scholar 

  • Falk DE, Yi H-Y, Hilton ME. Age of onset and temporal sequencing of lifetime DSM-IV alcohol use disorders relative to comorbid mood and anxiety disorders. Drug Alcohol Depend. 2008;94(1–3):234–45.

    Article  Google Scholar 

  • Gau SSF, Chong MY, Yang PC, Yen CF, Liang KY, Cheng ATA. Psychiatric and psychosocial predictors of substance use disorders among adolescents—longitudinal study. Br J Psychiatry. 2007;190:42–8.

    Article  Google Scholar 

  • Giaconia RM, Reinherz HZ, Silverman AB, Pakiz B, Frost AK, Cohen E. Ages of onset of psychiatric-disorders in a community population of older adolescents. J Am Acad Child Adolesc Psychiatry. 1994;33(5):706–17.

    Article  CAS  Google Scholar 

  • Goncalves DC, Pachana NA, Byrne GJ. Prevalence and correlates of generalized anxiety disorder among older adults in the Australian National Survey of Mental Health and Well-Being. J Affect Disord. 2011;132(1–2):223–30.

    Article  Google Scholar 

  • Goncalves DC, Byrne GJ. Sooner or later: age at onset of generalized anxiety disorder in older adults. Depress Anxiety. 2012;29(1):39–46.

    Article  Google Scholar 

  • Goodwin RD, Stein DJ. Anxiety disorders and drug dependence: evidence on sequence and specificity among adults. Psychiatry Clin Neurosci. 2013;67(3):167–73.

    Article  Google Scholar 

  • Gureje O, Uwakwe R, Udofia O, Wakil A, Adeyemi O, Enyidah N. Common psychiatric disorders over a lifetime: age of onset, risk and treatment contact in the Nigerian survey of mental health and wellbeing. Afr J Med Med Sci. 2008;37(3):207–17.

    CAS  PubMed  Google Scholar 

  • Hettema JM, Prescott CA, Myers JM, Neale MC, Kendler KS. The structure of genetic and environmental risk factors for anxiety disorders in men and women. Arch Gen Psychiatry. 2005;62:182–9.

    Article  Google Scholar 

  • Hoehnsaric R, Hazlett RL, Mcleod DR. Generalized anxiety disorder with early and late-onset of anxiety symptoms. Compr Psychiatry. 1993;34(5):291–8.

    Article  CAS  Google Scholar 

  • Hyland P, Shevlin M, Elklit A, Christoffersen M, Murphy J. Social, familial and psychological risk factors for mood and anxiety disorders in childhood and early adulthood: a birth cohort study using the Danish Registry System. Soc Psychiatry Psychiatr Epidemiol. 2016;51(3):331–8.

    Article  Google Scholar 

  • Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.

    Article  Google Scholar 

  • Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359–64.

    Article  Google Scholar 

  • Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009;18(1):23–33.

    Article  Google Scholar 

  • Knappe S, Beesdo-Baum K, Lieb R, Wittchen HU. Specificity of family risk-factors for the onset and course of social phobia. Eur Neuropsychopharmacol. 2011;21:S532–3.

    Article  Google Scholar 

  • Lauber C, Rössler W. Stigma towards people with mental illness in developing countries in Asia. Int Rev Psychiatry. 2007;19:157–78.

    Article  Google Scholar 

  • Lee S, Tsang A, Zhang MY, Huang YQ, He YL, Liu ZR, et al. Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China. Psychol Med. 2007;37(1):61–71.

    Article  Google Scholar 

  • Levinson D, Zilber N, Lerner Y, Grinshpoon A, Levav I. Prevalence of mood and anxiety disorders in the community: results from the Israel National Health Survey. Isr J Psychiatry Relat Sci. 2007;44(2):94–103.

    PubMed  Google Scholar 

  • Lewinsohn PM, Gotlib IH, Lewinsohn M, Seeley JR, Allen NB. Gender differences in anxiety disorders and anxiety symptoms in adolescents. J Abnorm Psychol. 1998;107(1):109–17.

    Article  CAS  Google Scholar 

  • Li SH, Graham BM. Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Lancet Psychiatry. 2017;4:73–82.

    Article  Google Scholar 

  • Lim SW, Ha J, Shin YC, Shin DW, Bae SM, Oh KS. Clinical differences between early- and late-onset social anxiety disorders. Early Interv Psychiatry. 2013;7(1):44–50.

    Article  Google Scholar 

  • Marquenie LA, Schade A, van Balkom AJLM, et al. Origin of the comorbidity of anxiety disorders and alcohol dependence: findings of a general population study. Eur Addict Res. 2007;13(1):39–49.

    Article  Google Scholar 

  • McGorry PD, Purcell R, Goldstone S, Amminger GP. Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Curr Opin Psychiatry. 2011;24(4):301–6.

    Article  Google Scholar 

  • McLean CP, Anderson ER. Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev. 2009;29:496–505.

    Article  Google Scholar 

  • McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45(8):1027–35.

    Article  Google Scholar 

  • Olatunji BO, Cisler JM, Tolin DF. Quality of life in the anxiety disorders: a meta-analytic review. Clin Psychol Rev. 2007;27(5):572–81.

    Article  Google Scholar 

  • Oram S, Khalifeh H, Howard LM. Violence against women and mental health. Lancet Psychiatry. 2017;4:159–70.

    Article  Google Scholar 

  • Ramsawh HJ, Weisberg RB, Dyck I, Stout R, Keller MB. Age of onset, clinical characteristics, and 15-year course of anxiety disorders in a prospective, longitudinal, observational study. J Affect Disord. 2011;132(1–2):260–4.

    Article  Google Scholar 

  • Rapee RM, Kennedy S, Ingram M, Edwards S, Sweeney L. Prevention and early intervention of anxiety disorders in inhibited preschool children. J Consult Clin Psychol. 2005;73(3):488–97.

    Article  Google Scholar 

  • Reardon LE, Leen-Feldner EW, Hayward C. Clin Psychol Rev. 2009;29:1–23.

    Article  Google Scholar 

  • Remes O, Brayne C, van der Linde R, Lafortune L. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain Behav. 2016;6:e00487.

    Article  Google Scholar 

  • Rhebergen D, Aderka IM, van der Steenstraten IM, van Balkom A, van Oppen P, Stek ML, et al. Admixture analysis of age of onset in generalized anxiety disorder. J Anxiety Disord. 2017;50:47–51.

    Article  Google Scholar 

  • Riecher-Rössler A. Sex and gender differences in mental disorders. Lancet Psychiatry. 2017;4:8–9.

    Article  Google Scholar 

  • Ritchie K, Artero S, Beluche I, Ancelin ML, Mann A, Dupuy AM, et al. Prevalence of DSM-IV psychiatric disorder in the French elderly population. Br J Psychiatry. 2004;184:147–52.

    Article  CAS  Google Scholar 

  • Rosellini AJ, Rutter LA, Bourgeois ML, Emmert-Aronson BO, Brown TA. The relevance of age of onset to the psychopathology of social phobia. J Psychopathol Behav Assess. 2013;35(3):356–65.

    Article  Google Scholar 

  • Sareen J, Cox BJ, Afifi TO, de Graaf R, Asmundson GJG, ten Have M, et al. Anxiety disorders and risk for suicidal ideation and suicide attempts—a population-based longitudinal study of adults. Arch Gen Psychiatry. 2005;62(11):1249–57.

    Article  Google Scholar 

  • Sihvo S, Hamalainen J, Kiviruusu O, Pirkola S, Isometsa E. Treatment of anxiety disorders in the Finnish general population. J Affect Disord. 2006;96(1–2):31–8.

    Article  Google Scholar 

  • Simon GE, Vonkorff M. Recall of psychiatric history in cross-sectional surveys—implications for epidemiologic research. Epidemiol Rev. 1995;17(1):221–7.

    Article  CAS  Google Scholar 

  • Stein DJ, Seedat S, Herman A, Moomal H, Heeringa SG, Kessler RC, et al. Lifetime prevalence of psychiatric disorders in South Africa. Br J Psychiatry. 2008;192(2):112–7.

    Article  Google Scholar 

  • Steinhausen HC, Jakobsen H, Meyer A, Jorgensen PM, Lieb R. Family aggregation and risk factors in phobic disorders over three-generations in a nation-wide study. PLoS One. 2016;11(1):e0146591.

    Article  Google Scholar 

  • Swendsen J, Conway KP, Degenhardt L, Glantz M, Jin R, Merikangas KR, et al. Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction. 2010;105(6):1117–28.

    Article  Google Scholar 

  • Tibi L, van Oppen P, Aderka IM, van Balkom AJ, Batelaan NM, Spinhoven P, et al. An admixture analysis of age of onset in agoraphobia. J Affect Disord. 2015;180:112–5.

    Article  Google Scholar 

  • Vaingankar JA, Rekhi G, Subramaniam M, Abdin E, Chong SA. Age of onset of life-time mental disorders and treatment contact. Soc Psychiatry Psychiatr Epidemiol. 2013;48(5):835–43.

    Article  Google Scholar 

  • Viana MC, Andrade LH. Lifetime Prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the Sao Paulo Metropolitan Area, Brazil: results from the Sao Paulo Megacity Mental Health Survey. Rev Bras Psiquiatr. 2012;34(3):249–60.

    Article  Google Scholar 

  • Wan X, Wang W, Liu J, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014;14(1):135.

    Article  Google Scholar 

  • Werner-Seidler A, Perry Y, Calear AL, Newby JM, Christensen H. School-based depression and anxiety prevention programs for young people: a systematic review and meta-analysis. Clin Psychol Rev. 2017;51:30–47.

    Article  Google Scholar 

  • Wittchen HU. Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety. 2002;16(4):162–71.

    Article  Google Scholar 

  • Wittchen HU, Stein MB, Kessler RC. Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychol Med. 1999;29(2):309–23.

    Article  CAS  Google Scholar 

  • Zarger MM, Rich BA. Predictors of treatment utilization among adolescents with social anxiety disorder. Child Youth Serv Rev. 2016;71:191–8.

    Article  Google Scholar 

  • Zbozinek TD, Rose RD, Wollitzky-Taylor KB, Sherbourne C, Sullivan G, Stein MB, et al. Diagnostic overlap in generalized anxiety disorder and major depressive disorder on a primary care sample. Depress Anxiety. 2012;29:1065–71.

    Article  Google Scholar 

  • Zhang X, Norton J, Carriere I, Ritchie K, Chaudieu I, Ancelin ML. Risk factors for late-onset generalized anxiety disorder: results from a 12-year prospective cohort (the ESPRIT study). Transl Psychiatry. 2015;5:e536.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC—Sophia Children’s Hospital, Rotterdam, The Netherlands

    Jeroen S. Legerstee, Bram Dierckx, Elisabeth M. W. J. Utens, Frank C. Verhulst, Carola Zieldorff, Gwen C. Dieleman & Jasmijn M. de Lijster

  2. Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands

    Elisabeth M. W. J. Utens

  3. Academic Center for Child Psychiatry the Bascule/Department Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, The Netherlands

    Elisabeth M. W. J. Utens

  4. Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark/Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University Hospital/University of Copenhagen, Copenhagen, Denmark

    Frank C. Verhulst

Authors
  1. Jeroen S. Legerstee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bram Dierckx
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elisabeth M. W. J. Utens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Frank C. Verhulst
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carola Zieldorff
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gwen C. Dieleman
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jasmijn M. de Lijster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeroen S. Legerstee .

Editor information

Editors and Affiliations

  1. Unit of Psychiatric Epidemiology and Evaluation, IRCCS St John of God Clinical Research Center, Brescia, Italy

    Giovanni de Girolamo

  2. Orygen The National Centre of Excellence, University of Melbourne, Victoria, Australia

    Patrick D. McGorry

  3. Association for the Improvement of Mental Health Programmes, Geneva, Switzerland

    Norman Sartorius

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Legerstee, J.S. et al. (2019). The Age of Onset of Anxiety Disorders. In: de Girolamo, G., McGorry, P., Sartorius, N. (eds) Age of Onset of Mental Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-72619-9_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72619-9_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72618-2

  • Online ISBN: 978-3-319-72619-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation