Changes in depression, anxiety and stress over two decades

The research for the NIHR School for Public Health Research (SPHR), a partnership between nine leading centres of academic public health research excellence across England, was completed as part of SPHR’s public mental health programme. 

The findings published in Psychological Medicine found that by the end of the study period, these common mental disorders accounted for 12.5% of sick leave in the UK. 

The analysis included more than 29 million (29,480,164) individuals in the UK followed for an average of 12.5 years. Data from 2,248 general practices was used from 2000–2020. In total, the data accounted for 237,123,186 years of people’s lives (or ‘person years’).

Overall, the incidence of common mental disorders increased between 2000–2019 from 55.9 to 76.9 per 1,000 person years.

Within this, important differences were seen by age with rates more than doubling in 16–24-year-olds. 

Dr Jen Dykxhoorn, lead author on the study from UCL’s Division of Psychiatry, says:

“This large study describes the increase in common mental disorders identified in primary care over the past 20 years. While the rates of common mental disorders increased overall, we found important differences between population groups. These patterns show increasing rates in adolescents and young adults, individuals living in more deprived areas, and some minoritised ethnic groups. These patterns provide critical insight to public health practitioners and policy makers to establish systems which provide support and treatment for those with common mental disorders.”

Between 2000–2010, incidence rose in all age groups but from 2011, it continued to rise in the youngest age groups, while stabilising in the 35–54s and decreasing in those 55 or older. Rates more than doubled in the 16–24s over the study period.

“One of the notable trends we observed was a sharp rise in the rates of anxiety, depression, and stress in adolescents and young adults over the past 20 years. Rates increased by more than two-fold for those aged 16–24, and understanding what is underlying these patterns is of critical importance.”

Across all time points, the incidence of common mental disorders was substantially higher among females than males and for those living in more deprived areas. In recent years, a steeper increase was also seen in Asian, Black and mixed ethnic groups. Rates of common mental disorders were elevated among those with multiple comorbid conditions, although these rates appear to be converging over time, with increasing incidence of common mental disorders among those without recorded comorbid conditions.

This study provides a descriptive look at the trends of common mental disorders but does not tell us the underlying reason for the overall increase or the differences across population groups. Increasing incidence of common mental disorders seen in the study may have several possible explanations. 

The researchers suggest that the differences by population group revealed in the study may warrant a more targeted and tailored approach to support and prevention with the striking rise in mental health disorders among adolescents and young adults demanding further investigation and public health action. 

• Research in Psychological Medicine
• Read the original article on the SPHR blog
• Dr Jen Dykxhoorn’s academic profile
• UCL Division of Psychiatry