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Chunk #28 — Discussion

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Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies.
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risk and protective factors (beyond genetics) in a comprehensive atlas [54]. Importantly, targeting the neurodevelopmental phase has the potential to accommodate multi-endpoint numerators across mental disorders that are essential to better justify the denominator of efforts and costs for preventive and early intervention [8]. Higher median age at disorder onset during the transitional period across adolescence and young adulthood emerged for another larger group of mental disorders, i.e., anorexia nervosa, bulimia nervosa, OCD, binge eating, and cannabis use disorders. For these disorders, good mental health promotion, prevention and early intervention could be delivered in primary and secondary schools [55–57]. A third group with median age at onset in the early adulthood included, schizophrenia, personality, panic and alcohol use disorders, and a fourth group included the remaining disorders that have a median age at onset in the later adulthood, such as PTSD, GAD, depressive and bipolar disorders, and ATPD. Secondary schools and colleges could become the most important setting for mental health promotion, prevention and early intervention across these two groups of mental disorders. Importantly, the diagnosis of personality disorder is artifactually delayed by diagnostic criteria allowing diagnosis after age 18, and clinically relevant symptoms occur earlier.