Skip to main content
    • Aa
    • Aa

Ageing and the prevalence and treatment of mental health problems

  • M. Jokela (a1) (a2), G. D. Batty (a1) (a3) and M. Kivimäki (a1) (a2) (a4)

Ageing is an important factor in the development of mental health problems and their treatment. We assessed age trajectories of common mental disorders (CMDs) and psychotherapy utilization from adolescence to old age, and examined whether these trajectories were modified by time period or birth cohort effects.


British Household Panel Survey (BHPS) with an 18-year follow-up between 1991 and 2009 (n = 30 224 participants, aged 15–100 years, with an average 7.3 person-observations per person). CMDs were assessed with the 12-item version of the General Health Questionnaire (GHQ). Psychotherapy treatment utilization during the past year was self-reported by the participants. The modifying influences of time period and cohort effects were assessed in a cohort-sequential longitudinal setting.


Following a moderate decrease after age 50, the prevalence of GHQ caseness increased steeply from age 75. This increase was more marked in the 2000s (GHQ prevalence increasing from 24% to 43%) than in the 1990s (from 22% to 34%). Psychotherapy utilization decreased after age 55, with no time period or cohort effects modifying the age trajectory. These ageing patterns were replicated in within-individual longitudinal analysis.


Old age is associated with higher risk of CMDs, and this association has become more marked during the past two decades. Ageing is also associated with an increasing discrepancy between prevalence of mental disorders and provision of treatment, as indicated by lower use of psychotherapy in older individuals.

Corresponding author
*Address for correspondence: Dr M. Jokela, Department of Psychology, Institute of Behavioural Sciences, University of Helsinki, Siltavuorenpenger 1A, PO Box 9, 00014 Helsinki, Finland. (Email:
Hide All
B Baird , R Lucas , M Donnellan (2010). Life satisfaction across the lifespan: findings from two nationally representative panel studies. Social Indicators Research 99, 183203.

T Bell , M Watson , D Sharp , I Lyons , G Lewis (2005). Factors associated with being a false positive on the General Health Questionnaire. Social Psychiatry and Psychiatric Epidemiology 40, 402407.

DG Blanchflower , AJ Oswald (2008). Is well-being U-shaped over the life cycle? Social Science and Medicine 66, 17331749.

T Brugha , P Bebbington , N Singleton , D Melzer , R Jenkins , G Lewis , M Farrell , D Bhugra , A Lee , H Meltzer (2004). Trends in service use and treatment for mental disorders in adults throughout Great Britain. British Journal of Psychiatry 185, 378384.

C Cooper , P Bebbington , S McManus , H Meltzer , R Stewart , M Farrell , M King , R Jenkins , G Livingston (2010). The treatment of common mental disorders across age groups: results from the 2007 Adult Psychiatric Morbidity Survey. Journal of Affective Disorders 127, 96101.

PJ Curran , DJ Bauer (2011). The disaggregation of within-person and between-person effects in longitudinal models of change. Annual Review of Psychology 62, 583619.

DP Farrington (1991). Longitudinal research strategies: advantages, problems and prospects. Journal of the American Academy of Child and Adolescent Psychiatry 30, 369374.

G Hawthorne , R Goldney , A Taylor (2008). Depression prevalence: is it really increasing? Australian and New Zealand Journal of Psychiatry 42, 606616.

M Jokela , JE Ferrie , D Gimeno , T Chandola , MJ Shipley , J Head , J Vahtera , H Westerlund , MG Marmot , M Kivimäki (2010 a). From midlife to early old age health trajectories associated with retirement. Epidemiology 21, 284290.

AF Jorm (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine 30, 1122.

GL Klerman , MM Weissman (1989). Increasing rates of depression. Journal of the American Medical Association 261, 22292235.

V Lehtinen , T Lindholm , J Veijola , E Väisänen , P Puukka (1991). Stability of prevalences of mental disorders in a normal population cohort followed for 16 years. Social Psychiatry and Psychiatric Epidemiology 26, 4046.

G Lewis , G Wilkinson (1993). Another British disease? A recent increase in the prevalence of psychiatric morbidity. Journal of Epidemiology and Community Health 47, 358361.

Y Miyazaki , SW Raudenbush (2000). Tests for linkage of multiple cohorts in an accelerated longitudinal design. Psychological Methods 5, 4463.

M Moore , H Yuen , N Dunn , M Mullee , J Maskell , T Kendrick (2009). Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database. British Medical Journal 339, b3999.

D Mroczek , A Spiro (2005). Change in life satisfaction during adulthood: findings from the Veterans Affairs Normative Aging Study. Journal of Personality and Social Psychology 88, 189202.

J Murphy , N Laird , R Monson , A Sobol , A Leighton (2000). Incidence of depression in the Stirling County Study: historical and comparative perspectives. Psychological Medicine 30, 505514.

M Olfson , S Marcus , B Druss , H Pincus (2002). National trends in the use of outpatient psychotherapy. American Journal of Psychiatry 159, 19141920.

S Palsson , S Ostling , I Skoog (2001). The incidence of first-onset depression in a population followed from the age of 70 to 85. Psychological Medicine 31, 11591168.

A Papassotiropoulos , R Heun (1999). Screening for depression in the elderly: a study on misclassification by screening instruments and improvement of scale performance. Progress in Neuro-Psychopharmacology and Biological Psychiatry 23, 431446.

E Paykel (2000). Not an age of depression after all? Incidence rates may be stable over time. Psychological Medicine 30, 489490.

D Pevalin (2000). Multiple applications of the GHQ-12 in a general population sample: an investigation of long-term retest effects. Social Psychiatry and Psychiatric Epidemiology 35, 508512.

N Spiers , P Bebbington , S McManus , T Brugha , R Jenkins , H Meltzer (2011). Age and birth cohort differences in the prevalence of common mental disorder in England: National Psychiatric Morbidity Surveys 1993–2007. British Journal of Psychiatry 198, 479484.

JM Twenge (2000). The age of anxiety? Birth cohort change in anxiety and neuroticism, 1952–1993. Journal of Personality and Social Psychology 79, 10071021.

J Twenge , B Gentile , C Dewall , D Ma , K Lacefield , D Schurtz (2010). Birth cohort increases in psychopathology among young Americans, 1938–2007: a cross-temporal meta-analysis of the MMPI. Clinical Psychology Review 30, 145154.

D Vink , M Aartsen , H Comijs , M Heymans , B Penninx , M Stek , DJ Deeg , AT Beekman (2009). Onset of anxiety and depression in the aging population: comparison of risk factors in a 9-year prospective study. American Journal of Geriatric Psychiatry 17, 642652.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary Materials

Jokela Supplementary Material

 Word (276 KB)
276 KB
Supplementary Materials

Jokela Supplementary Material

 Word (344 KB)
344 KB


Altmetric attention score

Full text views

Total number of HTML views: 12
Total number of PDF views: 36 *
Loading metrics...

Abstract views

Total abstract views: 206 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 17th October 2017. This data will be updated every 24 hours.