Purpose of review.: In this review, we provide an update of recent studies on the age of onset (AOO) of the major mental disorders, with a special focus on the availability and use of services providing prevention and early intervention.Recent findings.: The studies reviewed here confirm previous reports on the AOO of the major mental disorders. Although the behaviour disorders and specific anxiety disorders emerge during childhood, most of the high-prevalence disorders (mood, anxiety and substance use) emerge during adolescence and early adulthood, as do the psychotic disorders. Early AOO has been shown to be associated with a longer duration of untreated illness, and poorer clinical and functional outcomes.Summary.: Although the onset of most mental disorders usually occurs during the first three decades of life, effective treatment is typically not initiated until a number of years later. There is increasing evidence that intervention during the early stages of disorder may help reduce the severity and/or the persistence of the initial or primary disorder, and prevent secondary disorders. However, additional research is needed on effective interventions in early-stage cases, as well as on the long-term effects of early intervention, and for an appropriate service design for those with emerging mental disorders. This will mean not only the strengthening and re-engineering of existing systems, but is also crucial the construction of new streams of care for young people in transition to adulthood.

Objective: To evaluate the length of the interval between the onset and the initial management of bipolar disorder (BD). Method: We conducted a meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Systematic searches located studies reporting estimates of the age of onset (AOO) and indicators of the age at initial management of BD. We calculated a pooled estimate of the interval between AOO and age at management. Factors influencing between-study heterogeneity were investigated using sensitivity analyses, meta-regression, and multiple meta-regression. Results: Twenty-seven studies, reporting 51 samples and a total of 9415 patients, met the inclusion criteria. The pooled estimate for the interval between the onset of BD and its management was 5.8 years (standardized difference, .53; 95% confidence interval, .45 to .62). There was very high between-sample heterogeneity ( I² = 92.6; Q = 672). A longer interval was found in studies that defined the onset according to the first episode (compared to onset of symptoms or illness) and defined management as age at diagnosis (rather than first treatment or first hospitalization). A longer interval was reported among more recently published studies, among studies that used a systematic method to establish the chronology of illness, among studies with a smaller proportion of bipolar I patients, and among studies with an earlier mean AOO. Conclusions: There is currently little consistency in the way researchers report the AOO and initial management of BD. However, the large interval between onset and management of BD presents an opportunity for earlier intervention.

Background: Mental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students. Methods: This study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions. Results: Results showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help. Conclusions: This study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.