Most epidemiological studies show a decrease of internalizing disorders at older ages, but it is unclear how the prevalence exactly changes with age, and whether there are different patterns for internalizing symptoms and traits, and for men and women. This study investigates the impact of age and sex on the point prevalence across different mood and anxiety disorders, internalizing symptoms, and neuroticism.

We used cross-sectional data on 146 315 subjects, aged 18–80 years, from the Lifelines Cohort Study, a Dutch general population sample. Between 2012 and 2016, five current internalizing disorders – major depression, dysthymia, generalized anxiety disorder, social phobia, and panic disorder – were assessed according to DSM-IV criteria. Depressive symptoms, anxiety symptoms, neuroticism, and negative affect (NA) were also measured. Generalized additive models were used to identify nonlinear patterns across age, and to investigate sex differences.

The point prevalence of internalizing disorders generally increased between the ages of 18 and 30 years, stabilized between 30 and 50, and decreased after age 50. The patterns of internalizing symptoms and traits were different. NA and neuroticism gradually decreased after age 18. Women reported more internalizing disorders than men, but the relative difference remained stable across age (relative risk ~1.7).

The point prevalence of internalizing disorders was typically highest between age 30 and 50, but there were differences between the disorders, which could indicate differences in etiology. The relative gap between the sexes remained similar across age, suggesting that changes in sex hormones around the menopause do not significantly influence women's risk of internalizing disorders.

大多数流行病学研究表明，随着年龄的增长，内化障碍有所减少，但尚不清楚患病率如何随年龄变化，以及男性和女性的内化症状和特征是否存在不同模式。本研究调查了年龄和性别对不同情绪和焦虑障碍、内化症状和神经质的点流行率的影响。

我们使用了 146 315 名年龄在 18-80 岁之间的受试者的横断面数据，这些受试者来自生命线队列研究，这是一项荷兰一般人口样本。2012 年至 2016 年间，根据 DSM-IV 标准评估了五种当前的内化障碍——重度抑郁症、心境恶劣、广泛性焦虑症、社交恐惧症和恐慌症。还测量了抑郁症状、焦虑症状、神经质和消极情绪 (NA)。广义加性模型用于识别跨年龄的非线性模式，并研究性别差异。

内化障碍的点患病率普遍在18~30岁之间增加，在30~50岁之间趋于稳定，50岁以后呈下降趋势。内化症状和特征的模式存在差异。NA 和神经质在 18 岁后逐渐减少。女性报告的内化障碍多于男性，但相对差异在整个年龄段保持稳定（相对风险 ~1.7）。

内化障碍的患病率通常在 30 到 50 岁之间最高，但这些障碍之间存在差异，这可能表明病因学存在差异。两性之间的相对差距在不同年龄段保持相似，这表明绝经前后性激素的变化不会显着影响女性患内在障碍的风险。