Hostname: page-component-745bb68f8f-cphqk Total loading time: 0 Render date: 2025-01-28T02:47:16.441Z Has data issue: false hasContentIssue false
  • English
  • Français

Incidence of schizophrenia in Nottingham

A comparison of two cohorts, 1978–80 and 1992–94

Published online by Cambridge University Press:  03 January 2018

J. Brewin ,
R. Cantwell ,
T. Dalkin ,
R. Fox ,
I. Medley ,
C. Glazebrook ,
R. Kwiecinski  and
G. Harrison
J. Brewin*
Affiliation:
Department of Psychiatry, University of Nottingham
R. Cantwell
Affiliation:
Department of Psychiatry, University of Nottingham
T. Dalkin
Affiliation:
Department of Psychiatry, University of Nottingham
R. Fox
Affiliation:
Department of Psychiatry, University of Nottingham
I. Medley
Affiliation:
Department of Psychiatry, University of Nottingham
C. Glazebrook
Affiliation:
Department of Psychiatry, University of Nottingham
R. Kwiecinski
Affiliation:
Department of Psychiatry, University of Nottingham
G. Harrison
Affiliation:
Department of Psychiatry, University of Nottingham
*
Dr J. Brewin, Psychiatry Department, B Floor, South Block, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Several studies have reported a decline of up to 50% in the incidence of schizophrenia over recent decades. We aimed to measure changes in the incidence and diagnostic patterns of first-episode psychosis by comparing two Nottingham cohorts, identified in two equal periods separated by 14 years.

Method

Two prospectively ascertained cohorts of first-episode psychotic disorder were identified over the time periods 1978–80 and 1992–94. The earlier cohort was of the World Health Organization Determinants of Outcome of Severe Mental Disorder (DOSMD) ten-country study. The later cohort was obtained using similar methodology. Both groups were diagnosed using ICD-10 diagnostic criteria and age-standardised incidence rates were compared.

Results

The standardised incidence rate for all psychotic disorders rose slightly from 2.49 to 2.87 per 10 000 population per year, but the F20 classification fell significantly by over a third (1.41 to 0.87 per 10 000 per year). The second study group (1992–1994) included a greater diversity of psychotic diagnoses compared with the first, in particular an increased proportion of acute and drug-related psychoses.

Conclusions

Methodological considerations call for caution in interpreting such data, but we conclude that the significant fall in the narrowly defined diagnostic category of schizophrenia reflects a real change in the syndromal presentation of psychotic disorders.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 140 - 144
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM–III–R). Washington. DC: APA.Google Scholar
Andreasen, N. C. (1982) Negative symptoms in schizophrenia. Archives of General Psychiatry, 39, 784–788.Google Scholar
Bamrah, J. S., Freeman, H. L. & Goldberg, D. P. (1991) Epidemiology of schizophrenia in Salford, 1974–84. Changes in an urban community over 10 years. British Journal of Psychiatry, 159, 802–810.Google Scholar
Castle, D., Wessely, S., Der, G., et al (1991) The incidence of operationally defined schizophrenia in Camberwell, 1965–84. British Journal of Psychiatry, 159, 790–794.CrossRefGoogle ScholarPubMed
Cooper, J. E., Goodhead, D., Craig, T., et al (1987) The incidence of schizophrenia in Nottingham. British Journal of Psychiatry, 151, 619–626.Google Scholar
de Alarcon, J., Seagroatt, V. & Goldacre, M. (1990) Trends in schizophrenia. Lancet, 335, 852–853.Google Scholar
Eagles, J. M. & Whalley, L. J. (1985) Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969–78. British Journal of Psychiatry, 146, 151–154.Google Scholar
Eagles, J., Hunter, D. & McCance, C. (1988) Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-east Scotland. 1969–1984. British Journal of Psychiatry, 152, 793–798.Google Scholar
Gaddas, J. R., Black, R. J., Whalley, L. J., et al (1993) Persistence in the decline of diagnosis of schizophrenia among first admissions to Scottish hospitals from 1969 to 1988. British Journal of Psychiatry, 163, 620–626.Google Scholar
Haffner, H. & an der Heiden, W. (1986) The contribution of European case registers to research on schizophrenia. Schizophrenia Bulletin, 12, 26–51.Google Scholar
Harrison, G. (1993) Disappearing schizophrenia ? Schizophrenia Monitor, 3, 1–5.Google Scholar
Harrison, G., Cooper, J. E. & Gancarczyk, R. (1991) Changes in the administrative incidence of schizophrenia. British Journal of Psychiatry, 159, 811–816.Google Scholar
Jablensky, A., Sartorius, N., Ernberg, G., et al (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten country study. Psychological Medicine monograph supplement 20.Google Scholar
Joyce, P. R. (1987) Changing trends in first admissions and readmissions for mania and schizophrenia in New Zealand 1974 to 1984. Australian and New Zealand Journal of Psychiatry, 21, 82–86.CrossRefGoogle ScholarPubMed
Kendall, R. E., Malcolm, D E. & Adams, W. (1993) The problem of detectng changes in the incidence of schizophrenia. British Journal of Psychiatry, 162, 212–218.Google Scholar
Munk-Jorgensen, P. (1986) Decreasing first admission rates of schizophrenia among males in Denmark from 1970 to 1984. Acta Psychiatrica Scandinavica, 73, 645–650.Google Scholar
Munk-Jorgensen, P. (1995) Decreasing rates of incident schizophrenia cases in psychiatric service: a review of the literature. European Psychiatry, 10, 129–141.Google Scholar
Munk-Jorgensen, P. & Mortensen, P. R. (1992) Incidence and other aspects of the epidemiology of schizophrenia in Denmark, 1971–87. British Journal of Psychiatry, 161, 489–495.CrossRefGoogle ScholarPubMed
Office of Population Censuses and Surveys (1992) Census 1991. London: HMSO.Google Scholar
Parker, G., O'Donnell, M. & Walter, S. (1985) Changes in the diagnoses of the functional psychoses associated with the introduction of lithium. British Journal of Psychiatry, 146, 377–382.Google Scholar
World Health Organization (1993) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10): Diagnostic Criteria for Research. Geneva: WHO.Google Scholar
World Health Organization (1994) Schedules for Clinical Assessment in Neuropsychiatry, version 2. Geneva: WHO.Google Scholar
Zubin, J., Magaziner, J. & Steinhauser, S. R. (1983) The metamorphosis of schizophrenia: from chronicity to vulnerability. Psychological Medicine, 13, 551–571.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.