A systematic review of the incidence of schizophrenia: The distribution of rates and the influence of sex, urbanicity, migrant status and methodology

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Title A systematic review of the incidence of schizophrenia: The distribution of rates and the influence of sex, urbanicity, migrant status and methodology
Author McGrath, John Joseph; Saha, Sukanta; Welham, Joy; Saadi, Ossama El; MacCauley, Clare; Chant, David
Journal Name BMC Medicine
Year Published 2004
Place of publication UK
Publisher BioMed Central Ltd.
Abstract Background: Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. Methods: Studies with original data related to the incidence of schizophrenia (published 1965–2001) were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Betweenand within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various ethodological features. Results: We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates), the distribution of rates was asymmetric and had a median value (10%–90% quantile) of 15.2 (7.7–43.0) per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%–90% quantile) was 1.40 (0.9–2.4). Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%–90% quantile) was 4.6 (1.0–12.8). Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e.g. overall quality, methods related to case finding, diagnostic confirmation and criteria, the use of age-standardization and age range). Conclusions: There is a wealth of data available on the incidence of schizophrenia. The width and skew of the rate distribution, and the significant impact of sex, urbanicity and migrant status on these distributions, indicate substantial variations in the incidence of schizophrenia.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1186/1741-7015-2-13
Volume 2
Issue Number 13
Page from 1
Page to 22
ISSN 1741-7015
Date Accessioned 2009-08-17
Date Available 2010-07-16T06:08:30Z
Language en_AU
Faculty Faculty of Science, Environment, Engineering and Technology
Subject Epidemiology
URI http://hdl.handle.net/10072/32289
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1x

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