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Annual incidence rate of schizophrenia and schizophrenia spectrum disorders in a longitudinal population-based cohort study

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Abstract

Background

Longitudinal incidence studies of schizophrenia spectrum disorders (SSD) performed in mental health service organizations are prone to confounding factors not found in research performed in the general population.

Objectives

To estimate the incidence rates (IRs) over a 10-year period of SSD (broadly defined) and schizophrenia (narrowly defined) in the general population and to analyze associated risk factors.

Methods

A cohort study (1996–2006) in a large general practitioners research database was conducted with longitudinal medical records of 350,524 patients throughout the Netherlands. Cases of SSD were identified and classified by systematic review of medical records. Age- and gender-specific IRs were calculated per calendar year, date of birth, degree of urbanicity and deprivation.

Results

Overall IR of SSD in this population was 22/100,000 person years (PY) (95 % CI 19–24). IR of schizophrenia was 12/100,000 PY (95 % CI 10–14). Period prevalence was 3.5 per 1,000 PY. IRs were higher in men compared to women, had a peak at age 15–25 years, decreasing rapidly after 25 years by 40 % per 10 years. IRs of SSD were significantly higher in urban areas, irrespective of deprivation. No association was found between IRs of SSD and living in deprived areas or month of birth. There was no significant time trend of the IR during the period under study.

Conclusions

IRs of SSD are higher in urban areas, independent of social deprivation. Age- and gender-specific differences in IR were found. The magnitude of these differences was larger in narrowly defined schizophrenia than in SSD.

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References

  1. Allardyce J, Morrison G, van Os J, Kelly J, Murray RM, McCreadie RG (2000) Schizophrenia is not disappearing in south-west Scotland. Br J Psychiatry 177:38–41

    Article  PubMed  CAS  Google Scholar 

  2. APA (1994) Diagnostic and statistical manual of mental disorder (fourth version). American Psychiatric Association, Washington

    Google Scholar 

  3. Bijl RV, Ravelli A, van Zessen G (1998) Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 33(12):587–595

    Article  PubMed  CAS  Google Scholar 

  4. Boonstra N, Wunderink L, de Wit PH, Noorthoorn E, Wiersma D (2008) The administrative incidence of non-affective psychoses in Friesland and Twente. Tijdschr Psychiatr 50:637–643

    PubMed  CAS  Google Scholar 

  5. Boydell J, van Os J, Lambri M, Castle D, Allardyce J, McCreadie RG, Murray RM (2003) Incidence of schizophrenia in south-east London between 1965 and 1997. Br J Psychiatry 182:45–49

    Article  PubMed  CAS  Google Scholar 

  6. CBS. Central Bureau of Statistics (CBS). 2012. Ref Type: Online Source. http://www.cbs.nl

  7. de Lusignan S (2005) Codes, classifications, terminologies and nomenclatures: definition, development and application in practice. Inform Prim Care 13:65–70

    PubMed  Google Scholar 

  8. Deuning CM, Zwakhals SLN, Verkleij H (2012) Trend van gemiddelde afstand en draagvlakprofiel voor huisartsen en ziekenhuizen. Zorgbalans 2008. RIVM, Bilthoven. www.rivm.nl

  9. Drukker M, Krabbendam L, Driessen G, van Os J (2006) Social disadvantage and schizophrenia. A combined neighborhood and individual-level analysis. Soc Psychiatry Psychiatr Epidemiol 41:595–604

    Article  PubMed  Google Scholar 

  10. Faris REL, Dunham HW (1939) Mental disorders in urban areas. University of Chicago Press, Chicago

    Google Scholar 

  11. Folnegovic Z, Folnegovic-Smalc V, Kulcar Z (1990) The incidence of schizophrenia in Croatia. Br J Psychiatry 156:363–365

    Article  PubMed  CAS  Google Scholar 

  12. Frisher M, Crome I, Martino O, Croft P (2012) Assessing the impact of cannabis use on trends in diagnosed schizophrenia in the United Kingdom from 1996 to 2005. Schizophr Res 113:123–128

    Article  Google Scholar 

  13. Geddes JR, Black RJ, Whalley LJ, Eagles JM (1993) Persistence of the decline in the diagnosis of schizophrenia among first admissions to Scottish hospitals from 1969 to 1988. Br J Psychiatry 163:620–626

    Article  PubMed  CAS  Google Scholar 

  14. Goldner EM, Hsu L, Waraich P, Somers JM (2002) Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Can J Psychiatry 47:833–843

    PubMed  Google Scholar 

  15. Hafner H, Riecher-Rossler A, Der An HW, Maurer K, Fatkenheuer B, Loffler W (1993) Generating and testing a causal explanation of the gender difference in age at first onset of schizophrenia. Psychol Med 23:925–940

    Article  PubMed  CAS  Google Scholar 

  16. Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 20:1–97

    Article  PubMed  CAS  Google Scholar 

  17. Kendell RE, Malcolm DE, Adams W (1993) The problem of detecting changes in the incidence of schizophrenia. Br J Psychiatry 162:212–218

    Article  PubMed  CAS  Google Scholar 

  18. Kendler KS, Gallagher TJ, Abelson JM, Kessler RC (1996) Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Arch Gen Psychiatry 53:1022–1031

    Article  PubMed  CAS  Google Scholar 

  19. Kirkbride JB, Cooper JE, Doody GA, Jones PB (2009) Is the incidence of psychotic disorder in decline? Epidemiological evidence from two decades of research. Int J Epidemiol 38:1255–1264

    Article  PubMed  CAS  Google Scholar 

  20. Kirkbride JB, Errazuriz A, Croudace TJ, Morgan C, Jackson D, Boydell J, Murray RM, Jones PB (2012) Incidence of schizophrenia and other psychoses in England, 1950–2009: a systematic review and meta-analyses. PLoS One 7:e31660

    Article  PubMed  CAS  Google Scholar 

  21. Kirkbride JB, Morgan C, Fearon P, Dazzan P, Murray RM, Jones PB (2007) Neighborhood-level effects on psychoses: re-examining the role of context. Psychol Med 37:1413–1425

    Article  PubMed  Google Scholar 

  22. Kroon JS, Wohlfahrt T, Dieleman J, Sutterland AL, Storosum J, Denys DAJD, de Haan L, Sturkenboom MCJM (2012) Incidence rates and risk factors of bipolar disorders in the general population: a population based cohort study (submitted)

  23. Marcelis M, Takei N, van Os J (1999) Urbanization and risk for schizophrenia: does the effect operate before or around the time of illness onset? Psychol Med 29:1197–1203

    Article  PubMed  CAS  Google Scholar 

  24. McGrath J, Saha S, Chant D, Welham J (2008) Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev 30:67–76

    Article  PubMed  Google Scholar 

  25. McGrath J, Saha S, Welham J, El SO, MacCauley C, Chant D (2004) A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med 2:13

    Article  PubMed  Google Scholar 

  26. Mortensen PB, Pedersen CB, Westergaard T, Wohlfahrt J, Ewald H, Mors O, Andersen PK, Melbye M (1999) Effects of family history and place and season of birth on the risk of schizophrenia. N Engl J Med 340:603–608

    Article  PubMed  CAS  Google Scholar 

  27. Munk-Jorgensen P, Mortensen PB (1993) Is schizophrenia really on the decrease? Eur Arch Psychiatry Clin Neurosci 242:244–247

    Article  PubMed  CAS  Google Scholar 

  28. Oldehinkel AJ, Giel R (1995) Time trends in the care-based incidence of schizophrenia. Br J Psychiatry 167:777–782

    Article  PubMed  CAS  Google Scholar 

  29. Osby U, Hammar N, Brandt L, Wicks S, Thinsz Z, Ekbom A, Sparen P (2001) Time trends in first admissions for schizophrenia and paranoid psychosis in Stockholm County, Sweden. Schizophr Res 47:247–254

    Article  PubMed  CAS  Google Scholar 

  30. Perala J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isometsa E, Pirkola S, Partonen T, Tuulio-Henriksson A, Hintikka J, Kieseppa T, Harkanen T, Koskinen S, Lonnqvist J (2007) Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry 64:19–28

    Article  PubMed  Google Scholar 

  31. Proctor SE, Mitford E, Paxton R (2004) First episode psychosis: a novel methodology reveals higher than expected incidence; a reality-based population profile in Northumberland, UK. J Eval Clin Pract 10:539–547

    Article  PubMed  CAS  Google Scholar 

  32. Reay R, Mitford E, McCabe K, Paxton R (2010) Incidence and diagnostic diversity in first-episode psychosis. Acta Psychiatr Scand 121:315–319

    Article  PubMed  CAS  Google Scholar 

  33. Rothman K (2008) Episheet [online]. 24-10-2007. Ref Type: Computer Program

  34. Saha S, Chant D, Welham J, McGrath J (2005) A systematic review of the prevalence of schizophrenia. PLoS Med 2(5):e141

    Article  PubMed  Google Scholar 

  35. Sartorius N, Jablensky A, Korten A, Ernberg G, Anker M, Cooper JE, Day R (1986) Early manifestations and first-contact incidence of schizophrenia in different cultures. A preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders. Psychol Med 16:909–928

    Article  PubMed  CAS  Google Scholar 

  36. Sundquist K, Frank G, Sundquist J (2004) Urbanisation and incidence of psychosis and depression: follow-up study of 4.4 million women and men in Sweden. Br J Psychiatry 184:293–298

    Article  PubMed  Google Scholar 

  37. Suvisaari JM, Haukka JK, Tanskanen AJ, Lonnqvist JK (1999) Decline in the incidence of schizophrenia in Finnish cohorts born from 1954 to 1965. Arch Gen Psychiatry 56:733–740

    Article  PubMed  CAS  Google Scholar 

  38. Valmaggia LR, McCrone P, Knapp M, Woolley JB, Broome MR, Tabraham P, Johns LC, Prescott C, Bramon E, Lappin J, Power P, McGuire PK (2009) Economic impact of early intervention in people at high risk of psychosis. Psychol Med. 39(10):1617-1626

    Google Scholar 

  39. van der Lei J, Duisterhout JS, Westerhof HP, van der Does E, Cromme PV, Boon WM, van Bemmel JH (1993) The introduction of computer-based patient records in The Netherlands. Ann Intern Med 119:1036–1041

    Article  PubMed  Google Scholar 

  40. van Os J, Kapur S (2009) Schizophrenia. Lancet 374:635–645

    Article  PubMed  Google Scholar 

  41. van Os J, Kapur S (2010) Psychosis: from diagnosis to syndrome. Ned Tijdschr Geneeskd 154:A1874

    PubMed  Google Scholar 

  42. van Os J, Pedersen CB, Mortensen PB (2004) Confirmation of synergy between urbanicity and familial liability in the causation of psychosis. Am J Psychiatry 161:2312–2314

    Article  PubMed  Google Scholar 

  43. Vanasse A, Courteau J, Fleury MJ, Grégoire JP, Lesage A, Moisan J (2012) Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates. Soc Psychiatry Psychiatr Epidemiol 47(4):533–543

    Article  PubMed  Google Scholar 

  44. Veling W, Selten JP, Veen N, Laan W, Blom JD, Hoek HW (2006) Incidence of schizophrenia among ethnic minorities in the Netherlands: a four-year first-contact study. Schizophr Res 86(1–3):189–193

    Article  PubMed  Google Scholar 

  45. Veling W, Susser E, van Os J, Mackenbach JP, Selten JP, Hoek HW (2008) Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants. Am J Psychiatry 165:66–73

    Article  PubMed  Google Scholar 

  46. Vlug AE, van der Lei J, Mosseveld BM, van Wijk MA, van der Linden PD, Sturkenboom MC, van Bemmel JH (1999) Postmarketing surveillance based on electronic patient records: the IPCI project. Methods Inf Med 38:339–344

    PubMed  CAS  Google Scholar 

  47. Waddington JL, Youssef HA (1994) Evidence for a gender-specific decline in the rate of schizophrenia in rural Ireland over a 50-year period. Br J Psychiatry 164:171–176

    Article  PubMed  CAS  Google Scholar 

  48. Wiegers TA, DevilleW (2008) Herijking stedelijke achterstandsgebieden 2008, NIVEL. http://www.nivel.nl

  49. Wiersma D, Nienhuis FJ, Slooff CJ, Giel R (1998) Natural course of schizophrenic disorders: a 15-year followup of a Dutch incidence cohort. Schizophr Bull 24(1):75–85

    Article  PubMed  CAS  Google Scholar 

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No potential conflict of interest or financial support relevant to this article was reported.

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Authors and Affiliations

  1. Department of Psychiatry, Academic Medical Center (AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands

    Arjen L. Sutterland, Jitschak G. Storosum, Jojanneke Kroon, Joris Veldhuis, Damiaan A. J. P. Denys & Lieuwe de Haan

  2. Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands

    Arjen L. Sutterland, Jeanne Dieleman & Miriam C. J. M. Sturkenboom

  3. Medicines Evaluation Board, The Hague, The Netherlands

    Bettie A. C. Voordouw & Joris Veldhuis

  4. The Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands

    Damiaan A. J. P. Denys

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  1. Arjen L. Sutterland
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Correspondence to Arjen L. Sutterland.

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Sutterland, A.L., Dieleman, J., Storosum, J.G. et al. Annual incidence rate of schizophrenia and schizophrenia spectrum disorders in a longitudinal population-based cohort study. Soc Psychiatry Psychiatr Epidemiol 48, 1357–1365 (2013). https://doi.org/10.1007/s00127-013-0651-9

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  • DOI: https://doi.org/10.1007/s00127-013-0651-9

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