Epidemiology of schizophrenia

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DALY for schizophrenia per 100,000 inhabitants in 2004.
  no data
  ≤ 185
  185–197
  197–207
  207–218
  218–229
  229–240
  240–251
  251–262
  262–273
  273–284
  284–295
  ≥ 295

Schizophrenia affects around 0.3–0.7% of people at some point in their life,[1] or 21 million people worldwide as of 2011 (about one of every 285).[2] By using precise methods in its diagnosis and a large, representative population, schizophrenia seems to occur with relative consistency over time during the last half-century.[3]

While it is claimed that schizophrenia occurs at similar rates worldwide, its prevalence and incidence varies across the world,[4] within countries,[5] and at the local and neighborhood level.[6] It causes approximately 1% of worldwide disability-adjusted life years (DALYs).[7] The rate of schizophrenia varies up to threefold depending on how it is defined.[1]

By age and gender[edit]

Schizophrenia is diagnosed 1.4 times more frequently in males than females, and typically appears earlier in men[7]—the peak ages of onset are 20–28 years for males and 26–32 years for females.[8] Onset in childhood is much rarer,[9] as is onset in middle- or old age.[10]

Generally, the mean age of first hospital admission for treatment of schizophrenia is between 25 and 35. Studies have suggested that lower income individuals tend to have their disorder diagnosed later after the onset of symptoms, relative to those of better economic standings. As a result, the lower social classes are more likely to be living with their illness untreated.[3]

It is generally accepted that women tend to present with schizophrenia anywhere between 4–10 years after their male counterparts.[11] However, using broad criteria for diagnosing schizophrenia shows that males have a bimodal age of onset, with peaks at 21.4 years and 39.2 years old, while females have a trimodal age of onset with peaks at 22.4, 36.6, and 61.5 years old.[12]

This additional post-menopausal peak of late-onset schizophrenia in women calls into question the etiology of the disease and raises a debate about "subtypes" of schizophrenia, with men and women being susceptible to different types (see Causes of Schizophrenia). This is further supported by the variability in presentation of the disease between the genders.[13]

Other theories that may explain this difference include protective or predisposing factors in men or women that may render them more (or less) susceptible to the disease at different points in life. For example, estrogen may be a protective factor for women, as estradiol has been found to be effective in treating schizophrenia when added to antipsychotic therapy.[13]

By country[edit]

In 2000, the World Health Organization found the prevalence and incidence of schizophrenia to be roughly similar around the world, with age-standardized prevalence per 100,000 ranging from 343 in Africa to 544 in Japan and Oceania for men and from 378 in Africa to 527 in Southeastern Europe for women.[14]

However, the impact of schizophrenia tends to be highest in Oceania, the Middle East, and East Asia, while the nations of Australia, Japan, the United States, and most of Europe typically have low impact. Despite relative geographical proximity, the DALY rate of schizophrenia in Indonesia nearly doubles that of Australia (the nations with the highest and lowest respective DALY rates). Discrepancies between DALY rates and prevalence may arise from differences in availability of medical treatment: years lived with mental disorders carry significantly higher DALY values when unmedicated than when medicated.[14]

The following tables record the age-standardised disability-adjusted life years rates per 100,000 inhabitants (recorded in 2004).[15]

Rank Country DALY rate
1  Indonesia 321.870
2  Philippines 317.079
3  Thailand 315.533
4  Malaysia 314.199
5  Sri Lanka 312.278
6  Brunei 312.101
7  Singapore 311.872
8  Tuvalu 287.660
9  Laos 287.175
10  Uzbekistan 286.942
11  Marshall Islands 284.733
12  Burma 281.795
13  Papua New Guinea 281.681
14  Kyrgyzstan 279.941
15  Iraq 279.362
16  Samoa 279.080
17  Palau 278.983
18  Tonga 278.129
19  Federated States of Micronesia 277.711
20  Vanuatu 277.423
21  Syria 277.308
22  Niue 276.384
23  Vietnam 275.786
24  Lebanon 275.768
25  Iran 275.672
26  Solomon Islands 275.561
27  Yemen 275.117
28  Cambodia 274.896
29  Cook Islands 274.401
30  Tunisia 273.845
31  Morocco 273.587
32  Libya 273.506
33  Egypt 273.441
34  Jordan 273.298
35  Cyprus 273.036
36  Saudi Arabia 270.202
37  Mongolia 270.025
38  Oman 270.003
39  Bahrain 269.861
40  Armenia 269.694
41  Azerbaijan 269.573
42  Kuwait 269.369
43  China 269.146
44  North Korea 269.064
45  Kiribati 268.930
46  Nauru 268.930
47  India 268.903
48  Suriname 268.690
49  Fiji 268.504
50  South Korea 268.395
51  Qatar 267.384
52  U.A.E. 267.316
53  Pakistan 266.348
54  Tajikistan 266.302
55  Bangladesh 265.704
56    Nepal 265.396
57  Bhutan 264.924
58  Turkmenistan 264.634
59  East Timor 259.483
60  Maldives 257.915
61  Uruguay 257.220
62  Nicaragua 256.836
63  Cuba 256.254
64  Honduras 256.040
65  Brazil 255.328
66  Mexico 254.998
67  Trinidad and Tobago 254.966
68  Dominican Republic 254.906
69  Grenada 254.731
70  Saint Vincent and the Grenadines 254.731
71  Guatemala 254.603
72  El Salvador 254.538
73  Saint Lucia 254.249
74  Chile 254.056
75  Jamaica 254.052
76  Afghanistan 253.778
77  Ecuador 253.573
78  Colombia 253.524
79  Haiti 253.521
80  Venezuela 253.432
81  Argentina 253.404
82  Bolivia 253.353
83  Bahamas 253.284
84  Dominica 253.184
85  Antigua and Barbuda 253.183
86  Saint Kitts and Nevis 253.183
87  Peru 253.060
88  Panama 252.960
89  Barbados 252.912
90  Belize 252.768
91  Costa Rica 252.764
92  Guyana 252.626
93  Paraguay 252.615
94  Angola 252.602
95  Sierra Leone 250.554
96  Mali 248.112
97  Albania 247.412
98  Liberia 247.215
99  Niger 247.160
100  Equatorial Guinea 247.009
101  Chad 246.930
102  Guinea-Bissau 246.913
103  Nigeria 246.675
104  Burkina Faso 246.534
105  Guinea 244.827
106  Benin 244.670
107  Cameroon 244.614
108  Senegal 244.417
109  Togo 244.322
110  Gambia 244.157
111  Madagascar 244.013
112  Burundi 242.958
113  Mauritania 242.681
114  Côte d'Ivoire 242.415
115  Comoros 242.247
116  D.R. of the Congo 241.964
117  Bosnia and Herzegovina 241.524
118  Gabon 241.036
119  Rwanda 240.859
120  South Africa 240.510
121  C.A.R. 239.919
122  Algeria 239.752
123  Tanzania 239.346
124  Cape Verde 239.200
125  Mozambique 239.198
126  Bulgaria 238.471
127  Ethiopia 238.315
128  Zimbabwe 238.167
129  Zambia 238.155
130  Swaziland 237.481
131  Malawi 237.361
132  Romania 237.228
133  Lesotho 237.095
134  Uganda 236.848
135  Mauritius 236.587
136  Seychelles 236.317
137  Georgia 235.629
138  Eritrea 235.605
139  Djibouti 235.323
140  Kenya 234.975
141  Somalia 234.846
142  São Tomé and Príncipe 234.730
143  Rep. of the Congo 234.554
144  Botswana 234.546
145  Sudan 234.492
146  Serbia and Montenegro 234.431
147  Macedonia 234.208
148  Turkey 234.024
149  Ghana 234.009
150  Poland 233.876
151  Slovakia 233.549
152  Namibia 233.280
153  Kazakhstan 210.649
154  Ukraine 209.780
155  Russia 206.910
156  Hungary 206.746
157  Belarus 206.098
158  Lithuania 205.798
159  Latvia 203.750
160  Moldova 202.684
161  Estonia 201.738
162  New Zealand 193.707
163  Japan 193.509
164  France 189.104
165   Switzerland 188.713
166  Israel 188.005
167  Croatia 187.935
168  Finland 187.699
169  Denmark 187.542
170  Norway 187.493
171  Slovenia 187.209
172  Spain 186.362
173  Netherlands 186.282
174  Portugal 186.253
175  Belgium 186.130
176  Sweden 186.011
177  Canada 185.942
178  Czech Republic 185.826
179  Germany 185.762
180  Andorra 185.725
181  United States 185.629
182  Ireland 185.626
183  Italy 185.589
184  Luxembourg 185.307
185  United Kingdom 185.182
186  Austria 185.116
187  Greece 185.063
188  Malta 184.870
189  San Marino 184.854
190  Monaco 184.831
191  Iceland 184.830
192  Australia 164.255

United States[edit]

In 2010, there were approximately 397,200 hospitalizations for schizophrenia in the United States. About 88,600 (22.3%) were readmitted within 30 days.[16]

See also[edit]

References[edit]

  1. ^ a b van Os J, Kapur S. Schizophrenia. Lancet. 2009;374(9690):635–45. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006.
  2. ^ "Schizophrenia". World Health Organization. 2011. Retrieved February 27, 2011.
  3. ^ a b Häfner H, an der Heiden W. Epidemiology of Schizophrenia. The Canadian Journal of Psychiatry. 1997;42:139–151. doi:10.1177/070674379704200204.
  4. ^ Jablensky A, Sartorius N, Ernberg G, et al.. Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychological Medicine Monograph Supplement. 1992;20:1–97. doi:10.1017/S0264180100000904. PMID 1565705.
  5. ^ Kirkbride JB, Fearon P, Morgan C, et al.. Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Archives of General Psychiatry. 2006;63(3):250–8. doi:10.1001/archpsyc.63.3.250. PMID 16520429.
  6. ^ Kirkbride JB, Fearon P, Morgan C, et al.. Neighbourhood variation in the incidence of psychotic disorders in Southeast London. Social Psychiatry and Psychiatric Epidemiology. 2007;42(6):438–45. doi:10.1007/s00127-007-0193-0. PMID 17473901.
  7. ^ a b Picchioni MM, Murray RM. Schizophrenia. BMJ. 2007;335(7610):91–5. doi:10.1136/bmj.39227.616447.BE. PMID 17626963.
  8. ^ Castle D, Wessely S, Der G, Murray RM. The incidence of operationally defined schizophrenia in Camberwell, 1965–84. The British Journal of Psychiatry. 1991;159:790–4. doi:10.1192/bjp.159.6.790. PMID 1790446.
  9. ^ Kumra S, Shaw M, Merka P, Nakayama E, Augustin R. Childhood-onset schizophrenia: research update. Canadian Journal of Psychiatry. 2001;46(10):923–30. doi:10.1177/070674370104601004. PMID 11816313.
  10. ^ Hassett, Anne M.; et al. (20 June 2005). Psychosis in the Elderly. London: Taylor & Francis. p. 6. ISBN 978-1-84184-394-0.
  11. ^ Hafner H, Maurer K, Loffler W, et al.. The epidemiology of early schizophrenia: Influence of age and gender on onset and early course. The British Journal of Psychiatry. 1994;164(23):29–38. PMID 8037899.
  12. ^ Castle D, Sham P, Murray R.. Differences in distribution of ages of onset in males and females with schizophrenia. Schizophrenia Research. 1998;33(3):179–183. doi:10.1016/s0920-9964(98)00070-x.
  13. ^ a b Kulkarni J, Riedel A, de Castella AR, et al.. Estrogen – A potential treatment for schizophrenia. Schizophrenia Research. 2001;48(1):137–144. doi:10.1016/s0920-9964(00)00088-8. PMID 11278160.
  14. ^ a b Ayuso-Mateos, Jose Luis. "Global burden of schizophrenia in the year 2000" (PDF). World Health Organization. Retrieved February 27, 2013.
  15. ^ "Age-standardized DALYs per 100,000 by cause, and Member State, 2004". Global burden of disease: 2004 update. World Health Organization (WHO). 2004. Retrieved 2011-04-01.
  16. ^ Elixhauser A, Steiner C. Readmissions to U.S. Hospitals by Diagnosis, 2010. HCUP Statistical Brief #153. Agency for Healthcare Research and Quality. April 2013.

Further reading[edit]