© 2000 The Royal College of Psychiatrists
Schizophrenia is not disappearing in south-west Scotland
Department of Clinical Research, Crichton Royal Hospital, Dumfries
European School of Neurosciences, Maastricht University, The Netherlands
Institute of Psychiatry, London
Correspondence: Dr J. Allardyce, Department of Clinical Research, Crichton Royal Hospital, Dumfries DGI 4TG, Scotland, UK. Tel : +44 1387 244000 ; Fax : +44 1387 257735 ; e-mail : j.allardyce{at}clinmed.gla.ac.uk
Declaration of interest This work was supported by the Stanley Foundation.
Background Recent work has reported a decline in the incidence of schizophrenia, but it is unclear if these findings reflect a true decrease in its incidence or are an artefact arising from methodological difficulties.
Aims To take account of these methodological difficulties and report service-based incidence rates for schizophrenia in Dumfries and Galloway in south-west Scotland for 1979-98.
Method Using both clinical diagnoses and diagnoses generated from the Operational Checklist for Psychotic Disorders (OPCRIT) computer algorithm for ICD—10 and DSM-IV schizophrenia, we measured change in the incidence rates over time. We used indirect standardisation techniques and Poisson models to measure the rate ratio linear trend.
Results There was a monotonic and statistically significant decline in clinically diagnosed schizophrenia. The summary rate ratio linear trend was 0.77. However using OPCRIT-generated ICD—10 and DSM-IV diagnoses, there was no significant difference over time.
Conclusions OPCRIT-generated consistent diagnoses revealed no significant fall in the incidence of schizophrenia. Changes in diagnostic practice have caused the declining rates of clinically diagnosed schizophrenia in Dumfries and Galloway.
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