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Incidence of first-contact psychosis in São Paulo, Brazil

Department of Preventive Medicine, Faculty of Medicine and Section of Epidemiology, University Hospital, University of São Paulo, São Paulo, Brazil

MARCIA SCAZUFCA, PhD

Department of Psychiatry, Faculty of Medicine, and Section of Epidemiology, University Hospital, University of São Paulo, São Paulo, Brazil

GERALDO F. BUSATTO, MD, PhD

Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

LETÍCIA M. S. COUTINHO, CStat

Department of Preventive Medicine, Faculty of Medicine and Section of Epidemiology, University Hospital, University of São Paulo, São Paulo, Brazil

PHILIP K. McGUIRE, MD, PhD and ROBIN M. MURRAY, FRCPsych

Department of Psychological Medicine, Institute of Psychiatry, London, UK

Correspondence: Professor Dr Paulo R. Menezes, Department of Preventive Medicine, University of São Paulo Medical School, Av. Dr. Arnaldo 455, Sao Paulo–SP, Brazil, CEP 01246-903. Email: pmenezes{at}usp.br

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Little is known about the incidence of first-episode psychosis in urban centres of low- or middle-income countries.

Aims To estimate the incidence of psychosis in São Paulo, a large metropolis of Brazil.

Method Prospective survey of first-episode psychosis among residents aged 18–64 years resident in a defined area of São Paulo, over a 30-month period (July 20 2002–December 2004). Assessments were carried out withthe SCID–I, and diagnoses given according to DSM–IV criteria. Population at risk was drawn from the 2000 Census data.

Results There were 367 first-episode cases identified (51% women), and almost 40% fulfilled criteria for schizophrenia or schizophreniform disorder. The incidence rate for any psychosis was 15.8/100 000 person-years at risk (95% CI 14.3–17.6). Incidence of non-affective psychoses was higher among younger males.

Conclusions Incidence of psychosisin São Paulo was lower than expected for a large metropolis.

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