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Evidence for a Gender-Specific Decline in the Rate of Schizophrenia in Rural Ireland over a 50-Year Period

Published online by Cambridge University Press:  02 January 2018

John L. Waddington  and
Hanafy A. Youssef
John L. Waddington*
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin
Hanafy A. Youssef
Affiliation:
St Davnet's Hospital, Monaghan, Ireland
*
∗Correspondence
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Abstract

The issue of whether the incidence rate of schizophrenia may have declined over recent decades has generated considerable controversy. This study sought to ascertain and interview all patients who satisfied contemporary diagnostic criteria for schizophrenia within a defined and unusually homogeneous region of rural Ireland having a total population of 25 178 people; morbid risk for schizophrenia was then examined by quinquennia of birth from 1920–24 to 1965–69. Morbid risk appeared essentially constant for persons born between 1920 and 1939 but fell by 37% for those born between 1940 and 1969, the fall being considerably more prominent in females (–56%) than in males (–19%). Attention is focused on sexual dimorphism in cerebral development and on temporal changes in endogenous or exogenous factors that influence the rate of occurrence of schizophrenia in females.

Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 2 , February 1994 , pp. 171 - 176
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Alda, M., Dvorakova, M., Zvolsky, P., et al (1989) Genetic aspects in chronic schizophrenia: morbidity risks and contributory factors. Schizophrenia Research, 2, 339–344.10.1016/0920-9964(89)90025-XGoogle Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Castle, D. J. & Murray, R. M. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine, 21, 565–575.10.1017/S0033291700022194Google Scholar
Castle, D. J. Wessely, S., Der, G., et al (1991) The incidence of operationally defined schizophrenia in Camberwell, 1965–84. British Journal of Psychiatry, 159, 790–794.10.1192/bjp.159.6.790CrossRefGoogle ScholarPubMed
Central Statistics Office (1922–69) Annual Reports on Vital Statistics. Dublin, Ireland: Government Stationery Office.Google Scholar
Central Statistics Office (1987) Census '86: County Cavan. Dublin, Ireland: Government Stationery Office.Google Scholar
Crow, T. J. (1990) Trends in schizophrenia. Lancet, 335, 851.10.1016/0140-6736(90)90963-6Google Scholar
Dawber, T. R. (1980) The Framingham Study: the Epidemiology of Atherosclerotic Disease. Cambridge, MA: Harvard University Press.10.4159/harvard.9780674492097CrossRefGoogle Scholar
Dawber, T. R., Meadors, G. F. & Moore, F. E. (1951) Epidemiological approaches to heart disease: the Framingham study. American Journal of Public Health, 41, 279–286.10.2105/AJPH.41.3.279CrossRefGoogle ScholarPubMed
Der, G., Gupta, S. & Murray, R. M. (1990) Is schizophrenia disappearing? Lancet, 335, 513–516.10.1016/0140-6736(90)90745-QGoogle Scholar
Eagles, J. M. (1991) Is schizophrenia disappearing? British Journal of Psychiatry, 158, 834–835.10.1192/bjp.158.6.834Google Scholar
Eagles, J. M. & Whalley, L. J. (1985) Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969–78. British Journal of Psychiatry, 146, 151–154.10.1192/bjp.146.2.151Google Scholar
Eagles, J. M., Hunter, D. & McCance, C. (1988) Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-eastern Scotland, 1969–84. British Journal of Psychiatry, 152, 793–798.10.1192/bjp.152.6.793Google Scholar
Gardner, M. J. & Altman, D. G. (1989) Statistics with Confidence: Confidence Intervals and Statistical Guidelines. London: British Medical Journal.Google Scholar
Goldstein, J. M. & Tsuang, M. T. (1990) Gender and schizophrenia. Schizophrenia Bulletin, 16, 179–183.10.1093/schbul/16.2.179Google Scholar
Gottesman, I. I. & Shields, J. (1982) Schizophrenia: the Epigenetic Puzzle. Cambridge, UK: Cambridge University Press.Google Scholar
Graham, P. M. (1990) Trends in schizophrenia. Lancet, 335, 852.Google Scholar
Green, M. F., Satz, P., Gaier, D. J., et al (1989) Minor physical anomalies in schizophrenia. Schizophrenia Bulletin, 15, 91–99.10.1093/schbul/15.1.91Google Scholar
Hafner, H. (1987) Epidemiology of schizophrenia. In Search for the Causes of Schizophrenia (eds H. Hafner, W. F. Gattaz & W. Janzarik), pp. 47–74. Berlin: Springer-Verlag.10.1007/978-3-642-71765-9_6Google Scholar
Hafner, H. & Gattaz, W. F. (1991) Is schizophrenia disappearing? European Archives of Psychiatry and Clinical Neuroscience, 240, 374–376.Google Scholar
Hare, E. (1983) Was insanity on the increase? British Journal of Psychiatry, 142, 439–455.10.1192/bjp.142.5.439Google Scholar
Harrison, G., Cooper, J. E. & Gancarczyk, R. (1991) Changes in the administrative incidence of schizophrenia. British Journal of Psychiatry, 159, 811–816.10.1192/bjp.159.6.811Google Scholar
Jeste, D. V., Del Carman, R., Lohr, J. B., et al (1985) Did schizophrenia exist before the eighteenth century? Comprehensive Psychiatry, 26, 493–503.10.1016/0010-440X(85)90016-1Google Scholar
Joyce, P. R. (1987) Changing trends in first admissions and readmissions for mania and schizophrenia in New Zealand, 1974 to 1984. Australian and New Zealand Journal of Psychiatry, 21, 82–86.10.3109/00048678709160903Google Scholar
King, D. J. & Cooper, S. J. (1989) Viruses, immunity and mental disorder. British Journal of Psychiatry, 154, 1–7.10.1192/bjp.154.1.1Google Scholar
Kleinbaum, D. G., Kupper, L. L. & Morgenstern, H. (1982) Epidemiologic Research: Principles and Quantitative Methods. Belmont, CA: Lifetime Learning Publications.Google Scholar
Lewis, S. W. (1989) Congenital risk factors for schizophrenia. Psychological Medicine, 19, 5–13.10.1017/S0033291700010977CrossRefGoogle ScholarPubMed
Manderscheid, R. W., Locke, B. Z., Pato, C. N., et al (1990) Trends in schizophrenia. Lancet, 335, 1097–1098.10.1016/0140-6736(90)92671-4Google Scholar
McNeil, T. F. (1991) Obstetric complications in schizophrenic parents. Schizophrenia Research, 5, 89–101.10.1016/0920-9964(91)90036-QGoogle Scholar
Mednick, S. A., Machon, R. A., Huttenen, M. O., et al (1988) Adult schizophrenia following prenatal exposure to an influenza epidemic. Archives of General Psychiatry, 45, 189–192.10.1001/archpsyc.1988.01800260109013CrossRefGoogle Scholar
Midgard, R., Riise, T. & Nyland, H. (1991) Epidemiologic trends in multiple sclerosis in More and Romsdal, Norway. Neurology, 41, 887–892.10.1212/WNL.41.6.887Google Scholar
Munk-Jorgensen, P. (1986) Decreasing first-admission rates of schizophrenia among males in Denmark from 1970 to 1984. Acta Psychiatrica Scandinavica, 73, 645–650.10.1111/j.1600-0447.1986.tb02738.xGoogle Scholar
Munk-Jorgensen, P. & Jorgensen, P. (1986) Declining rates of first-admission diagnoses of schizophrenia among females in Denmark 1970–84. Acta Psychiatrica Scandinavica, 74, 379–383.Google Scholar
Murray, R. M. & Lewis, S. W. (1987) Is schizophrenia a neurodevelopmental disorder? British Medical Journal, 295, 681–682.10.1136/bmj.295.6600.681Google Scholar
Murray, R. M., Gupta, S. & Der, G. (1990) Trends in schizophrenia. Lancet, 335, 1214.10.1016/0140-6736(90)92729-2CrossRefGoogle ScholarPubMed
Nielsen, J. & Nielsen, J. A. (1977) A census study of mental illness in Samso. Psychological Medicine, 7, 491–503.10.1017/S0033291700004475Google Scholar
Ni Nuallain, M., O'Hare, A. & Walsh, D. (1990) The prevalence of schizophrenia in three counties in Ireland. Acta Psychiatrica Scandinavica, 82, 136–140.10.1111/j.1600-0447.1990.tb01370.xGoogle Scholar
O'Callaghan, E., Sham, P., Takei, N., et al (1991a) Schizophrenia after prenatal exposure to 1957 A2 influenza epidemic. Lancet, 337, 1248–1250.10.1016/0140-6736(91)92919-SCrossRefGoogle ScholarPubMed
O'Callaghan, E., Larkin, C., Kinsella, A., et al (1991b) Familial, obstetric and other clinical correlates of minor physical anomalies in schizophrenia. American Journal of Psychiatry, 148, 479–483.Google Scholar
Parker, G., O'Connell, M. & Walter, S. (1985) Changes in the diagnosis of the functional psychoses associated with the introduction of lithium. British Journal of Psychiatry, 146, 377–382.10.1192/bjp.146.4.377Google Scholar
Prince, M. J. & Phelan, M. C. (1990) Trends in schizophrenia. Lancet, 335, 851–852.Google Scholar
Roberts, G. W., Done, D. J., Bruton, C., et al (1990) A ‘mock up’ of schizophrenia: temporal lobe epilepsy and schizophrenialike psychosis. Biological Psychiatry, 28, 127–143.10.1016/0006-3223(90)90630-KGoogle Scholar
Stromgren, E. (1935) Zum Ersatz des Weinbergschen ‘abgekurzten Verfahrens’ zugleich ein Betreig zur Frage von der Erblichkeit des Erkrankung salters bei der Schizophrenie. Zeitung fur Neurologie und Psychiatrie, 153, 784–797.Google Scholar
Stromgren, E. (1987) Changes in the incidence of schizophrenia? British Journal of Psychiatry, 150, 1–7.10.1192/bjp.150.1.1Google Scholar
Susser, E. & Lin, S. (1992) Schizophrenia after prenatal exposure to the Dutch hunger winter of 1944–45. Archives of General Psychiatry, 49, 983–988.10.1001/archpsyc.1992.01820120071010Google Scholar
Torrey, E. F. (1987) Prevalence studies in schizophrenia. British Journal of Psychiatry, 150, 598–608.10.1192/bjp.150.5.598Google Scholar
Torrey, E. F. (1989) Schizophrenia: fixed incidence or fixed thinking? Psychological Medicine, 19, 285–287.10.1017/S0033291700012320Google Scholar
Torrey, E. F., Rawlings, R. & Waldman, I. N. (1988) Schizophrenic births and viral diseases in two states. Schizophrenia Research, 1, 73–77.10.1016/0920-9964(88)90043-6Google Scholar
Waddington, J. L. (1993) Schizophrenia: developmental neuroscience and pathobiology. Lancet, 341, 531–536.10.1016/0140-6736(93)90288-RGoogle Scholar
Waddington, J. L. & Weller, M. P. I. (1992) Schizophrenia: genetic retrenchment and epidemiological renaissance. Archives of General Psychiatry, 49, 990–994.10.1001/archpsyc.1992.01820120078011Google Scholar
Weinberger, D. R. (1987) Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry, 44, 660–669.10.1001/archpsyc.1987.01800190080012Google Scholar
Youssef, H. A., Kinsella, A. & Waddington, J. L. (1991) Evidence for geographical variations in the prevalence of schizophrenia in rural Ireland. Archives of General Psychiatry, 48, 254–258.10.1001/archpsyc.1991.01810270066009Google Scholar
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