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Time Trends in the Care-Based Incidence of Schizophrenia

Published online by Cambridge University Press:  02 January 2018

A. J. Oldehinkel*
Affiliation:
Department of Social Psychiatry, University Hospital Groningen, The Netherlands
R. Giel
Affiliation:
Department of Social Psychiatry, University Hospital Groningen, The Netherlands
*
Dr Oldehinkel, Department of Social Psychiatry, University Hospital Groningen, P. O. Box 30.001, 9700 RB Groningen, The Netherlands

Abstract

Background

Several studies have suggested a declining first-admission rate for schizophrenia. This study examines the care-based incidence of schizophrenia in a Dutch register area.

Method

Data from Groningen psychiatric case register were used to compare first-admission rates for schizophrenia over 1976–90 with those of other functional psychoses, and to consider various potential biases.

Results

Diagnostic habits probably affected time trends in incidence rates. Using a broader definition of schizophrenia, no evidence was found for a decrease in the incidence of schizophrenia. Although first admissions to intramural services showed a (non-significant) decrease, this effect seemed to be neutralised when all mental health services were taken into account.

Conclusions

Care-based studies of time trends in psychiatric disorders should embrace all mental health services. Furthermore, unless a diagnostic classification system with univocal criteria is used, bias caused by changing diagnostic habits cannot be ruled out.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

De Alarcon, J., Seagroatt, V. & Goldacre, M. (1990) Trends in schizophrenia. Lancet, 335, 852853.Google Scholar
American Psychiatric Association (1968) Diagnostic and Statistical Manual of Mental Disorders (2nd edn) (DSM–II). Washington, DC: APA.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Breslow, N. E. & Day, N. E. (1987) Statistical Methods in Cancer Research. Volume II – the Design and Analysis of Cohort Studies. Lyon: International Agency for Research on Cancer.Google Scholar
Cross-National Collaborative Group (1992) The changing rate of major depression: cross-national comparisons. JAMA, 268, 30983105.Google Scholar
Der, G., Gupta, S. & Murray, R. M. (1990) Is schizophrenia disappearing? Lancet, 335, 513516.Google Scholar
Eagles, J. M., Hunter, D. & McCance, C. (1988) Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-east Scotland, 1969–84. British Journal of Psychiatry, 152, 793798.Google Scholar
Farmer, A. E., McGuffin, P., Harvey, I., et al (1991) Schizophrenia: how far can we go in defining the phenotype? In The New Genetics of Mental Illness (eds McGuffin, P. & Murray, R.), pp 7184. Oxford: Butterworth-Heinemann.Google Scholar
Folnegović, Z., Folnegović-Šmalc, V. & Kulčar, Ž. (1990) The incidence of schizophrenia in Croatia. British Journal of Psychiatry, 156, 363365.Google Scholar
Geddes, J. R., Black, R. J., Whalley, L. J., et al (1993) Persistence of the decline in the diagnosis of schizophrenia among first admissions to Scottish hospitals from 1969 to 1988. British Journal of Psychiatry, 163, 620626.Google Scholar
Häfner, H. & Gattaz, W. F. (1991) Is schizophrenia disappearing? European Archives of Psychiatry and Clinical Neuroscience, 240, 374376.Google 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, 8286.Google Scholar
Kendell, R. E., Malcolm, D. E. & Adams, W. (1993) The problem of detecting changes in the incidence of schizophrenia. British Journal of Psychiatry, 162, 212218.Google Scholar
Löffler, W., Häfner, H., Fätkenheuer, B., et al (1994) Validation of Danish case register diagnosis for schizophrenia. Acta Psychiatrica Scandinavica, 90, 196203.Google Scholar
Loranger, A. W. (1990) The impact of DSM–III on diagnostic practice in a university hospital: a comparison of DSM–II and DSM–III in 10914 patients. Archives of General Psychiatry, 47, 672675.Google Scholar
Munk-J⊘rgensen, P. (1986) Decreasing first-admission rates of schizophrenia among males in Denmark from 1970 to 1984: changing diagnostic patterns? Acta Psychiatrica Scandinavica, 73, 645650.Google Scholar
Munk-J⊘rgensen, , & J⊘rgensen, P. (1986) Decreasing rates of first-admission diagnoses of schizophrenia among females in Denmark 1970–84. Acta Psychiatrica Scandinavica, 74, 379383.Google Scholar
Munk-J⊘rgensen, , & Mortensen, P. B. (1992) Incidence and other aspects of the epidemiology of schizophrenia in Denmark, 1971–87. British Journal of Psychiatry, 161, 489495.CrossRefGoogle Scholar
Nicole, L., Lesage, A. & Lalonde, P. (1992) Lower incidence and increased male:female ratio in schizophrenia. British Journal of Psychiatry, 161, 556557.CrossRefGoogle ScholarPubMed
Okasha, A., Sadek, A., Al-Haddad, M. K., et al (1993) Diagnostic agreement in psychiatry: a comparative study between ICD–9, ICD–10 and DSM–III–R. British Journal of Psychiatry, 162, 621626.Google Scholar
Parker, G., O'Donnell, M. & Walter, S. (1985) Changes in the diagnosis of the functional psychoses associated with the introduction of lithium. British Journal of Psychiatry, 146, 377382.Google Scholar
Sytema, S., Ten Horn, G. H. M. M., Balestrieri, M., et al (1989) The reliability of diagnostic coding in psychiatric case registers. Psychological Medicine, 19, 9991006.Google Scholar
Waddington, J. L. & Youssef, H. A. (1994) Evidence for a gender-specific decline in the rate of schizophrenia in rural Ireland over a 50-year period. British Journal of Psychiatry, 164, 171176.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1965) International Classification of Disease (8th edn) (ICD–8). Geneva: WHO.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Division of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
World Health Organization (1992) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.Google Scholar
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