Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T21:31:49.471Z Has data issue: false hasContentIssue false
  • English
  • Français

First admissions to inpatient care in Ireland for schizophrenia 1971-2004: trends in gender and age

Published online by Cambridge University Press:  13 June 2014

Caroline Hart ,
Donna T Doherty  and
Dermot Walsh
Caroline Hart
Affiliation:
Mental Health Research Unit, Health Research Board, Third Floor, Knockmaun House, 42-47 Lower Mount Street, Dublin 2, Ireland.
Donna T Doherty
Affiliation:
Mental Health Research Unit, Health Research Board, Third Floor, Knockmaun House, 42-47 Lower Mount Street, Dublin 2, Ireland.
Dermot Walsh
Affiliation:
Mental Health Research Unit, Health Research Board, Third Floor, Knockmaun House, 42-47 Lower Mount Street, Dublin 2, Ireland.
Get access Rights & Permissions [Opens in a new window]

Abstract

First admissions for schizophrenia to inpatient psychiatric services in Ireland are declining. The reason for this decline has been debated and it has been proposed that it could be attributable to either a decline in incidence or to policy changes or to both.

Objectives: This study examines the trends in first admission numbers for schizophrenia in Ireland and the influence of gender and marital status on age at first admission over the time period 1971-2004.

Method: Data were derived from the National Psychiatric Inpatient Recording System (NPIRS) for the years 1971-2004 inclusive. All first admissions with a diagnosis of schizophrenia during these years were included in the analysis.

Results: The results showed a significant decline in the number of first admissions with the number of first admissions for males exceeding those for females. The average age of first admission was higher for females than males (p < 0.001). The average age of first admission showed a decline for males (p < 0.001), but not for females. Marital status was a stronger predictor of age of admission than gender (p < 0.001). Never married persons had a lower age of first admission than those married and the delaying effect of marriage on age at first admission was evident in males and females (p < 0.001).

Conclusions: An examination of first admission hospital data confirm male disadvantage in schizophrenia. The study highlighted a number of areas for future research which include examining gender differences in more refined diagnostic sub groups of schizophrenia and the monitoring of first contacts with community-based mental health services.

Keywords

Time trendsAge of admissionGender and ageFirst admissionsMarital statusInpatient admissionsIncidenceDelaying effects.
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 24 , Issue 4 , December 2007 , pp. 132 - 139
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Daly, A, Walsh, D, Kartalova O'Doherty, Y, Moran, R, Comish, J, O'Reilly, A. Activities of Irish Psychiatric Units and Hospitals 2004. Dublin: Health Research Board, 2005.Google Scholar
2.Walsh, D, Daly, A. Mental Illness in Ireland 1750-2002, Reflections on the rise and fall of institutional care. Dublin: Health Research Board, 2004.Google Scholar
3.Salokangas, RKR, Homkonen, T, Saarinen, S. Women have later onset than men in schizophrenia – but only in its paranoid form. Results of the DSD project. Eur Psychiatry 2003; 18: 274–281.CrossRefGoogle ScholarPubMed
4.Naqvi, H, Khan, M, Faizi, F. Gender differences in age at onset of schizophrenia. J Coll Physicians Surg Pakistan 2005; 15(6): 345–348.Google ScholarPubMed
5.Jablensky, A, Cole, S. Is the earlier age at onset of schizophrenia in males a confounded finding? Results from a cross-cultural investigation. Br J Psychiatry 1997; 170: 234–240.CrossRefGoogle Scholar
6.Eaton, W. Epidemiology of Schizophrenia. Epidemiological Rev 1985; 7: 105–126.CrossRefGoogle ScholarPubMed
7.Piccinelli, M, Homen, F. Gender differences in the epidemiology of affective disorders and schizophrenia. Geneva: World Health Organisation, 1997: 111. www.who.int/mental_health/media/en/54.pdfGoogle Scholar
8.Lewine, RJ, Strauss, JS, Gift, MD. Gender differences in age at first hospital admission for schizophrenia: fact or artefact? Am J Psychiatry 1981; 138: 4.Google Scholar
9.Hafner, H, Maurer, K, Loffler, W, Riecher-Rossler, A. The influence of age and sex on the onset and course of early schizophrenia. Br J Psychiatry 1993; 162: 80–86.CrossRefGoogle Scholar
10.Angermeyer, MC, Kuhn, L. Gender differences in age at onset of schizophrenia. Eur Arch Psychiatry Clin Neurosci 1988; 237: 351–364.Google ScholarPubMed
11.Eagles, JM, Whalley, LJ. Decline in the diagnosis of schizophrenia among first admissions to Scottish Mental Hospitals irom 1969-1978. Br J Psychiatry 1985; 146: 151–154.CrossRefGoogle Scholar
12.Prince, M, Phelan, JC. ‘Letters to the Editor’. The Lancet 1990; 335: 851.Google Scholar
13.Jalensky, A. Schizophrenia: Recent epidemiologic issues. Epidemiol Rev 1995; 17: 10–20.CrossRefGoogle Scholar
14.Oldehinkel, AJ, Giel, R. Time trends in the care-based incidence of schizophrenia. Br J Psychiatry 1995; 167: 777–782.CrossRefGoogle ScholarPubMed
15.Waddington, JL, Youssef, HA. The evidence for a gender specific decline in the rate of schizophrenia in rural Ireland over a 50 year period. Br J Psychiatry 1994; 164(Feb): 171–176.CrossRefGoogle Scholar
16.Ni Nuallain, M, O'Hare, M, Walsh, D. The prevalence of schizophrenia in three counties in Ireland. Acta Psychiatr Scand 1990; 82: 136–140.CrossRefGoogle ScholarPubMed
17.Scully, PJet al.First-episode schizophrenia, bipolar disorder and other psychoses in a rural catchment area: incidence and gender in the Cavan-Monaghan study at 5 years. Br J Psychiatry 2002; 181(43):S3–S9.CrossRefGoogle Scholar
18.Baldwin, Pet al.Epidemiology of First Episode Psychosis: Illustrating the Challenges Across Diagnostic Boundaries Through the Cavan-Monaghan Study at 8 Years. Schizophrenian Bull 2005; 31(3): 624–638.CrossRefGoogle Scholar
19.Osby, U, Hammar, N, Brandt, L, Wicks, S, Thinsz, Z, Ekbom, A & Sparen, P. Time trends in first admissions for schizophrenia and paranoid psychosis in Stockholm County, Sweden. Schizophr Res 2001; 47(2-3): 247–254.CrossRefGoogle ScholarPubMed
20.World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders: Conversion Tables between ICD-8, ICD-9 and ICD-10. Geneva: World Health Organisation, Division of Mental Health, 1992.Google Scholar
21.Barbato, A. Schizophrenia and Public Health. Geneva: World Health Organisation, 1998.Google Scholar
22.Department of Health. Planning for the Future. Dublin: Stationery Office, 1984.Google Scholar
23.Department of Health and Children. A Vision for Change. Dublin: Stationery Office, 2006.Google Scholar
24.Kirkbride, JBet al.Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes. Findings from the 3-centre Aesop study. Arch Gen Psychiatry 2006; 63: 250–258.CrossRefGoogle Scholar
25.Jablensky, Aet al.Schizophrenia: Manifestations, incidence and course in different cultures -A World Health Organisation ten-country study. Psychol Med 1992; 20: 1–97.Google ScholarPubMed
26.Takahashi, Set al.Age at onset of schizophrenia: Gender differences and influence of temporal socioeconomic change. Psychiatry Clin Neurosci 2000; 54: 153–156.CrossRefGoogle ScholarPubMed
27.Riecher-Rossler, A, Fatkenheuer, B, Loffler, W, Maurer, K, Hafner, H. Is age of onset in schizophrenia influenced by marital status? Some remarks on the difficulties and pitfalls in the systematic testing of a simple question. Soc Psychiat Psychiatric Epidem 1992; 27(3): 122–128.CrossRefGoogle ScholarPubMed
28.Lawlor, E. Early Psychosis Intervention, DETECT (Dublin East Treatment and Early Care Team. The Irish Psychologist 2006; 32(8).Google Scholar