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The Problem of Detecting Changes in the Incidence of Schizophrenia

Published online by Cambridge University Press:  02 January 2018

R. E. Kendell ,
D. E. Malcolm  and
W. Adams
R. E. Kendell*
Affiliation:
Edinburgh University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh EH10 5HF
D. E. Malcolm
Affiliation:
Royal Edinburgh Hospital
W. Adams
Affiliation:
Medical Statistics Unit, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AF
*
∗The Scottish Office, Home and Health Department, St Andrew's House, Edinburgh EH1 3DE
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Abstract

Despite reports of falling first-admission rates for schizophrenia in the UK and other Western countries, it would be rash to conclude that the incidence of schizophrenia is falling. An attempt was made to tackle the many methodological problems and sources of bias influencing the relationship between admission rates and incidence in an analysis of inception rates for schizophrenia and other psychoses in Edinburgh between 1971 and 1989. However it was calculated, the inception rate for schizophrenia fell significantly, but because there was evidence that diagnostic criteria for schizophrenia had narrowed between 1971 and 1989, and because a substantial and changing proportion of recorded first admissions were not true first admissions, it was impossible to conclude that the incidence of schizophrenia had fallen. Changes in the incidence of psychiatric syndromes are difficult to establish, particularly in retrospect, and future studies must pay more attention to the many possible confounding influences.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 2 , February 1993 , pp. 212 - 218
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Anderson, I. B., Sorensen, T. I. A. & Prener, A. (1991) Increase in incidence of disease due to diagnostic drift: primary liver cancer in Denmark, 1943–85. British Medical Journal, 302, 437–440.CrossRefGoogle ScholarPubMed
Bamrah, J. S., Freeman, H. L. & Goldberg, D. P. (1991) Epidemiology of schizophrenia in Salford, 1974–84. British Journal of Psychiatry, 159, 802–810.CrossRefGoogle ScholarPubMed
Castle, D., Wessely, S., Der, G., et al (1991) The incidence of operationally defined schizophrenia in Camberwell, 1965–84. British Journal of Psychiatry, 159, 790–794.CrossRefGoogle ScholarPubMed
Cooper, J. E., Goodhead, D., Craig, T., et al (1987) The incidence of schizophrenia in Nottingham. British Journal of Psychiatry, 151, 619–626.Google Scholar
de Alarçon, J., Seagroatt, V., & Goldacre, M. (1990) Trends in schizophrenia. Lancet, 335, 852–853.Google Scholar
Der, G., Gupta, S. & Murray, R. M. (1990) Is schizophrenia disappearing? Lancet, 335, 513–516.CrossRefGoogle Scholar
Dickson, W. E. & Kendell, R. E. (1986) Does maintenance lithium therapy prevent recurrences of mania under ordinary clinical conditions? Psychological Medicine, 16, 521–530.CrossRefGoogle ScholarPubMed
Eagles, J. M. & Whalley, L. J. (1985) Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969–1978. British Journal of Psychiatry, 146, 151–154.CrossRefGoogle Scholar
Eagles, J. M. & Whalley, L. J., Hunter, D. & McCance, C. (1988) Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in North East Scotland, 1969–1984. British Journal of Psychiatry, 152, 793–798.Google Scholar
Endicott, J. & Spitzer, R. L. (1978) Schedule for Affective Disorders and Schizophrenia - Life-time Version (3rd edn). New York: New York State Psychiatric Institute.Google Scholar
Häfner, H. & Gattaz, W. F. (1991) Is schizophrenia disappearing? European Archives of Psychiatry and Clinical Neuroscience, 240, 374–376.Google Scholar
Hare, E. H. (1988) Schizophrenia as a recent disease. British Journal of Psychiatry, 153, 521–531.CrossRefGoogle ScholarPubMed
Harrison, G., Cooper, J. E. & Gancarczyk, R. (1991) Changes in the administrative incidence of schizophrenia. British Journal of Psychiatry, 159, 811–816.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Klerman, G. L., Lavori, P. W., Rice, J., et al (1985) Birth cohort trends in rates of major depressive disorder among relatives of patients with affective disorder. Archives of General Psychiatry, 42, 689–693.CrossRefGoogle ScholarPubMed
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the opcrit system. Archives of General Psychiatry, 48, 764–770.CrossRefGoogle ScholarPubMed
Munk-Jörgensen, P. (1986) Decreasing first admission rates of schizophrenia among males in Denmark from 1970 to 1984. Acta Psychiatrica Scandinavica, 73, 645–650.CrossRefGoogle ScholarPubMed
Munk-Jörgensen, P. & Jörgensen, P. (1986) Decreasing rates of first admission diagnoses of schizophrenia among females in Denmark 1970–84. Acta Psychiatrica Scandinavica, 74, 379–383.CrossRefGoogle ScholarPubMed
Parker, G., O'Donnell, M. & Walter, S. (1985) Changes in the diagnoses of the functional psychoses associated with the introduction of lithium. British Journal of Psychiatry, 146, 377–382.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders (3rd edn). New York: New York State Psychiatric Institute.Google Scholar
Syvänne, S. (1952) Incidence of schizophrenic diseases in Helsinki in 1929–1938 and 1946–1950. Acta Psychiatrica Scandinavica (suppl. 80), 53–59.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
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