Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T04:52:11.705Z Has data issue: false hasContentIssue false

Prevalence of schizophrenia and related disorders in Malaga (Spain): results using multiple clinical databases

Published online by Cambridge University Press:  15 October 2014

B. Moreno-Küstner*
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
F. Mayoral
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
D. Navas-Campaña
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
J. M. García-Herrera
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
P. Angona
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
C. Martín
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
F. Rivas
Affiliation:
Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
*
*Address for correspondence: Professor B. Moreno-Küstner, Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Malaga, Campus Universitario Teatinos, 29071 Malaga, Spain. (Email: bertamk@uma.es)

Abstract

Background.

To calculate the 1-year prevalence of schizophrenia and related disorders in a catchment area of Malaga (Spain) and determine the prevalence by gender, dwelling (rural or urban) and socioeconomic area (deprived or non-deprived area).

Method.

This cross-sectional study comprised the mental health area covered by Carlos Haya Hospital. We used multiple large clinical databases and key informants to identify cases.

Results.

The mean 1-year prevalence of schizophrenia and related disorders was 6.27 per 1000. It was nearly double in men (8.45 per 1000) than in women (4.26 per 1000) (p < 0.001), with a male-to-female ratio of 1.98. The rate was higher in urban (6.64 per 1000) than rural areas (3.95 per 1000) (p < 0.0001) and in socioeconomic deprived areas (7.56 per 1000) than non-deprived areas (6.12 per 1000) (p = 0.005). For the subgroup of schizophrenia, the rates were: men, 5.88 per 1000 and women, 2.2 per 1000 (p < 0.0001), with a male-to-female ratio of 2.67. The rate was also higher in urban (4.2 per 1000) than rural areas (2.49 per 1000) (p < 0.0001) and in socioeconomic deprived areas (4.49 per 1000) than non-deprived areas (3.9 per 1000) (p = 0.149).

Conclusions.

The use of multiple clinical sources of information not only from mental health services, but also from emergency departments, primary care and private settings revealed high prevalence rates of schizophrenia and related disorders. This diagnosis is more common in men and in cities. Such precise estimates of the prevalence of schizophrenia have important repercussions for resource allocation and policy planning.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

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

Anderson, KK (2013). Health service registry data in psychiatric epidemiology: challenges for definition and interpretation. Acta Psychiatrica Scandinavica 127, 910.Google Scholar
Aleman, A, Kahn, RS, Selten, JP (2003). Sex differences in the risk of schizophrenia, evidence from meta-analysis. Archives of General Psychiatry 60, 565571.Google Scholar
Aräjarvi, R, Suvisaari, J, Suokas, J, Schreck, M, Haukka, J, Hintikka, J, Partonen, T, Lönnqvist, J (2005). Prevalence and diagnosis of schizophrenia based on register, case record and interview data in an isolated Finnish birth cohort born 1940–1969. Social Psychiatry and Psychiatric Epidemiology 40, 808816.Google Scholar
Ayuso-Mateos, JL, Gutierrez-Recacha, P, Haro, JM, Chisholm, D (2006). Estimating the prevalece of schizophrenia in Spain using a disease model. Schizophrenia Research 86, 194201.Google Scholar
Bamrah, JS, Freeman, HL, Goldberg, DP (1991). Epidemiology of schizophrenia in Salford, 1974–84. Changes in an urban community over ten years. British Journal of Psychiatry 159, 802810.Google Scholar
Byrne, N, Regan, C, Howard, L (2005). Administrative registers in psychiatric research, a systematic review of validity studies. Acta Psychiatrica Scandinavica 112, 409414.Google Scholar
de Salvia, D, Barbato, A, Salvo, P, Zadro, F (1993). Prevalence and incidencre of schizophreic disorders in Portogruaro. An Italian Case Register Study. Journal of Nervous and Mental Disease 181, 275282.CrossRefGoogle ScholarPubMed
Drukker, M, Krabbendam, L, Driessen, G, vas Os, J (2006). Social disadvantage and schizophrenia. A combined neighbourhood and individual-level analysis. Social Psychiatry and Psychiatric Epidemiology 41, 595604.Google Scholar
Fletcher, RH, Fletcher, SW, Wagner, EH (2002). Epidemiología Clínica. Masson: Barcelona.Google Scholar
Häfner, H, Maurer, K, Heiden, W (2013). ABC Schizophrenia study: an overview of results since 1996. Social Psychiatry and Psychiatric Epidemiology 48, 10211031.Google Scholar
Harvey, CA, Pantelis, C, Taylor, J, Mccabe, PJ, Lefevre, K, Campbell, PG, Hirsch, SR (1996). The Camden schizophrenia surveys. II. High prevalence of schizophrenia in an inner London borough and its relationship to socio-demographic factors. British Journal of Psychiatry 168, 418426.CrossRefGoogle Scholar
Iniesta, R, Ochoa, S, Usall, J (2012). Gender differences in service use in a sample of people with schizophrenia and other psychoses. Schizophrenia Research Treatment, 365452.Google Scholar
Jablensky, A (2000). Prevalence and incidence of schizophrenia spectrum disorders, implications for prevention. Australian New Zeland Journal of Psychiatry 34(Suppl.), S26S34.Google Scholar
Jablensky, A, McGrath, J, Herrman, H, Castle, D, Gureje, O, Evans, M, Carr, V, Morgan, V, Koerten, A, Harvey, C (2000). Psychotic disorders in urban areas: an overview of the study on low prevalence disorders. Australian and New Zealand Journal of Psychiatry 34, 221236.Google Scholar
Jeffreys, SE, Harvey, CA, Mcnaught, AS, Quayle, AS, King, MB, Bird, AS (1997). The Hampstead Schizophrenia Survey 1991. I, Prevalence and service use comparisons in an inner London health authority, 1986–1991. British Journal of Psychiatry 170, 301306.Google Scholar
Jörgensen, L, Ahlbom, A, Allebeck, P, Dalman, C (2010). The Stockholm non-affective psychoses study (SNAPS), the importance of including out-patient data in incidence studies. Acta Psychiatrica Scandinavica 121, 389392.Google Scholar
Jörgensen, L, Dalman, C, Allebeck, P (2014). Prevalence of psychoses in Stockholm County. A population-based study using comprehensive healthcare registers. Nordic Journal of Psychiatry 68, 6065.Google Scholar
Junta de Andalucía (2004). Atención a la Salud en las Zonas con Necesidades de Transformación Social. Consejería para la Igualdad y el Bienestar Social de la Junta de Andalucía: Sevilla.Google Scholar
Katschnig, H (2011). Monitoring service utilization of persons with mental disorders-a case for mapping pathways of care. Epidemiology and Psychiatric Sciences 20, 713.Google Scholar
Kirkbride, JB, Boydell, J, Ploubidis, GB, Morga, C, Dazzan, P, McKenzie, K, Murray, RM and Jones, PB (2008). Testing the association between the incidence of schizophrenia and social capital in an urban area. Psychological Medicine 38, 10831094.Google Scholar
Kirkbride, JB, Errazuriz, A, Croudace, TJ, Morgan, C, Jackson, D, McCrone, P, Murray, RM, Jones, PB (2012). Department of Health report on prevalence (Chapter 5). Retrieved 13 June 2014 from http://www.psychiatry.cam.ac.uk/wp-content/uploads/2012/05/Final-report-v1.05-Jan-12.pdf Google Scholar
Kirkbride, J, Jones, PB, Ullrich, S, Coid, JW (2014). Social Deprivation, inequality, and the neihborhood-level incidence of psychotic syndromes in East London. Schizophrenia Bulletin 40, 169180.Google Scholar
Lix, LM, Deverteuil, G, Walker, JR, Robinson, RJ, Hinds, AM, Roos, LL (2007). Residential mobility of individuals with diagnoses schizophrenia: a comparison of single and multiple movers. Social Psychiatry and Psychiatric Epidemiology 42, 221228.Google Scholar
March, D, Hatch, SL, Morgan, C, Kirkbride, JB, Bresnahan, M, Fearon, P, Susser, E (2008). Psychosis and Place. Epidemiologic Reviews 30, 84100.CrossRefGoogle ScholarPubMed
McCreadie, RG, Leese, M, Tilak-Singh, D, Loftus, L, Macewan, T, Thornicroft, G (1997). Nithsdale, Nunhead and Norwood, similarities and differences in prevalence of schizophrenia and utilisation of services in rural and urban areas. British Journal of Psychiatry 170, 3136.Google Scholar
McGrath, JJ (2005). Myths and plain truths about schizophrenia epidemiology. The NAPE lecture 2004. Acta Psychiatrica Scandinavica 111, 411.Google Scholar
McGrath, JJ (2007). The surprisingly rich contours of schizophrenia epidemiology. Archives of General Psychiatry 64, 1416.Google Scholar
McGrath, JJ, Susser, E (2009). New directions in the epidemiology of schizophrenia. Medical Journal of Australia 190, S7S9.Google Scholar
McGrath, JJ, Saha, S, Chant, D, Welham, J (2008). Schizophrenia, A concise overview of incidence, prevalence and mortality. Epidemiological Review 30, 6776.CrossRefGoogle ScholarPubMed
Moreno, B, Arroyo, B, Torres, F, Luna, JD, Cervilla, J (2007). Social Predictors of out-patient mental health contact in schizophrenia patients. Social Psychiatry and Psychiatric Epidemiology 42, 452456.Google Scholar
Moreno, B, Mayoral, F, Pérez, O, García-Herrera, JM, Algarra, J, Rivas, F, Pérez, R, Becerra, F, Gornemann, I (2009). The Málaga Schizophrenia Case-Register (RESMA). Overview of methodology and patient cohort. International Journal of Social Psychiatry 55, 515.Google Scholar
Moreno-Küstner, B, Mayoral, F, Rivas, F, Angona, P, Requena, J, García-Herrera, JM, Navas, D, Moreno, P, Serrano-Blanco, A, Bellón, JA (2011). Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis. BMC Health Services Research 11, 257.CrossRefGoogle ScholarPubMed
Moreno-Küstner, B, Martín, C, Almenara, J (2014). Revisión crítica de las fuentes de variabilidad en la medición de la prevalencia de esquizofrenia. Salud Mental 37, 127138.Google Scholar
Morgan, VA, Jablensky, A (2010). From inventory to benchmark: quality of psychiatric case registers in research. British Journal of Psychiatry 197, 810.Google Scholar
Morgan, VA, Castle, DJ, Jablensky, AV (2008). Do women express and experience psychosis differently from men? Epidemiological evidence from the Australian National Study of Low Prevalence (Psychotic) Disorders. Australian and New Zealand Journal of Psychiatry 42, 7482.Google Scholar
Ngamini Ngui, A, Cohen, AA, Courteau, J, Lesage, A, Fleury, MJ, Grégoire, JP, Moisan, J, Vanesse, A (2013). Does elapsed time between first diagnosis of schizophrenia and migration between health territories vary by place of residence? A survival analysis approach. Health and Place 20, 6674.CrossRefGoogle ScholarPubMed
Ochoa, S, Usall, J, Cobo, J, Labad, X, Kulkarni, J (2012). Gender differences in schizophrenia and first-episode psychosis. A comprehensive literature review. Schizophrenia Research Treatment, 916198.Google Scholar
Oiesvold, T, Nivison, M, Hansen, V, Skre, I, Ostensen, L, Sorgaard, KW (2013). Diagnosing comorbidity in psychiatric hospital: challenging the validity of administrative registers. BMC Psychiatry 13, 13.Google Scholar
Përalä, J, Suvisaari, J, Saarni, SI, Kuoppasalmi, K, Isometsä, E, Pirkola, S, Partonen, T, Tuulio-Henriksson, A, Hintikka, J, Kieseppä, T, Härkänen, T, Koskinen, S, Lönnqvist, J (2007). Lifetime prevalence of psychotic and bipolar I disorders in a general population. Archives of General Psychiatry 64, 1928.CrossRefGoogle ScholarPubMed
Ruggeri, M, Leese, M, Thornicroft, G, Bisoffi, G, Tansella, M (2000). Definition and prevalence of severe and persistent mental illness. British Journal of Psychiatry 177, 149155.Google Scholar
Saha, S, Chant, D, Welham, J, McGrath, JJ (2005). A systematic review of the prevalence of schizophrenia. PLoS Medicine 2, 413433.Google Scholar
Stata Corporation LP (2009). Stata, Release 11. Statistical Software: College Station, Texas.Google Scholar
Tandon, R, Keshavan, MS, Nasrallah, HA (2008). Schizophrenia, “Just the Facts” What we know in 2008. 2. Epidemiology and etiology. Schizophrenia Research 102, 118.Google Scholar
Thornicroft, G, Strathdee, G, Phelan, M, Holloway, F, Wykes, T, Dunn, G, McCrone, P, Leese, M, Johnson, S, Szmukler, G (1998). Rationale and design. PRiSM Psychosis Study I. British Journal of Psychiatry 173, 363370.Google Scholar
Tizón, J, Ferrando, J, Parés, A, Artigué, J, Parra, B, Pérez, C (2007). Schizophrenic disorders in primary care mental health. Atención Primaria 39, 119126.Google Scholar
Usall, J, Haro, JM, Araya, S, Moreno, B, Muñoz, PE, Martínez, A, Salvador, L, Psicost Group. (2007). Social functioning in schizophrenia, what is the influence of gender? European Journal of Psychiatry 21, 199205.Google Scholar
Widerlöv, B, Lindström, E, Von Knorring, L (1997). One-year prevalence of long-term functional psychosis in three different areas of Uppsala. Acta Psychiatrica Scandinavica 96, 452458.CrossRefGoogle ScholarPubMed
World Health Organization (1993). International Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research, 10th revision. World Health Organization: Geneva.Google Scholar
Youssef, HA, Kinsella, A, Waddington, JL (1991). Evidence for geographical variations in the prevalence of schizophrenia in rural Ireland. Archives of General Psychiatry 48, 254258.CrossRefGoogle ScholarPubMed