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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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