Myths and plain truths about schizophrenia epidemiology - the NAPE lecture 2004

McGrath, J. J. (2005) Myths and plain truths about schizophrenia epidemiology - the NAPE lecture 2004. Acta Psychiatrica Scandinavica, 111 1: 4-11. doi:10.1111/j.1600-0447.2004.00467.x

Author McGrath, J. J.
Title Myths and plain truths about schizophrenia epidemiology - the NAPE lecture 2004
Journal name Acta Psychiatrica Scandinavica   Check publisher's open access policy
ISSN 0001-690X
Publication date 2005-01-01
Sub-type Article (original research)
DOI 10.1111/j.1600-0447.2004.00467.x
Open Access Status Not Open Access
Volume 111
Issue 1
Start page 4
End page 11
Total pages 8
Editor P. Moerk-Joergensen
Place of publication Denmark
Publisher Blackwell Munksgaard
Language eng
Subject C1
321021 Psychiatry
730211 Mental health
Abstract Objective: Science needs to constantly match research models against the data. With respect to the epidemiology of schizophrenia, the widely held belief that the incidence of schizophrenia shows little variation may no longer be supported by the data. The aims of this paper are (i) to explore data-vs.-belief mismatch with respect to the incidence of schizophrenia, and (ii) to speculate on the causes and consequences of such discrepancies. Method: Based on a recently published systematic review of the incidence of schizophrenia, the distribution of incidence rates around the world was examined. In order to examine if the incidence of schizophrenia differed by sex, male vs. female risk ratios were generated. Results: The distribution of incidence rates for schizophrenia is asymmetrical with many high rates skewing the distribution. Based on the central 80% of rates, the incidence of schizophrenia varies in a five-fold range (between 7.7 and 43.0 per 100 000). Males have a significantly higher incidence of schizophrenia compared with females (median male to female risk ratio = 1.4), and this difference could not be accounted for by diagnostic criteria or age range. Conclusion: The beliefs that (i) the incidence of schizophrenia does not vary between sites and (ii) males and females are equally affected, may have persisted because of an unspoken deeper belief that schizophrenia is an egalitarian and exceptional disorder. Our ability to generate productive hypotheses about the aetiology of schizophrenia rests on an accurate appraisal of the data. Beliefs not supported by data should be identified and relabelled as myths.
Keyword Psychiatry
Sex Differences
Urban-rural Differences
Psychotic Disorders
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 49 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 15 Aug 2007, 16:26:04 EST