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Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study.
Arch Gen Psychiatry. 2006 Mar; 63(3):250-8.AG

Abstract

CONTEXT

Convention suggests uniformity of incidence of schizophrenia and other psychoses; variation would have implications for their causes and biological characteristics.

OBJECTIVE

To investigate variability in the incidence of psychotic syndromes in terms of place, ethnicity, age, and sex.

DESIGN

Three-center, prospective, comprehensive survey of clinically relevant first-onset psychotic syndromes over a 2-year period (1997-1999). Census data provided the denominator.

SETTING

Southeast London, Nottingham, and Bristol, England.

PARTICIPANTS

One million six hundred thousand person-years yielded 568 subjects aged 16 to 64 years with clinically relevant psychotic syndromes.

MAIN OUTCOME MEASURES

The World Health Organization Psychosis Screen and the Schedules for Clinical Assessment in Neuropsychiatry to classify, blind to ethnicity, all DSM-IV psychotic syndromes and the subclasses of schizophrenia, other nonaffective disorders, affective disorders, and substance-induced psychosis.

RESULTS

All syndromes showed a characteristic age distribution. Schizophrenia was significantly more common in men (incidence rate ratio [IRR], 2.3 [95% confidence interval (CI), 1.7-3.1]); affective disorders occurred equally in men and women (IRR, 1.0 [95% CI, 0.7-1.3]). All psychoses were more common in the black and minority ethnic group (crude IRR, 3.6 [95% CI, 3.0-4.2]). Differences in age, sex, and study center accounted for approximately a quarter of this effect (adjusted IRR, 2.9 [95% CI, 2.4-3.5]) in each psychosis outcome. The age-sex standardized incidence rate for all psychoses was higher in Southeast London (IRR, 49.4 [95% CI, 43.6-55.3]) than Nottingham (IRR, 23.9 [95% CI, 20.6-27.2]) or Bristol (IRR, 20.4 [95% CI, 15.1-25.7]). Rates of all outcomes except affective disorders remained significantly higher in Southeast London when the model was expanded to control for ethnicity.

CONCLUSIONS

There is significant and independent variation of incidence of schizophrenia and other psychoses in terms of sex, age, ethnicity, and place. This confirms that environmental effects at the individual, and perhaps neighborhood level, may interact together and with genetic factors in the etiology of psychosis.

Authors+Show Affiliations

Department of Psychiatry, University of Cambridge, Cambridge, England. jbk25@cam.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16520429

Citation

Kirkbride, James B., et al. "Heterogeneity in Incidence Rates of Schizophrenia and Other Psychotic Syndromes: Findings From the 3-center AeSOP Study." Archives of General Psychiatry, vol. 63, no. 3, 2006, pp. 250-8.
Kirkbride JB, Fearon P, Morgan C, et al. Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Arch Gen Psychiatry. 2006;63(3):250-8.
Kirkbride, J. B., Fearon, P., Morgan, C., Dazzan, P., Morgan, K., Tarrant, J., Lloyd, T., Holloway, J., Hutchinson, G., Leff, J. P., Mallett, R. M., Harrison, G. L., Murray, R. M., & Jones, P. B. (2006). Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Archives of General Psychiatry, 63(3), 250-8.
Kirkbride JB, et al. Heterogeneity in Incidence Rates of Schizophrenia and Other Psychotic Syndromes: Findings From the 3-center AeSOP Study. Arch Gen Psychiatry. 2006;63(3):250-8. PubMed PMID: 16520429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. AU - Kirkbride,James B, AU - Fearon,Paul, AU - Morgan,Craig, AU - Dazzan,Paola, AU - Morgan,Kevin, AU - Tarrant,Jane, AU - Lloyd,Tuhina, AU - Holloway,John, AU - Hutchinson,Gerard, AU - Leff,Julian P, AU - Mallett,Rosemarie M, AU - Harrison,Glynn L, AU - Murray,Robin M, AU - Jones,Peter B, PY - 2006/3/8/pubmed PY - 2006/3/30/medline PY - 2006/3/8/entrez SP - 250 EP - 8 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 63 IS - 3 N2 - CONTEXT: Convention suggests uniformity of incidence of schizophrenia and other psychoses; variation would have implications for their causes and biological characteristics. OBJECTIVE: To investigate variability in the incidence of psychotic syndromes in terms of place, ethnicity, age, and sex. DESIGN: Three-center, prospective, comprehensive survey of clinically relevant first-onset psychotic syndromes over a 2-year period (1997-1999). Census data provided the denominator. SETTING: Southeast London, Nottingham, and Bristol, England. PARTICIPANTS: One million six hundred thousand person-years yielded 568 subjects aged 16 to 64 years with clinically relevant psychotic syndromes. MAIN OUTCOME MEASURES: The World Health Organization Psychosis Screen and the Schedules for Clinical Assessment in Neuropsychiatry to classify, blind to ethnicity, all DSM-IV psychotic syndromes and the subclasses of schizophrenia, other nonaffective disorders, affective disorders, and substance-induced psychosis. RESULTS: All syndromes showed a characteristic age distribution. Schizophrenia was significantly more common in men (incidence rate ratio [IRR], 2.3 [95% confidence interval (CI), 1.7-3.1]); affective disorders occurred equally in men and women (IRR, 1.0 [95% CI, 0.7-1.3]). All psychoses were more common in the black and minority ethnic group (crude IRR, 3.6 [95% CI, 3.0-4.2]). Differences in age, sex, and study center accounted for approximately a quarter of this effect (adjusted IRR, 2.9 [95% CI, 2.4-3.5]) in each psychosis outcome. The age-sex standardized incidence rate for all psychoses was higher in Southeast London (IRR, 49.4 [95% CI, 43.6-55.3]) than Nottingham (IRR, 23.9 [95% CI, 20.6-27.2]) or Bristol (IRR, 20.4 [95% CI, 15.1-25.7]). Rates of all outcomes except affective disorders remained significantly higher in Southeast London when the model was expanded to control for ethnicity. CONCLUSIONS: There is significant and independent variation of incidence of schizophrenia and other psychoses in terms of sex, age, ethnicity, and place. This confirms that environmental effects at the individual, and perhaps neighborhood level, may interact together and with genetic factors in the etiology of psychosis. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/16520429/Heterogeneity_in_incidence_rates_of_schizophrenia_and_other_psychotic_syndromes:_findings_from_the_3_center_AeSOP_study_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.63.3.250 DB - PRIME DP - Unbound Medicine ER -