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Incidence of schizophrenia in Nottingham: A comparison of two cohorts, 1978–80 and 1992–94

  • J. Brewin (a1), R. Cantwell (a1), T. Dalkin (a1), R. Fox (a1), I. Medley (a1), C. Glazebrook (a1), R. Kwiecinski (a1) and G. Harrison (a1)...
Abstract
Background

Several studies have reported a decline of up to 50% in the incidence of schizophrenia over recent decades. We aimed to measure changes in the incidence and diagnostic patterns of first-episode psychosis by comparing two Nottingham cohorts, identified in two equal periods separated by 14 years.

Method

Two prospectively ascertained cohorts of first-episode psychotic disorder were identified over the time periods 1978–80 and 1992–94. The earlier cohort was of the World Health Organization Determinants of Outcome of Severe Mental Disorder (DOSMD) ten-country study. The later cohort was obtained using similar methodology. Both groups were diagnosed using ICD-10 diagnostic criteria and age-standardised incidence rates were compared.

Results

The standardised incidence rate for all psychotic disorders rose slightly from 2.49 to 2.87 per 10 000 population per year, but the F20 classification fell significantly by over a third (1.41 to 0.87 per 10 000 per year). The second study group (1992–1994) included a greater diversity of psychotic diagnoses compared with the first, in particular an increased proportion of acute and drug-related psychoses.

Conclusions

Methodological considerations call for caution in interpreting such data, but we conclude that the significant fall in the narrowly defined diagnostic category of schizophrenia reflects a real change in the syndromal presentation of psychotic disorders.

Copyright
Corresponding author
Dr J. Brewin, Psychiatry Department, B Floor, South Block, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Incidence of schizophrenia in Nottingham: A comparison of two cohorts, 1978–80 and 1992–94

  • J. Brewin (a1), R. Cantwell (a1), T. Dalkin (a1), R. Fox (a1), I. Medley (a1), C. Glazebrook (a1), R. Kwiecinski (a1) and G. Harrison (a1)...
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