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Early manifestations and first-contact incidence of schizophrenia in different cultures: A preliminary report on the initial evaluation phase of the WHO Collaborative Study on Determinants of Outcome of Severe Mental Disorders

Published online by Cambridge University Press:  09 July 2009

N. Sartorius ,
A. Jablensky ,
A. Korten ,
G. Ernberg ,
M. Anker ,
J. E. Cooper  and
R. Day
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Synopsis

In a context of a WHO collaborative study, 12 research centres in 10 countries monitored geographically defined populations over 2 years to identify individuals making a first-in-lifetime contact with any type of ‘helping agency’ because of symptoms of psychotic illness. A total of 1379 persons who met specified inclusion criteria for schizophrenia and other related non-affective disorders were examined extensively, using standardized instruments, on entry into the study and on two consecutive follow-ups at annual intervals. Patients in different cultures, meeting the ICD and CATEGO criteria for schizophrenia, were remarkably similar in their symptom profiles and 49% of them presented the central schizophrenic conditions as defined by CATEGO class S+. However, the 2-year pattern of course was considerably more favourable in patients in developing countries compared with patients in developed countries, and the difference could not be fully explained by the higher frequency of acute onsets among the former. Age- and sex-specific incidence rates and estimates of disease expectancy were determined for a ‘broad’ diagnostic group of schizophrenic illness and for CATEGO S+ cases. While the former showed significant differences among the centres, the differences in the rates for S+ cases were non-significant or marginal. The results provide strong support for the notion that schizophrenic illnesses occur with comparable frequency in different populations and support earlier findings that the prognosis is better in less industrialized societies.

Information

Type
Preliminary Communication
Information
Psychological Medicine , Volume 16 , Issue 4 , November 1986 , pp. 909 - 928
Copyright
Copyright © Cambridge University Press 1986

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References

Brown, G. W. & Birley, J. L. T. (1968). Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behaviour 9, 203–214.CrossRefGoogle ScholarPubMed
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry 121, 241–258.CrossRefGoogle ScholarPubMed
Jablensky, A. (1984). Gli studi trans-culturali dell'Organizazzione Mondiale della Sanita sulla schizofrenia: implicazioni teoriche e pratiche. In Le Psicosi Schizofreniche (ed. Faccincani, C.), pp. 36–64. Patron: Bologna.Google Scholar
Jablensky, A., Schwarz, R. & Tomov, T. (1980). WHO collaborative study on impairments and disabilities associated with schizophrenic disorders. Acta Psychiatrica Scandinavica 62, Suppl. 285, 152–163.CrossRefGoogle Scholar
Katz, M. M., Sanborn, K. O., Lowery, H. A. & Ching, J. (1978). Ethnic studies in Hawaii: on psychopathology and social deviance. In The Nature of Schizophrenia. (ed. Wynne, L. C., Cromwell, R. L. and Matthysse, S.), pp. 572–585. Wiley: New York.Google Scholar
Leff, J., Kuipers, L., Berkowitz, R., Vaughn, C. & Sturgeon, D. (1983). Life events, relatives' expressed emotion and maintenance neuroleptics in schizophrenic relapse. Psychological Medicine 13, 799–806.CrossRefGoogle ScholarPubMed
Murphy, H. B. M. (1978). Cultural differences in incidence, course and treatment response. In The Nature of Schizophrenia (ed. Wynne, L. C., Cromwell, R. L. and Matthysse, S.), pp. 586–594. Wiley: New York.Google Scholar
Murphy, H. B. M. & Raman, A. C. (1971). The chronicity of schizophrenia in indigenous tropical people. British Journal of Psychiatry 118, 489–497.CrossRefGoogle Scholar
Reid, D. D. (1960). Epidemiological Methods in the Study of Mental Disorders. WHO: Geneva.Google Scholar
Sartorius, N., Jablensky, A. & Shapiro, R. (1977). Two-year follow-up of the patients included in the WHO International Pilot Study of Schizophrenia. Psychological Medicine 7, 529–541.CrossRefGoogle Scholar
Schwartz, C. C. & Myers, J. K. (1977). Life events and schizophrenia. I. Comparison of schizophrenics with a community sample. Archives of General Psychiatry 34, 1238–1241.CrossRefGoogle ScholarPubMed
Sow, I. (1977). Psychiatrie dynamique africaine. Payot: Paris.Google Scholar
Torey, E. F. (1980). Schizophrenia and Civilization. Jason Aronson: New York.Google Scholar
Watt, D. C., Katz, K. & Shepherd, M. (1983). The natural history of schizophrenia: a 5-year prospective follow-up of a representative sample of schizophrenics by means of a standardized clinical and social assessment. Psychological Medicine 13, 663–670.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
World Health Organization (1973). Report of the International Pilot Study of Schizophrenia, Vol. 1. WHO: Geneva.Google Scholar
World Health Organization (1979). Schizophrenia. An International Follow-up Study. Wiley: Chichester.Google Scholar