Epidemiologic Reviews Advance Access first published online on May 14, 2008
This version published online on June 14, 2008
Epidemiologic Reviews, doi:10.1093/epirev/mxn001
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Schizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality
1 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
2 Department of Psychiatry, University of Queensland, St. Lucia, Queensland, Australia
3 Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia
Correspondence to Professor John McGrath, Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia (e-mail: john_mcgrath{at}qcmhr.uq.edu.au).
accepted for publication March 11, 2008.
Recent systematic reviews have encouraged the psychiatric research community to reevaluate the contours of schizophrenia epidemiology. This paper provides a concise overview of three related systematic reviews on the incidence, prevalence, and mortality associated with schizophrenia. The reviews shared key methodological features regarding search strategies, analysis of the distribution of the frequency estimates, and exploration of the influence of key variables (sex, migrant status, urbanicity, secular trend, economic status, and latitude). Contrary to previous interpretations, the incidence of schizophrenia shows prominent variation between sites. The median incidence of schizophrenia was 15.2/100,000 persons, and the central 80% of estimates varied over a fivefold range (7.7–43.0/100,000). The rate ratio for males:females was 1.4:1. Prevalence estimates also show prominent variation. The median lifetime morbid risk for schizophrenia was 7.2/1,000 persons. On the basis of the standardized mortality ratio, people with schizophrenia have a two- to threefold increased risk of dying (median standardized mortality ratio = 2.6 for all-cause mortality), and this differential gap in mortality has increased over recent decades. Compared with native-born individuals, migrants have an increased incidence and prevalence of schizophrenia. Exposures related to urbanicity, economic status, and latitude are also associated with various frequency measures. In conclusion, the epidemiology of schizophrenia is characterized by prominent variability and gradients that can help guide future research.
incidence • mortality • prevalence • review • schizophrenia
SMR, standardized mortality ratio
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