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Prevalence of schizophrenia in China between 1990 and 2010.

Chan KY, Zhao FF, Meng S, Demaio AR, Reed C, Theodoratou E, Campbell H, Wang W, Rudan I, Global Health Epidemiology Reference Group (GHER - J Glob Health (2015)

Bottom Line: In rural areas, the corresponding rates were 0.37% (0.34-0.40%), 0.43% (0.42-0.44%) and 0.50% (0.47-0.53%).The number of cases rose to 7.16 (6.57-7.75) million in 2010, a 132% increase, while the total population increased by 18%.The contribution of cases from urban areas to the overall burden increased from 27% in 1990 to 62% in 2010.

View Article: PubMed Central - PubMed

Affiliation: Centre for Population Health Sciences and Global Health Academy, University of Edinburgh Medical School, Scotland, UK ; World Health Organization's Collaborative Centre for Population Health Research and Training ; Nossal Institute for Global Health, University of Melbourne, Australia ; Joint first authors.

ABSTRACT

Background: Dramatic development and changes in lifestyle in many low and middle-income countries (LMIC) over the past three decades may have affected mental health of their populations. Being the largest country and having the most striking record of development, industrialization and urbanization, China provides an important opportunity for studying the nature and magnitude of possible effects.

Methods: We reviewed CNKI, WanFang and PubMed databases for epidemiological studies of schizophrenia in mainland China published between 1990 and 2010. We identified 42 studies that reported schizophrenia prevalence using internationally recognized diagnostic criteria, with breakdown by rural and urban residency. The analysis involved a total of 2 284 957 persons, with 10 506 diagnosed with schizophrenia. Bayesian methods were used to estimate the probability of case of schizophrenia ("prevalence") by type of residency in different years.

Findings: In urban China, lifetime prevalence was 0.39% (0.37-0.41%) in 1990, 0.57% (0.55-0.59%) in 2000 and 0.83% (0.75-0.91%) in 2010. In rural areas, the corresponding rates were 0.37% (0.34-0.40%), 0.43% (0.42-0.44%) and 0.50% (0.47-0.53%). In 1990 there were 3.09 (2.87-3.32) million people in China affected with schizophrenia during their lifetime. The number of cases rose to 7.16 (6.57-7.75) million in 2010, a 132% increase, while the total population increased by 18%. The contribution of cases from urban areas to the overall burden increased from 27% in 1990 to 62% in 2010.

Conclusions: The prevalence of schizophrenia in China has more than doubled between 1990 and 2010, with rates being particularly high in the most developed areas of modern China. This has broad implications, as the ongoing development in LMIC countries may be increasing the global prevalence of schizophrenia.

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Related in: MedlinePlus

Geographic location of 48 study sites in 42 retained studies. The studies are shown on the map of China that represents the areas of urban and rural areas (I = most developed; IV = least developed) around the mid–point of the study period.
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Figure 2: Geographic location of 48 study sites in 42 retained studies. The studies are shown on the map of China that represents the areas of urban and rural areas (I = most developed; IV = least developed) around the mid–point of the study period.

Mentions: After all exclusions, 42 prevalence studies were retained. Their full references are presented in Table s2 in Online Supplementary Document(Online Supplementary Document). The key characteristics of the studies are summarized in Table 1. The studies were mostly large population–based studies. They typically used a two–stage data collection design in which trained medical assessors performed an initial population–based screening in Phase 1 and psychiatrists performed a detailed evaluation in Phase 2 (see Table s3 in Online Supplementary Document(Online Supplementary Document) for further explanation on study design, agreement statistics and validation of the estimates). We defined “year of study” as the median year of the exact period during which the study was conducted. Geographically, the retained studies covered 21 of mainland China’s 31 provinces, municipalities and autonomous regions (Table s4 in Online Supplementary Document(Online Supplementary Document)). Their geographic distribution is shown in Figure 2.


Prevalence of schizophrenia in China between 1990 and 2010.

Chan KY, Zhao FF, Meng S, Demaio AR, Reed C, Theodoratou E, Campbell H, Wang W, Rudan I, Global Health Epidemiology Reference Group (GHER - J Glob Health (2015)

Geographic location of 48 study sites in 42 retained studies. The studies are shown on the map of China that represents the areas of urban and rural areas (I = most developed; IV = least developed) around the mid–point of the study period.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663755&req=5

Figure 2: Geographic location of 48 study sites in 42 retained studies. The studies are shown on the map of China that represents the areas of urban and rural areas (I = most developed; IV = least developed) around the mid–point of the study period.
Mentions: After all exclusions, 42 prevalence studies were retained. Their full references are presented in Table s2 in Online Supplementary Document(Online Supplementary Document). The key characteristics of the studies are summarized in Table 1. The studies were mostly large population–based studies. They typically used a two–stage data collection design in which trained medical assessors performed an initial population–based screening in Phase 1 and psychiatrists performed a detailed evaluation in Phase 2 (see Table s3 in Online Supplementary Document(Online Supplementary Document) for further explanation on study design, agreement statistics and validation of the estimates). We defined “year of study” as the median year of the exact period during which the study was conducted. Geographically, the retained studies covered 21 of mainland China’s 31 provinces, municipalities and autonomous regions (Table s4 in Online Supplementary Document(Online Supplementary Document)). Their geographic distribution is shown in Figure 2.

Bottom Line: In rural areas, the corresponding rates were 0.37% (0.34-0.40%), 0.43% (0.42-0.44%) and 0.50% (0.47-0.53%).The number of cases rose to 7.16 (6.57-7.75) million in 2010, a 132% increase, while the total population increased by 18%.The contribution of cases from urban areas to the overall burden increased from 27% in 1990 to 62% in 2010.

View Article: PubMed Central - PubMed

Affiliation: Centre for Population Health Sciences and Global Health Academy, University of Edinburgh Medical School, Scotland, UK ; World Health Organization's Collaborative Centre for Population Health Research and Training ; Nossal Institute for Global Health, University of Melbourne, Australia ; Joint first authors.

ABSTRACT

Background: Dramatic development and changes in lifestyle in many low and middle-income countries (LMIC) over the past three decades may have affected mental health of their populations. Being the largest country and having the most striking record of development, industrialization and urbanization, China provides an important opportunity for studying the nature and magnitude of possible effects.

Methods: We reviewed CNKI, WanFang and PubMed databases for epidemiological studies of schizophrenia in mainland China published between 1990 and 2010. We identified 42 studies that reported schizophrenia prevalence using internationally recognized diagnostic criteria, with breakdown by rural and urban residency. The analysis involved a total of 2 284 957 persons, with 10 506 diagnosed with schizophrenia. Bayesian methods were used to estimate the probability of case of schizophrenia ("prevalence") by type of residency in different years.

Findings: In urban China, lifetime prevalence was 0.39% (0.37-0.41%) in 1990, 0.57% (0.55-0.59%) in 2000 and 0.83% (0.75-0.91%) in 2010. In rural areas, the corresponding rates were 0.37% (0.34-0.40%), 0.43% (0.42-0.44%) and 0.50% (0.47-0.53%). In 1990 there were 3.09 (2.87-3.32) million people in China affected with schizophrenia during their lifetime. The number of cases rose to 7.16 (6.57-7.75) million in 2010, a 132% increase, while the total population increased by 18%. The contribution of cases from urban areas to the overall burden increased from 27% in 1990 to 62% in 2010.

Conclusions: The prevalence of schizophrenia in China has more than doubled between 1990 and 2010, with rates being particularly high in the most developed areas of modern China. This has broad implications, as the ongoing development in LMIC countries may be increasing the global prevalence of schizophrenia.

Show MeSH
Related in: MedlinePlus