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  1. Article: Schizophrenia: a concise overview of incidence, prevalence, and mortality.

    McGrath, John / Saha, Sukanta / Chant, David / Welham, Joy

    Epidemiologic reviews

    2008  Volume 30, Page(s) 67–76

    Abstract: 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 ... ...

    Abstract 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.
    MeSH term(s) Humans ; Incidence ; Prevalence ; Risk Factors ; Schizophrenia/epidemiology ; Schizophrenia/mortality
    Language English
    Publishing date 2008
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 445346-3
    ISSN 1478-6729 ; 0193-936X
    ISSN (online) 1478-6729
    ISSN 0193-936X
    DOI 10.1093/epirev/mxn001
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  2. Article: The antecedents of schizophrenia: a review of birth cohort studies.

    Welham, Joy / Isohanni, Matti / Jones, Peter / McGrath, John

    Schizophrenia bulletin

    2008  Volume 35, Issue 3, Page(s) 603–623

    Abstract: Background: Birth cohort (BC) studies demonstrate that individuals who develop schizophrenia differ from the general population on a range of developmental indices. The aims of this article were to summarize key findings from BC studies in order to ... ...

    Abstract Background: Birth cohort (BC) studies demonstrate that individuals who develop schizophrenia differ from the general population on a range of developmental indices. The aims of this article were to summarize key findings from BC studies in order to identify areas of convergence and to outline areas requiring further research.
    Method: We define BC studies as studies based on general population BCs where data are collected prospectively from birth or childhood and which identify schizophrenia or related disorders as an outcome. To identify such studies, we searched various electronic databases using the search parameters (schizo* OR psych*) AND (birth cohort). We also checked the references of relevant articles and previous reviews.
    Results: We identified 11 BCs from 7 countries that have examined schizophrenia as an outcome in adulthood. There is relatively consistent evidence that, as a group, children who later develop schizophrenia have behavioral disturbances and psychopathology, intellectual and language deficits, and early motor delays. Evidence with respect to alterations in language, educational performance, and physical growth has also been identified in some studies. BC studies have also contributed evidence about a wide range of putative risk factors for schizophrenia.
    Conclusions: BC studies have provided important, convergent insights into how the developmental trajectory of individuals who develop schizophrenia differs from their peers. The combination of new paradigms and larger cohorts, with the tools of modern epidemiology and biomedical science, is advancing our understanding of the developmental pathways to schizophrenia.
    MeSH term(s) Adolescent ; Adult ; Causality ; Child ; Child, Preschool ; Cohort Studies ; Cross-Cultural Comparison ; Developmental Disabilities/diagnosis ; Developmental Disabilities/epidemiology ; Developmental Disabilities/etiology ; Female ; Humans ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Pregnancy ; Prenatal Exposure Delayed Effects/diagnosis ; Prenatal Exposure Delayed Effects/epidemiology ; Prenatal Exposure Delayed Effects/etiology ; Retrospective Studies ; Risk Factors ; Schizophrenia/diagnosis ; Schizophrenia/epidemiology ; Schizophrenia/etiology ; Young Adult
    Language English
    Publishing date 2008-07-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 439173-1
    ISSN 1745-1701 ; 0586-7614
    ISSN (online) 1745-1701
    ISSN 0586-7614
    DOI 10.1093/schbul/sbn084
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  3. Article: Incidence of schizophrenia does not vary with economic status of the country: evidence from a systematic review.

    Saha, Sukanta / Welham, Joy / Chant, David / McGrath, John

    Social psychiatry and psychiatric epidemiology

    2006  Volume 41, Issue 5, Page(s) 338–340

    Abstract: Background: A recent systematic review found that the prevalence of schizophrenia was lower in developing nations compared to developed nations. However, there is a lack of information about the association between economic status and the incidence of ... ...

    Abstract Background: A recent systematic review found that the prevalence of schizophrenia was lower in developing nations compared to developed nations. However, there is a lack of information about the association between economic status and the incidence of schizophrenia. The aim of this study was to examine the association between economic status and the underlying incidence of schizophrenia based on a recently published systematic review of the incidence of schizophrenia.
    Methods: The analyses were based on 167 discrete incidence rates from 52 studies. Nations were divided into three categories according to per capita gross national product. Based on these categories, we compared the incidence rates for schizophrenia when adjusted for within-study variation.
    Results: The median (and 10-90% quantiles) incidence rates per 100,000 persons for Least Developed Countries (three studies), Emerging Economies (nine studies), and Developed Countries (42 studies) were 20.0 (0.4-35.0), 11.0 (5.0-26.0) and 16.0 (8.0-48.0) respectively. There was no significant difference in incidence rates between these groups.
    Conclusions: While there is a lack of information on the incidence of schizophrenia in the developing world, there is no evidence to suggest that the incidence of schizophrenia varies by economic status. In light of the evidence that the prevalence of schizophrenia is higher in developed countries, more research is warranted focused on the interaction between economic measures, and the incidence, prevalence and course of schizophrenia.
    MeSH term(s) Developed Countries/statistics & numerical data ; Developing Countries/statistics & numerical data ; Humans ; Incidence ; Prevalence ; Schizophrenia/economics ; Schizophrenia/epidemiology ; Social Class
    Language English
    Publishing date 2006-05
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 623071-4
    ISSN 1433-9285 ; 0933-7954 ; 0037-7813
    ISSN (online) 1433-9285
    ISSN 0933-7954 ; 0037-7813
    DOI 10.1007/s00127-006-0041-7
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  4. Article ; Online: Authors' Reply

    John McGrath / Sukanta Saha / Joy Welham / David Charles Chant

    PLoS Medicine, Vol 2, Iss

    Measurement Errors in Schizophrenia Epidemiology.

    2005  Volume 9

    Keywords Medicine ; R
    Language English
    Publishing date 2005-09-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Age-at-first-registration and heterogeneity in affective psychoses.

    Welham, Joy L / Thomis, Richard / McGrath, John J

    The Australian and New Zealand journal of psychiatry

    2003  Volume 37, Issue 1, Page(s) 66–69

    Abstract: Background: Previous research into age of onset in affective disorders has produced conflicting results. This paper examines the influence of heterogeneity on the age-at-first-registration distribution for the ICD-9 diagnostic group 'affective psychosis' ...

    Abstract Background: Previous research into age of onset in affective disorders has produced conflicting results. This paper examines the influence of heterogeneity on the age-at-first-registration distribution for the ICD-9 diagnostic group 'affective psychosis'.
    Method: For 1979-1991, data for age-at-first-registration for 4985 individuals diagnosed with affective psychosis (ICD-9 296.x) were extracted from a name-linked mental health register. These data were divided into (i) '296.1 only', a category used to code unipolar depression (males = 700; females = 1321); and (ii) '296 other', all 296 cases other than 296.1 (males = 1280; females = 1684). Inception rates for each 5-year age division were adjusted for the background population age-structure as a rate per 100,000 population.
    Results: The age-at-first-registration distribution for affective psychosis has a wide age range, with women outnumbering men. There is a near-linear increase in inception rates for both men and women with 296.1 only, while the bulk of those with affective psychoses (296 other) have an inverted U-shaped age distribution. Males have an earlier modal age-at-first-registration for 296 other compared to females.
    Conclusion: The heterogeneity in terms of subtypes and sex in affective psychosis clouds the interpretation of age-at-first-registration. Separating those with unipolar psychotic depression from other subclassifications and differentiating by sex may provide clues to factors that precipitate the onset of affective psychosis.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Bipolar Disorder/diagnosis ; Bipolar Disorder/epidemiology ; Bipolar Disorder/psychology ; Cross-Over Studies ; Depressive Disorder/diagnosis ; Depressive Disorder/epidemiology ; Depressive Disorder/psychology ; Female ; Humans ; International Classification of Diseases ; Male ; Middle Aged ; Mood Disorders/diagnosis ; Mood Disorders/epidemiology ; Mood Disorders/psychology ; Psychotic Disorders/diagnosis ; Psychotic Disorders/epidemiology ; Psychotic Disorders/psychology ; Sex Distribution
    Language English
    Publishing date 2003-02
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 221140-3
    ISSN 1440-1614 ; 0004-8674
    ISSN (online) 1440-1614
    ISSN 0004-8674
    DOI 10.1046/j.1440-1614.2003.01106.x
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  6. Article ; Online: Growth in young adults who screen positive for non-affective psychosis: birth cohort study.

    Welham, Joy / Scott, James / Williams, Gail / Najman, Jake / O'Callaghan, Michael / McGrath, John

    The Australian and New Zealand journal of psychiatry

    2009  Volume 43, Issue 1, Page(s) 61–67

    Abstract: Objective: While birth cohort studies have shown that individuals who develop non-affective psychosis show subtle deviations in cognitive and behavioural developmental trajectories, there is less evidence about deviations in physical growth in these ... ...

    Abstract Objective: While birth cohort studies have shown that individuals who develop non-affective psychosis show subtle deviations in cognitive and behavioural developmental trajectories, there is less evidence about deviations in physical growth in these individuals. The purpose of the present study was to examine the association between behaviour and growth and maturation from infancy, through childhood and adolescence to early adulthood and the development of non-affective psychosis in young adults.
    Method: Based on a birth cohort of 3801 young adults, weight and length/height were examined at birth and at years 5, 14 and 21, together with pubertal maturation at year 14. Behavioural measures taken at years 5 and 14 were also examined. Screen-positive non-affective psychosis (SP-NAP) was assessed at year 21 using Composite International Diagnostic Interview, or a self-report checklist. The association between the behavioural and growth measures at birth and at years 5, 14 and 21, and SP-NAP at year 21 was examined using logistic regression.
    Results: There were 60 subjects in the cohort who were classified as having SP-NAP. In female subjects SP-NAP was significantly associated with being longer with a larger head circumference at birth, and less likely to be associated with being shorter at 21 years, with consistent trend associations for height between. There were no differences for weight. There was no significant association between the variables of interest in male subjects or for the total group. There was also no significant association between pubertal development at age 14 and risk of SP-NAP in either sex.
    Conclusions: Unlike developmental behavioural problems, which showed continuity from childhood through adolescence, SP-NAP was not associated with marked deviations in growth trajectory for male subjects, but the present data suggests that female subjects with SP-NAP had an altered skeletal growth trajectory.
    MeSH term(s) Adolescent ; Age Factors ; Body Height ; Child ; Child, Preschool ; Cohort Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Interview, Psychological ; Longitudinal Studies ; Male ; Mass Screening/statistics & numerical data ; Menarche ; Psychotic Disorders/diagnosis ; Psychotic Disorders/epidemiology ; Psychotic Disorders/psychology ; Puberty ; Queensland ; Schizophrenia/diagnosis ; Schizophrenia/epidemiology ; Schizophrenic Psychology ; Sex Factors ; Young Adult
    Language English
    Publishing date 2009-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 221140-3
    ISSN 1440-1614 ; 0004-8674
    ISSN (online) 1440-1614
    ISSN 0004-8674
    DOI 10.1080/00048670802534333
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  7. Article: Age-at-first-registration for affective psychosis and schizophrenia.

    Welham, Joy L / Thomis, Richard J / McGrath, John J

    Schizophrenia bulletin

    2005  Volume 30, Issue 4, Page(s) 849–853

    Abstract: We compared the age-at-first-registration for patients with schizophrenia and affective psychosis in a statewide mental health register. After excluding those receiving (1) a diagnosis of both schizophrenia (ICD-9 295.x) and affective psychosis (ICD-9 ... ...

    Abstract We compared the age-at-first-registration for patients with schizophrenia and affective psychosis in a statewide mental health register. After excluding those receiving (1) a diagnosis of both schizophrenia (ICD-9 295.x) and affective psychosis (ICD-9 296.x), or (2) a diagnosis of ICD-9 296.1 (which can cover "major depressive episode"), we adjusted the distributions for the age structure of the background general population. We found that all distributions showed a wide age range of onset, with a similar male modal age group of 20-24 for schizophrenia and 25-29 for affective psychosis. The female modal age group was 50-54 for both diagnoses. Although more individuals were diagnosed with schizophrenia (males = 2,434, females = 1,609) than with affective psychosis (males = 670, females = 913), the shape of the two distributions was similar. This finding suggests that factors influencing age-at-first-registration for schizophrenia and affective psychosis may be similar, especially for females.
    MeSH term(s) Adult ; Affect ; Age Factors ; Age of Onset ; Aged ; Female ; Humans ; International Classification of Diseases ; Male ; Middle Aged ; Psychotic Disorders/diagnosis ; Psychotic Disorders/etiology ; Schizophrenia/complications ; Schizophrenia/diagnosis ; Schizophrenia/epidemiology
    Language English
    Publishing date 2005-05-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 439173-1
    ISSN 1745-1701 ; 0586-7614
    ISSN (online) 1745-1701
    ISSN 0586-7614
    DOI 10.1093/oxfordjournals.schbul.a007137
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  8. Article: No association between the deficit syndrome in psychosis and summer birth in a Southern hemisphere country.

    Welham, Joy / Chant, David / Saha, S / McGrath, J / Kirkpatrick, Brian / Castle, David

    The Australian and New Zealand journal of psychiatry

    2006  Volume 40, Issue 10, Page(s) 935–936

    MeSH term(s) Australia/epidemiology ; Humans ; Prevalence ; Psychotic Disorders/diagnosis ; Psychotic Disorders/epidemiology ; Psychotic Disorders/psychology ; Schizophrenia/epidemiology ; Seasons
    Language English
    Publishing date 2006-10
    Publishing country England
    Document type Letter
    ZDB-ID 221140-3
    ISSN 1440-1614 ; 0004-8674
    ISSN (online) 1440-1614
    ISSN 0004-8674
    DOI 10.1080/j.1440-1614.2006.01913.x
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  9. Article ; Online: A systematic review of the prevalence of schizophrenia.

    Saha, Sukanta / Chant, David / Welham, Joy / McGrath, John

    PLoS medicine

    2005  Volume 2, Issue 5, Page(s) e141

    Abstract: Background: Understanding the prevalence of schizophrenia has important implications for both health service planning and risk factor epidemiology. The aims of this review are to systematically identify and collate studies describing the prevalence of ... ...

    Abstract Background: Understanding the prevalence of schizophrenia has important implications for both health service planning and risk factor epidemiology. The aims of this review are to systematically identify and collate studies describing the prevalence of schizophrenia, to summarize the findings of these studies, and to explore selected factors that may influence prevalence estimates.
    Methods and findings: Studies with original data related to the prevalence of schizophrenia (published 1965-2002) were identified via searching electronic databases, reviewing citations, and writing to authors. These studies were divided into "core" studies, "migrant" studies, and studies based on "other special groups." Between- and within-study filters were applied in order to identify discrete prevalence estimates. Cumulative plots of prevalence estimates were made and the distributions described when the underlying estimates were sorted according to prevalence type (point, period, lifetime, and lifetime morbid risk). Based on combined prevalence estimates, the influence of selected key variables was examined (sex, urbanicity, migrant status, country economic index, and study quality). A total of 1,721 prevalence estimates from 188 studies were identified. These estimates were drawn from 46 countries, and were based on an estimated 154,140 potentially overlapping prevalent cases. We identified 132 core studies, 15 migrant studies, and 41 studies based on other special groups. The median values per 1,000 persons (10%-90% quantiles) for the distributions for point, period, lifetime, and lifetime morbid risk were 4.6 (1.9-10.0), 3.3 (1.3-8.2), 4.0 (1.6-12.1), and 7.2 (3.1-27.1), respectively. Based on combined prevalence estimates, we found no significant difference (a) between males and females, or (b) between urban, rural, and mixed sites. The prevalence of schizophrenia in migrants was higher compared to native-born individuals: the migrant-to-native-born ratio median (10%-90% quantile) was 1.8 (0.9-6.4). When sites were grouped by economic status, prevalence estimates from "least developed" countries were significantly lower than those from both "emerging" and "developed" sites (p = 0.04). Studies that scored higher on a quality score had significantly higher prevalence estimates (p = 0.02).
    Conclusions: There is a wealth of data about the prevalence of schizophrenia. These gradients, and the variability found in prevalence estimate distributions, can provide direction for future hypothesis-driven research.
    MeSH term(s) Epidemiologic Studies ; Female ; Humans ; Male ; Needs Assessment ; Prevalence ; Rural Population ; Schizophrenia/epidemiology ; Sex Factors ; Social Class ; Urban Population
    Language English
    Publishing date 2005-05-31
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 2185925-5
    ISSN 1549-1676 ; 1549-1277
    ISSN (online) 1549-1676
    ISSN 1549-1277
    DOI 10.1371/journal.pmed.0020141
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  10. Article: No significant association between prenatal exposure poliovirus epidemics and psychosis.

    Cahill, Matthew / Chant, David / Welham, Joy / McGrath, John

    The Australian and New Zealand journal of psychiatry

    2002  Volume 36, Issue 3, Page(s) 373–375

    Abstract: Objective: To examine the association between prenatal exposure to poliovirus infection and later development of schizophrenia or affective psychosis in a Southern Hemisphere psychiatric register.: Methods: We calculated rates of poliomyelitis cases ... ...

    Abstract Objective: To examine the association between prenatal exposure to poliovirus infection and later development of schizophrenia or affective psychosis in a Southern Hemisphere psychiatric register.
    Methods: We calculated rates of poliomyelitis cases per 10 000 background population and rates for schizophrenia(n = 6078) and affective psychosis (n = 3707)per 10 000 births for the period 1930-1964. Empirically weighted regression was used to measure the association between a given psychosis birth-rate and a poliomyelitis epidemic during gestation.
    Results: There was no statistically significant association between exposure to a poliomyelitis epidemic during gestation and subsequent development of schizophrenia or affective psychosis.
    Conclusions: The lack of a consistent statistically significant association between poliovirus epidemics and schizophrenia suggests that either poliovirus may have a small effect which is only detectable with large data-sets and/or the effect may be modified by location. Further investigation of such inconsistencies may help elucidate candidate risk-modifying factors for schizophrenia.
    MeSH term(s) Affective Disorders, Psychotic/etiology ; Australia ; Female ; Humans ; Male ; Poliomyelitis/complications ; Pregnancy ; Prenatal Exposure Delayed Effects ; Schizophrenia/etiology
    Language English
    Publishing date 2002-05-31
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 221140-3
    ISSN 1440-1614 ; 0004-8674
    ISSN (online) 1440-1614
    ISSN 0004-8674
    DOI 10.1046/j.1440-1614.2001.01006.x
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