Changes in the diagnosed incidence of early onset schizophrenia over four decades

Okkels, Niels; Vernal, Ditte Lammers; Jensen, Sigmund; McGrath, J.; Nielsen, René Ernst

doi:10.1111/j.1600-0447.2012.01913.x

Cited by 57 publications

(58 citation statements)

References 39 publications

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“…It cannot be determined whether the increase in incidence represents an actual increase in the number of affected people as many factors influence the application of different diagnoses (Kjeldsen et al 2012). Therefore, our finding represents the diagnosed or treated incidence, which could either over-or underestimate the true incidence, depending on the diagnostic practices regarding the disorder (Kjeldsen et al 2012;Okkels et al 2013).…”

Section: Main Findingsmentioning

confidence: 71%

“…Therefore, the number of patients with diagnoses other than ADHD is probably underestimated, as the patients registered with a diagnosis of ADHD at their latest contact could have received another diagnosis at their previous visits. Further, they could have other psychiatric disorders registered as auxiliary diagnoses and emergency room contacts, which were not included in this study due to a low validity (Okkels et al 2013). As the findings of this study are not being used to claim any causal correlation between ADHD and certain disorders, but rather to enlighten the stability of the diagnosis, the possible underestimation is acceptable.…”

Section: Strengths and Limitationsmentioning

confidence: 85%

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Increasing incidence and diagnostic instability in adult attention-deficit hyperactivity disorder nationwide between 1995 and 2012

Kristiansen

Shanmuganathan

Gustafsson

et al. 2014

ADHD Atten Def Hyp Disord

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Increasing numbers of adult attention-deficit hyperactivity disorder (ADHD) patients are reported. Co-occurring disorders are reported, and treatment with pharmacological stimulants (PS) increases. The aim of this study was to analyse the incidence of adult ADHD in Denmark between 1995 and 2012 and the diagnostic stability and the diagnoses of patients contraindicating treatment with PS. This was a nationwide register-based study of patients diagnosed with ADHD aged ≥ 18 years between 1995 and 2012. The study included 6,701 patients. Incidence increases exponentially; 40.4 % of all patients had another psychiatric diagnosis before being diagnosed with ADHD. Afterwards, 17.4 % received other diagnoses. Diagnoses contraindicating PS were found in 25.8 % of the patients with other diagnoses before (10.5 % of total) and in 40.0 % (6.9 % of total) after a diagnosis of ADHD. There is an increasing incidence and instability in the diagnosis of ADHD. Patients receive diagnoses contraindicating treatment with PS.

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Section: Main Findingsmentioning

confidence: 71%

Section: Strengths and Limitationsmentioning

confidence: 85%

Increasing incidence and diagnostic instability in adult attention-deficit hyperactivity disorder nationwide between 1995 and 2012

Kristiansen

Shanmuganathan

Gustafsson

et al. 2014

ADHD Atten Def Hyp Disord

View full text Add to dashboard Cite

show abstract

“…Okkels et al estimated the incidence of early onset schizophrenia in Denmark using a nationwide, population-based, mental health register. Their findings suggest that the sex differential has narrowed over time and the usual male excess has disappeared in recent years (75). A comprehensive literature review focusing on gender differences in schizophrenia showed that no epidemiological studies have found a significant difference in males and females (76).…”

Section: Prevalence By Gendermentioning

confidence: 98%

The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys

Long

Huang

Liang

et al. 2014

Acta Psychiatr Scand

120

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“…We were unable to extrapolate our models to this age range, given the current absence of incidence data for this group in England. Data from Scandinavia suggest that the incidence of such 'early onset' psychoses is absolutely low, 29 although the rate may have increased over the last few decades, probably as a result of movement towards earlier detection. We were also unable to externally validate prediction models for people aged 36-64 years, because comparable observed incidence data were not available in our validation sample.…”

Section: Limitations and Future Developmentmentioning

confidence: 99%

A population-level prediction tool for the incidence of first-episode psychosis: translational epidemiology based on cross-sectional data

et al. 2013

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ObjectivesSpecialist early intervention services (EIS) for people aged 14–35 years with first episodes of psychosis (FEP) have been commissioned throughout England since 2001. A single estimate of population need was used everywhere, but true incidence varies enormously according to sociodemographic factors. We sought to develop a realistically complex, population-based prediction tool for FEP, based on precise estimates of epidemiological risk.Design and participantsData from 1037 participants in two cross-sectional population-based FEP studies were fitted to several negative binomial regression models to estimate risk coefficients across combinations of different sociodemographic and socioenvironmental factors. We applied these coefficients to the population at-risk of a third, socioeconomically different region to predict expected caseload over 2.5 years, where the observed rates of ICD-10 F10-39 FEP had been concurrently ascertained via EIS.SettingEmpirical population-based epidemiological data from London, Nottingham and Bristol predicted counts in the population at-risk in the East Anglia region of England.Main outcome measuresObserved counts were compared with predicted counts (with 95% prediction intervals (PI)) at EIS and local authority district (LAD) levels in East Anglia to establish the predictive validity of each model.ResultsA model with age, sex, ethnicity and population density performed most strongly, predicting 508 FEP participants in EIS in East Anglia (95% PI 459, 559), compared with 522 observed participants. This model predicted correctly in 5/6 EIS and 19/21 LADs. All models performed better than the current gold standard for EIS commissioning in England (716 cases; 95% PI 664–769).ConclusionsWe have developed a prediction tool for the incidence of psychotic disorders in England and Wales, made freely available online (http://www.psymaptic.org), to provide healthcare commissioners with accurate forecasts of FEP based on robust epidemiology and anticipated local population need. The initial assessment of some people who do not require subsequent EIS care means additional service resources, not addressed here, will be required.

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Changes in the diagnosed incidence of early onset schizophrenia over four decades

Abstract: In recent years, the diagnosed incidence of EOS has increased and the usual male excess has disappeared. The changes in IR could be a result of changes in the diagnostic system, increased awareness of early psychosis or a reflection of actual underlying incidence of the disorder.

Cited by 57 publications

References 39 publications

Increasing incidence and diagnostic instability in adult attention-deficit hyperactivity disorder nationwide between 1995 and 2012

Increasing incidence and diagnostic instability in adult attention-deficit hyperactivity disorder nationwide between 1995 and 2012

The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys

A population-level prediction tool for the incidence of first-episode psychosis: translational epidemiology based on cross-sectional data

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