Relationship between incidence and prevalence in psychotic disorders: An incidence–prevalence–mortality model

Pignon, Baptiste; Schürhoff, Franck; Baudin, Grégoire; Tortelli, Andrea; Ferchiou, Aziz; Saba, Ghassen; Richard, J. L.; Pélissolo, Antoine; Leboyer, Marion; Szöke, Andreı̈

doi:10.1002/mpr.1719

Cited by 6 publications

(3 citation statements)

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“…Thus, individuals without treatment, or with onset of psychotic disorders between 15 and 24 years-old but who received treatment after 24 yearsold, were not included. Missed incident cases phenomenon has been showed to bias incidence studies (Pignon et al, 2018). Therefore, it is possible that the increase in the incidence could also be due to improved detection of FEP.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Temporal variation in the incidence of treated psychotic disorders in young people

Pignon

Eaton

Schürhoff

et al. 2021

Schizophrenia Research

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The incidence of psychotic disorders varies between geographical areas, however less is known about whether it varies over time in the same region. Analyzing this temporal variation of incidence could improve the allocation of healthcare resources and our understanding of the aetiology of psychotic disorders. This study aimed to determine whether there was a change in the incidence of psychotic disorders over a six-year period. MethodsYoung people aged 15 to 24 presenting with a first episode of psychosis (FEP) attending an early intervention service in Melbourne between 2011 and 2016 were included. The population at-risk was determined from the two corresponding census periods and analyses were adjusted for age, sex and migrant status. ResultsA total of 1217 young people presented with a FEP over the six-year period and the crude incidence rate in 2011 was 102.4 per 100,000 population at-risk, compared to 125.4 in 2016.There was an increase in the incidence by 33% in 2015 (aIRR=1.33, 95% CI 1.09-1.63) and 28% in 2016 (aIRR=1.28, 95% CI 1.05-1.56). When examined according to diagnostic groups, there was an increase in the incidence of substance-induced psychotic disorders among females in 2015 (aIRR=4.62, 95% CI 1.02-20.8). DiscussionThis study shows significant temporal variations in the incidence of treated psychotic disorders. These findings demonstrate that early intervention services should continually monitor incidence case numbers and funding should be provided accordingly, to ensure the required intensive and comprehensive treatments can be sustained.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Temporal variation in the incidence of treated psychotic disorders in young people

Pignon

Eaton

Schürhoff

et al. 2021

Schizophrenia Research

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“… 2008 ; Pignon, Schürhoff, Baudin, et al. 2018 ). On the other hand, specifically, regarding urbanicity, the phenomenon of moving to cities could occur after the onset of the disease (Pedersen 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Urbanicity and psychotic disorders: Facts and hypotheses

Pignon,

Szöke,

et al. 2023

Dialogues in Clinical Neuroscience

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In the present qualitative literature review, we summarise data on psychotic disorders and urbanicity, focusing particularly on recent findings. Longitudinal studies of the impact of urbanicity on the risk for psychotic disorders have consistently shown a significant association, with a relative risk between 2 and 2.5. However, most of the original studies were conducted in Western Europe, and no incidence studies were conducted in low- and middle-income countries. European studies suggest that neighbourhood-level social fragmentation and social capital may partly explain this association. Exposure to air pollution (positive association) and green space (negative association) may also be part of the explanation, but to date, available data do not make it possible to conclude if they act independently from urbanicity, or as part of the effect of urbanicity on psychotic disorders. Finally, several studies have consistently shown significant associations between the polygenic risk score for schizophrenia and urbanicity, with several possible explanations (pleiotropic effects, results of prodromic symptoms, or selection/intergenerational hypothesis). Thus, more studies are needed to understand the factors that explain the association between urbanicity and the risk of psychotic disorders. Further studies should account for the interdependence and/or interactions of different psychosocial and physical exposures (as well as gene-environment interactions), and explore this association in low- and middle-income countries.

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“…Incidence must precede prevalence, and cause-specific mortality may only follow disease. Based on this premise, an incidence-prevalence-mortality model can be developed to supplement and/or evaluate agreement between available data and to explore shifting epidemiological dynamics [28][29][30]. The objective of the study described in this report was to develop an epidemiological model to estimate the prevalence of manifest HD by the Shoulson-Fahn stage and validate this with population-based prevalence estimates.…”

Section: Introductionmentioning

confidence: 99%

Modeling Manifest Huntington’s Disease Prevalence Using Diagnosed Incidence and Survival Time

Crowell

Houghton

Tomar³

et al. 2021

Neuroepidemiology

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Introduction: Understanding the epidemiology of Huntington’s disease (HD) is key to assessing disease burden and the healthcare resources required to meet patients’ needs. We aimed to develop and validate a model to estimate the diagnosed prevalence of manifest HD by the Shoulson-Fahn stage. Methods: A literature review identified epidemiological data from Brazil, Canada, France, Germany, Italy, Spain, the UK, and the USA. Data on staging distribution at diagnosis, progression, and mortality were derived from Enroll-HD. Newly diagnosed patients with manifest HD were simulated by applying annual diagnosed incidence rates to the total population in each country, each year from 1950 onwards. The number of diagnosed prevalent patients from the previous year who remained in each stage was estimated in line with the probability of death or progression. Diagnosed prevalence in 2020 was estimated as the sum of simulated patients, from all the incident cohorts, still alive. Results: The model estimates that in 2020, there were 66,787 individuals diagnosed with HD in the 8 included countries, of whom 62–63% were in Shoulson-Fahn stages 1 and 2 (with less severely limited functional capacity than those in stages 3–5). Diagnosed prevalence is estimated to be 8.2–9.0 per 100,000 in the USA, Canada, and the 5 included European countries and 3.5 per 100,000 in Brazil. Conclusion: The modeled estimates generally accord with the previously published data. This analysis contributes to better understanding of the epidemiology of HD and highlights areas of uncertainty.

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Relationship between incidence and prevalence in psychotic disorders: An incidence–prevalence–mortality model

Abstract: These results suggest that standard IPM models do not perform well for psychotic disorders and more complex models taking into account the heterogeneity of the sample (in terms of remission, mortality, population movements, etc.) need to be developed.

Cited by 6 publications

References 64 publications

Temporal variation in the incidence of treated psychotic disorders in young people

Temporal variation in the incidence of treated psychotic disorders in young people

Urbanicity and psychotic disorders: Facts and hypotheses

Modeling Manifest Huntington’s Disease Prevalence Using Diagnosed Incidence and Survival Time

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