Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates

Vanasse, Alain; Courteau, Josiane; Fleury, Marie‐Josée; Grégoire, Jean‐Pierre; Lesage, Alain; Moisan, Jocelyne

doi:10.1007/s00127-011-0371-y

Cited by 47 publications

(57 citation statements)

References 32 publications

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“…If the low rates for these migrant groups decreased the overall rate of the reference population, then our IRRs would overestimate the difference between groups. However, the incidence rate that we report for the general population is higher than estimates from other jurisdictions, 38 although consistent with other Canadian estimates 39,40 and with estimates obtained from studies using a longitudinal sampling frame, 41 as was done in the current analysis. This likely does not explain the differences in rates that we observed between groups.…”

Section: Strengths and Limitationssupporting

confidence: 91%

Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario

Anderson

Cheng

Süsser

et al. 2015

CMAJ

117

125

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Background: Evidence suggests that migrant groups have an increased risk of psychotic disorders and that the level of risk varies by country of origin and host country. Canadian evidence is lacking on the incidence of psychotic disorders among migrants. We sought to examine the incidence of schizophrenia and schizoaffective disorders in first-generation immigrants and refugees in the province of Ontario, relative to the general population. Methods:We constructed a retrospective cohort that included people aged 14-40 years residing in Ontario as of Apr. 1, 1999. Population-based administrative data from physician billings and hospital admissions were linked to data from Citizenship and Immigration Canada. We used Poisson regression models to calculate age-and sex-adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for immigrant and refugee groups over a 10-year period.Results: In our cohort (n = 4 284 694), we found higher rates of psychotic disorders among immigrants from the Caribbean and Bermuda (IRR 1.60, 95% CI 1.29-1.98). Lower rates were found among immigrants from northern Europe (IRR 0.50, 95% CI 0.28-0.91), southern Europe (IRR 0.60, 95% CI 0.41-0.90) and East Asia (IRR 0.56, 95% CI 0.41-0.78). Refugee status was an independent predictor of risk among all migrants (IRR 1.27, 95% CI 1.04-1.56), and higher rates were found specifically for refugees from East Africa (IRR 1.95, 95% CI 1.44-2.65) and South Asia (IRR 1.51, 95% CI 1.08-2.12). Interpretation:The differential pattern of risk across ethnic subgroups in Ontario suggests that psychosocial and cultural factors associated with migration may contribute to the risk of psychotic disorders. Some groups may be more at risk, whereas others are protected. AbstractCMAJ Podcasts: author interview at soundcloud.com/cmajpodcasts/psychotic-disorders See also www.cmaj.ca/lookup

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Section: Strengths and Limitationssupporting

confidence: 91%

Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario

Anderson

Cheng

Süsser

et al. 2015

CMAJ

117

125

View full text Add to dashboard Cite

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“…Two worldwide meta-analyses of the incidence of schizophrenia have been published over the past decade (McGrath et al 2004;van der Werf et al 2014 ). Core estimates in both studies were almost entirely based on first-contact studies.…”

Section: Introductionmentioning

confidence: 99%

“…Core estimates in both studies were almost entirely based on first-contact studies. For example, in the (very large) meta-analysis by van der Werf et al (2014), 97.8% of the total number of person-years pooled in the meta-analysis were based on first-contact studies of the first admission type (i.e. subjects identified in large in-patient registers on the basis of the discharge diagnosis after the first admission), with prototype first-contact studies such as the WHO Ten-Country study contributing the rest (Galdos et al 1993;van Os et al 1995;Thorup et al 2007;van der Werf et al 2014).…”

Section: Introductionmentioning

confidence: 99%

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Direct comparison of first-contact versus longitudinal register-based case finding in the same population: early evidence that the incidence of schizophrenia may be three times higher than commonly reported

et al. 2014

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“…Alors que les leaders de ces services continuent d'affirmer que la majorité des maladies mentales commencent chez les jeunes, ils n'admettent pas le fait que, dans au moins un tiers des cas, ces maladies commencent chez les adultes qui ont plus de 25 ans (Castle, 2012), ce qui est aussi observé au Québec à partir des bases de données administratives de santé (Vanasse et al, 2012). Il y a aussi un manque de preuves suffisantes quant à savoir si ces services sont vraiment efficaces pour les patients à long terme (Marshall et Rathbone, 2011).…”

Section: Les Réformes Des Services De Santé Mentaleunclassified

Services de santé mentale en Australie

Kisely

Lesage

2014

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Depuis 1992, quatre stratégies en santé mentale se sont succédé avec pour buts de promouvoir la santé mentale, d’augmenter la qualité des services et de forger une approche cohérente concernant la réforme du système de santé mentale dans tous les États et territoires australiens. Ces cycles systématiques de planification ont permis le passage d’un système dominé par les hôpitaux psychiatriques à un système de services dans la communauté. Les budgets en santé mentale se sont accrus, mais se sont réduits avant de s’accroître avec un ambitieux programme d’accès équitable à la psychothérapie, fondé sur un paiement à l’acte des psychologues après une référence des médecins de famille. Plus récemment, le développement de services pour les jeunes psychotiques a soulevé des craintes d’abandon des patients plus âgés et de réduction des budgets, d’autant plus qu’avec un excès de mortalité de ces derniers, la discrimination des services n’est pas résolue. Il demeure une disparité pour les peuples autochtones. La création récente d’une commission de la santé mentale marque un rôle accru de la participation des usagers et familles, de même qu’une surveillance indépendante continue de la performance du système de santé mentale australien.Canada is 1.5 times the size of Australia. Australia’s population of 20 million is located principally on the east coast. Like Canada, the Australia has a federal system of Government with 5 States and two territories. Each State and territory has its own legislation on mental health. The federal (Commonwealth) Government is responsible for health care planning. In addition, the federal Government subsidizes an insurance program (Medicare) that covers visits to specialists and family physicians, while provincial governments are involved in the provision of hospital care and community mental health services. The Commonwealth government also subsidises the cost of medication through the Pharmaceutical Benefits Scheme. These funds are supplemented by private health insurance. Mental health costs account for 6.5 per cent of all health care costs. Primary care treats the majority of common psychological disorders such as anxiety or depression, while specialist mental health services concentrate on those with severe mental illness. There have been 4 national mental health plans since 1992 with the long term aims of promoting mental health, increasing the quality and responsiveness of services, and creating a consistent approach to mental health service system reform among Australian states and territories. These systematic cycles of planning have first allowed a shift from psychiatric hospitals to community services, from reliance on psychiatric hospitals as pivotal to psychiatric care system. Community care budgets have increased, but overall have decreased with money not following patients; but recent deployment of federally funded through Medicare access to psychotherapy by psychologists for common mental disorders in primary care have increased overall budget. Concerns remain that shift to youth...

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Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates

Abstract: With an appropriate algorithm, treatment prevalence and incidence of schizophrenia can be conveniently estimated using administrative data. These estimates are a vital step toward appropriate planning of services for schizophrenia.

Cited by 47 publications

References 32 publications

Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario

Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario

Direct comparison of first-contact versus longitudinal register-based case finding in the same population: early evidence that the incidence of schizophrenia may be three times higher than commonly reported

Services de santé mentale en Australie

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