Decline in the Diagnosis of Schizophrenia among First Contacts with Psychiatric Services in North-East Scotland, 1969–1984

Abstract

Annual age-standardised rates for first contacts with psychiatric services in the Aberdeen area from 1969 to 1984 were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Highly significant declines occurred in the diagnosis of schizophrenia and of depressive neuroses. No concomitant increase occurred. It is concluded that these results probably indicate that there has been a fall in the incidence of schizophrenia in North-East Scotland. This may have arisen due to changes in the mode of expression and/or the severity of all functional psychoses.

The effects of early and sustained intervention on the long-term morbidity of schizophrenia

“…Several investigators (de Alarcon et al, 1990;Der et al, 1990;Eagles et al, 1988;Eagles and Whalley, 1985;Joyce, 1987;Munk-Jorgensen, 1987;Munk-Jorgensen and Jorgensen, 1986;Parker et al, 1985;Waddington and Youssef, 1994) have pointed to a substantial body of evidence that the incidence of schizophrenia has decreased over the last 50 to 60 years, while others (Bamrah et al, 1991;Castle et al, 1991;Häfner and Gattaz, 1991;Harrison et al, 1991;Kendell et al, 1993) have emphasized the many potential difficulties in making such estimates. One such difficulty is that there have been many changes in the way schizophrenia has been diagnosed over the last 50 to 60 years (Hegarty et al, 1994).…”

Trends in recruitment of new long-stay male schizophrenics

“…Eagles, Hunter & McCance (1988) considered this factor probably did not account for the fall in schizophrenic first-admissions and contacts observed in their own and other studies. A fall in the incidence of schizophrenia has to be considered in accounting for the results, but no definite conclusions can be drawn, since there were no data on total contacts for the 1967 to 1970 period, i.e.…”

Are incidence rates of schizophrenia decreasing?

“…Drift of schizophrenics, particularly men, towards larger cities is also a possibility, as Eagles et al (1988) mention. In Denmark where imigration is close to zero the decrease in first admission rates is highly significant (Munk-Jdrgensen & Mortensen, 1992).…”

“…Change in service organization has been mentioned (Eagles et al, 1988;Munk-Jrirgensen & Mortensen, 1992). This has both a positive and a negative impact.…”

“…The positive one points to an increased competence in outpatient clinics and daypatient settings. Some of the studies mentioned correct for this (Eagles et al, 1988, de Alarcon et al, 1990Castle et al, 1991;Harrison et al, 1991). Therefore, one cannot conclude that new cases are treated in other services than inpatient settings.…”