Lifetime Prevalence and Correlates of Schizophrenia and Other Psychotic Disorders in Singapore

Abstract

Introduction: The current study aimed to establish the lifetime prevalence of schizophrenia and other psychotic disorders, its sociodemographic correlates and association with physical disorders using data from the Singapore Mental Health Study (SMHS 2016).Methods: A two-phase design comprising population-level screening of psychotic symptoms using the World Health Organization Composite International Diagnostic Interview version 3.0 psychosis screen followed by clinical reappraisal based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria were used to establish the prevalence.Results: A total of 6,126 respondents completed the first phase of the study, giving a response rate of 69.5%. 5.2% (n = 326) of respondents endorsed at least one symptom in the psychosis screen. After the phase two clinical reappraisal interviews and adjusting for false-negative rate, the corrected prevalence of schizophrenia and other psychotic disorders was 2.3% (95% CI: 2.3–2.3%). The odds of having DSM-IV schizophrenia and other psychotic disorders was significantly higher among those of Malay ethnicity (OR = 3.9, 95% CI 1.4–11.0), and those who were unemployed (OR = 4.3, 95% CI 1.2–15.9). 80.4% of those with a psychotic disorder had consulted a doctor or a mental health professional for their symptoms.Conclusions: Our results indicate that approximately 2.3% of Singapore's community-dwelling adult population had a lifetime diagnosis of schizophrenia and other psychotic disorders. While the treatment gap of the disorder was relatively small, the severe nature of the disorder emphasizes the need for continued outreach and early diagnosis and treatment.

Positive mental health framework of transdiagnostic protective factors in elucidating the association between adverse childhood experiences and severe mental disorders

“…Participants who endorsed positive psychotic symptoms on the screener questionnaire were further assessed for lifetime schizophrenia and other psychotic disorders (i.e. brief psychotic disorder, schizophreniform disorder, schizoaffective disorder, delusional disorder, substance-induced psychotic disorder, and psychotic disorder not otherwise specified) on the SCID-1 by experienced clinicians ( Subramaniam et al, 2021 ). Accordingly, participants who were diagnosed with any of these mood and schizophrenia spectrum disorders were categorized into the severe mental disorders group; a binary (yes/no) outcome variable was formulated for severe mental disorders.…”

Aggression Amongst Outpatients With Schizophrenia and Related Psychoses in a Tertiary Mental Health Institution

“…Schizophrenia is a chronic and severe mental illness affecting 20 million people worldwide ( 5 ). A recent study conducted in Singapore reported that ~2.3% of Singapore's general adult population are affected by schizophrenia and related psychoses in their lifetime ( 6 ). People with schizophrenia are commonly perceived as unpredictable and dangerous ( 7 ), with fears of being injured by an individual with severe mental illness being fairly common in the general public ( 8 ).…”

Needs of patients with early psychosis: A comparison of patient’s and mental health care provider’s perception

“…In Singapore, the prevalence of schizophrenia spectrum and other psychotic disorders was 2.3% in the adult population, with an early age of onset (23.1 years) and low treatment gap [80.4% sought treatment, ( 23 )]. The Early Psychosis Intervention Programme (EPIP), a multidisciplinary nationwide program aims to diagnose and manage psychosis at an early stage to improve treatment outcomes and long-term prognosis ( 24 ).…”