Validation of Danish case register diagnosis for schizophrenia

Löffler, W.; Häfner, Heinz; Fätkenheuer, B.; Maurer, Kurt; Riecher-Rössler, Anita; Lutzhoft, Jan Holten; Skadhede, Søren; Munk‐Jørgensen, Povl; Strömgren, Erik

doi:10.1111/j.1600-0447.1994.tb01577.x

Cited by 92 publications

(44 citation statements)

References 23 publications

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“…After a decline female onsets reached a second, somewhat smaller peak in age group 45 to 50 years around premenopause with a significant difference to men. The same pattern also emerged in Castle et al's (1993) study, based on the Camberwell case register, and in our analysis of all first admissions for a diagnosis of schizophrenia from the Danish case register (Löffler et al, 1994).…”

Section: Promorbid Functioning (Domain 4)supporting

confidence: 87%

Schizophrenia: do men and women suffer from the same disease?

Häfner¹

2002

Rev. psiquiatr. clín.

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This article reviews the literature on normal brain development and behavioural development in men and women as well as on aetiological risk factors for schizophrenia, such as pre-, peri-and postnatal complications.The male-female comparisons of age and type of onset, symptomatology, course and outcome were based on a population-based sample of 232 first illness episodes -the ABC Schizophrenia Study sample. The probands were assessed using the IRAOS interview and other instruments retrospectively at first admission and prospectively at six cross sections over five years after first contact. A representative subsample of 130 first admissions or 115 first illness episodes were compared with 130 controls, matched by age, sex and area of residence.Women, 3 to 4 years older than men at illness onset, showed a second peak of onsets in age group 45 to 50 years. After animal experiments and a controlled clinical study this finding was explained by a protective effect of oestrogen persisting until menopause. The underlying neurobiological mechanism consisted in a sensitivity reducing effect of oestrogen on D2 receptors in the brain. The effect of oestrogen, meanwhile confirmed in randomised control trials, also includes genomic effects as well as interactions with free-radical detoxifying systems, thus demonstrating the neuroprotective capabilities of oestrogen.Postmenopausal schizophrenia was more frequent and more severe in women. Men fell ill more frequently and more severely at young age and less frequently and more mildly later in life. Illness course, too, was more unfavourable in postmenopausal women than in their male peers.The protective effect of oestrogen in women depended on the degree of their predisposition to the illness: the higher the familial load for schizophrenia, the weaker the protection by oestrogen. The more favourable illness course in premenopausal women resulted from their higher level of social development at illness onset -determined by their higher age at onset -and from their socially more adaptive behaviour. The illness behaviour of young men showed a significant excess of socially negative behaviours with an unfavourable impact on their early illness course. In contrast, older men were socially better adjusted. With genetic and morphological findings considered the subtypes of schizophrenia did not differ between men and women.Gender differences in symptomatology and course of schizophrenia obviously are not explained by differences in the disease process. They seem to be determined by a complex pattern of interaction between disease variables, hormonal and behavioural differences and their consequences for age at onset and illness course.

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Section: Promorbid Functioning (Domain 4)supporting

confidence: 87%

Schizophrenia: do men and women suffer from the same disease?

Häfner¹

2002

Rev. psiquiatr. clín.

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“…The study is part o f the more thor ough schizophrenia study o f the W H O Collaborating Centres of Aarhus and Mannheim. In a further analy sis o f the Danish casenotes the number o f cases is somewhat lower [12], which is explained by the reduc tion o f the upper age limit to 59 years. It is thus com patible with the one chosen for other data used in the Mannheim project [8] The selection o f cases from the register was con ducted at random in the S P S S X programme [16].…”

Section: Sample Descriptionmentioning

confidence: 99%

Symptom Assessment in Casenotes and the Clinical Diagnosis of Schizophrenia

Lutzhoft¹,

Skadhede²,

Fätkenheuer

et al. 1995

Psychopathology

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It is well known from several international studies that the incidence rates for schizophrenia, based on first-admission samples, are low in Denmark, especially in females, compared with other countries. This might be due to special diagnostic traditions in Denmark. To analyze how Danish psychiatrists reach a diagnosis of schizophrenia, a stratified subsample of 122 cases out of all 1,259 patients, aged between 12 and 64 years, with a first hospital admission in 1976 under the diagnosis of schizophrenia, paranoid psychosis, acute reactive paranoid psychosis, or casus limitaris was selected. For this subsample, psychopathological symptoms, as documented in the clinical case-notes, were rated by PSE-9 symptom lists for subsequent CATEGO analysis. The core syndrome of schizophrenia, as defined by the CATEGO class S+, showed no association with the clinical schizophrenia diagnosis compared with the other diagnoses mentioned. Also, positive symptoms of schizophrenia did not determine the diagnosis, but for typical negative symptoms such associations were indicated. Some negative symptoms also seemed to be linked to a depressive state. Furthermore, the present work indicates that using first-admission data leads to a higher age at schizophrenia onset and a lower first-admission rate in Denmark compared with Germany.

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“…However, in several studies, validation of some diagnoses (e.g. schizophrenia, single episode depression, dementia, autism), has been carried out with good results [8][9][10][11][12]. …”

Section: Validity Of Diagnosesmentioning

confidence: 99%

The Danish Psychiatric Central Research Register

Mors

Perto

Mortensen

2011

Scand J Public Health

1,381

1,302

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Introduction: The Psychiatric Central Research Register (PCRR) has continued since 1970 with electronic registration of patients treated at psychiatric departments in Denmark. Content: The register contains dates of onset and end of any treatment; all diagnoses; type of referral; place of treatment; municipality of residence; mode of admission. Validity and coverage: Systematic studies validating the clinical diagnoses do not exist. However, several studies have validated specific diagnoses. The nationwide registration of severe mental disorders is almost complete. However, most cases with mild to moderate mental disorders are diagnosed and treated by general practitioners or specialists in psychiatry working in private practice and are thus not registered in the PCRR. Conclusion: The PCRR is a valuable tool in national health planning and in epidemiological research.

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Validation of Danish case register diagnosis for schizophrenia

Cited by 92 publications

References 23 publications

Schizophrenia: do men and women suffer from the same disease?

Schizophrenia: do men and women suffer from the same disease?

Symptom Assessment in Casenotes and the Clinical Diagnosis of Schizophrenia

The Danish Psychiatric Central Research Register

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