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Systematic review and collaborative recalculation of 133 693 incident cases of schizophrenia

Published online by Cambridge University Press:  19 December 2012

M. van der Werf ,
M. Hanssen ,
S. Köhler ,
M. Verkaaik ,
F. R. Verhey ,
R. van Winkel ,
J. van Os ,
J. Allardyce  and
RISE Investigators
M. van der Werf*
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
M. Hanssen
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands Regional Centre for Ambulant Mental Health Maastricht, Maastricht, The Netherlands
S. Köhler
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
M. Verkaaik
Affiliation:
Regional Centre for Ambulant Mental Health Maastricht, Maastricht, The Netherlands
F. R. Verhey
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
R. van Winkel
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
J. van Os*
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, UK
J. Allardyce
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
*
*Address for correspondence: J. van Os, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616 (location VIJV), 6200 MD, Maastricht, The Netherlands. (Email: j.vanos@maastrichtuniversity.nl)
*Address for correspondence: J. van Os, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616 (location VIJV), 6200 MD, Maastricht, The Netherlands. (Email: j.vanos@maastrichtuniversity.nl)
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Abstract

Background

This systematic review and collaborative recalculation was set up to recalculate schizophrenia incidence rates from previously published studies by age and sex.

Method

PubMed, EMBASE and PsycINFO databases were searched (January 1950 to December 2009) for schizophrenia incidence studies. Numerator and population data were extracted by age, sex and, if possible, study period. Original data were requested from the authors to calculate age- and sex-specific incidence rates. Incidence rate ratios (IRRs) with their 95% confidence intervals (CIs) were computed by age and sex from negative binomial regression models.

Results

Forty-three independent samples met inclusion criteria, yielding 133 693 incident cases of schizophrenia for analysis. Men had a 1.15-fold (95% CI 1.00–1.31) greater risk of schizophrenia than women. In men, incidence peaked at age 20–29 years (median rate 4.15/10 000 person-years, IRR 2.61, 95% CI 1.74–3.92). In women, incidence peaked at age 20–29 (median rate 1.71/10 000 person-years, IRR 2.34, 95% CI 1.66–3.28) and 30–39 years (median rate 1.24/10 000 person-years, IRR 2.25, 95% CI 1.55–3.28). This peak was followed by an age–incidence decline up to age 60 years that was stronger in men than in women (χ2 = 57.90, p < 0.001). The relative risk of schizophrenia was greater in men up to age 39 years and this reversed to a greater relative risk in women over the age groups 50–70 years. No evidence for a second incidence peak in middle-aged women was found.

Conclusions

Robust sex differences exist in the distribution of schizophrenia risk across the age span, suggesting differential susceptibility to schizophrenia for men and women at different stages of life.

Keywords

Age at onsetage–sex interactionepidemiologyincidenceschizophrenia
Type
Review Article
Information
Psychological Medicine , Volume 44 , Issue 1 , January 2014 , pp. 9 - 16
Copyright
Copyright © Cambridge University Press 2012 

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