The Incidence and Prevalence Rate of Schizophrenia - Essay Example

Incidence and Prevalence Report ID Number & Total Number of Words: 2,015 Table of Contents 1. Introduction ............................................................................................................... 3 2. Literature Review ..................................................................................................... 4 a. Basic Information about the Incidence and Prevalence Rate of Schizophrenia ............................................................................................ 4 2.1.1 Signs and Symptoms ................................................................ 5 2.1.2 Common Age Affected by Schizophrenia ............................... 5 2.1.3 Current Treatments .................................................................. 5 2.2 Incidence and Prevalence Report ............................................................. 6 2.2.1 Calgary .................................................................................... 6 2.2.2 Alberta ..................................................................................... 6 2.2.3 Canada ..................................................................................... 7 2.2.4 The World ................................................................................ 7 2.3 Discussion .............................................................................................. 8 3 Conclusion and Recommendations ......................................................................... 9 References ............................................................................................................................ 10 - 12 Chapter 1 – Introduction Incidence is defined as “the fraction or proportion of a group of people initially free of the outcome of interest that develops the condition over a given period of time” whereas prevalence is defined as “the fraction (proportion or percent) of a group of people possessing a clinical condition or outcome at a given point in time” (Fletcher & Fletcher, 2005, p. 60). According to Fletcher and Fletcher (2005, p. 60), the term incidence can also refer to “new cases of disease” that can occur in each population that has once been free from a disease. Therefore, it is clear that incidence is totally different from the rate of prevalence in the sense that the incidence rate aims to measure the possibility of developing new cases of disease within a given period of time whereas the prevalence rate aims to measure the percentage of population that has already been diagnosed with a specific disease (McGrath et al., 2008). As a type of chronic brain disease, there is no cure for schizophrenia but is highly treatable (Kahn & Fawcett, 2008, p. 383). Schizophrenia is often characterized by having a distorted speech, perception, and thoughts. For this reason, it is difficult to handle cases of schizophrenia not only on the part of the patients but also amongst their family members and caregivers. To give the readers a better idea with regards to schizophrenia, the first part of this report will purposely discuss basic information about schizophrenia including its signs and symptoms, common age affected by schizophrenia, and current treatments. The main purpose of this report is to gather, compare and contrast the incidence and prevalence rate of schizophrenia in Calgary (local city), Alberta (provincial), Canada (national), and the world (global). To gather up-dated information about the incidence and prevalence of schizophrenia in these four (4) levels, a wide-range of online resources will be utilized in this report. Chapter 2 – Literature Review 2.1 Basic Information about the Incidence and Prevalence Rate of Schizophrenia Schizophrenia is a type of mental health problem that can equally affect both men and women (McGrath et al., 2004; Aleman, Kahn, & Selten, 2003). Even though Jablensky (2003, p. 212) strongly suggests that the incidence and prevalence rate of schizophrenia are comparable across populations, the research study of Goldner et al. (2002) proves otherwise. After conducting a systematic review of literature (between the 1st of January 1980 and the 31st of December 2000) with regards to the incidence and prevalence rate of schizophrenia, Goldner et al. (2002) found out that with a variation rates between 2-fold to 5-fold, the 1st year and lifetime prevalence rate of schizophrenia were 0.34 per 100 and 0.55 per 100 population respectively whereas the 1-year incidence rate of schizophrenia was 11.1 per 100,000 population. This figure strongly suggests that “there is a real variation in the distribution of schizophrenia around the world” (Goldner et al., 2002). A lot of past and current studies identified factors that can significantly affect the incidence and prevalence rate of schizophrenia (Pedersen & Mortensen, 2006; Cantor-Graae & Selten, 2005; Aleman, Kahn, & Selten, 2003). Based on the meta-analysis results that were conducted by Aleman, Kahn and Selten (2003), the authors revealed that “the incidence risk ratios for men to develop schizophrenia relative to women were 1.42”. It means that gender differences is one of the factors that can affect the incidence and prevalence rate of schizophrenia. After conducting a population-based cohort study, Pedersen & Mortensen (2006) found out that families or individuals are among the main factors that can affect the urban-rural differences with regards to the incidence and prevalence rate of schizophrenia. After conducting a meta-analysis review on schizophrenia and migration, Cantor-Graae and Selten (2005) concludes that the migration history of each family member is a signficant risk factor in the development of schizophrenia. It means that there is a strong possibility that the patterns of incidence and prevalence rate of schizophrenia could differ across the subgroups. 2.1.1 Signs and Symptoms Signs and symptoms of schizophrenia are categorized as: (1) positive symptoms (i.e. hallucination, delusion, thought disorders, and movement disorders); (2) negative symptoms (i.e. flat affect such as talking in monotonous tone, socially or functionally withdrawn); and (3) cognitive symptoms (i.e. inability to use information after learning) (NIMH, 2012a; NHS, 2010; Supina & Patten, 2006). This makes it difficult on the part of the caregivers and their family members to care for patients with schizophrenia. 2.1.2 Common Age Affected by Schizophrenia Although people more than 45 years old are most likely to have show more signs and symptoms of schizophrenia, people between 16 to 30 years old who are high risk of developing schizophrenia may start experiencing mild symptoms like hallucination or delusion (NIMH, 2012b; Health Canada Editorial Board Mental Illnesses in Canada, 2002, p. 51). Even though schizophrenia can equally affect both men and women, men can experience the symptoms of schizophrenia earlier as compared to women (NIMH, 2012b). 2.1.3 Current Treatments Common treatment for schizophrenia includes: (1) antipsychotic medicines (i.e. Chlorpromazine (Thorazine), Haloperidol (Haldol), Perphenazine (Etrafon, Trilafon), Fluphenazine (Prolixin), Clozapine (Clozaril), Risperidone (Risperdal), Olanzapine (Zyprexa), etc.); (2) psychosocial treatments; (3) self-help groups; (4) cognitive behavioral therapy; (5) illness management skills, and (6) rehabilitation programs (NIMH, 2012c; Health Canada Editorial Board Mental Illnesses in Canada, 2002, p. 49, 54). Even though people with schizophrenia are not violent, this group of individuals is at high risk of committing suicide (Meltzer et al., 2003; ealth Canada Editorial Board Mental Illnesses in Canada, 2002, p. 52). To save the lives of people with schizophrenia, it is important to study and further improve the existing treatment for schizophrenia. 2.2 Incidence and Prevalence Report 2.2.1 Calgary Based on 2012 census, the current population in Calgary is 1,120,225 (The City of Calgary, 2012). Based on Alberta Health Services 2006 report, the treated prevalence rate of schizophrenia in Calgary is 388 per 100,000 individuals (Alberta Health Services, 2006, p. 11). Since the total population of Calgary is 1,120,225 (The City of Calgary, 2012), it means that as much as 4,346 people in Calgary who are currently suffering from the symptoms of schizophrenia are receiving necessary treatment [{1,120,225 / 100,000} * 388]. The incidence rate of schizophrenia in Calgary is not available to the public. However, Supina and Patten (2006) reported that the yearly incidence rate of schizophrenia in Canada is between 0.20 to 0.40 per 1000 population. Assuming that the incidence rate of schizophrenia in Canada is applicable to the case of Calgary, it means that the number of new schizophrenia cases in Calgary each year is between 224 [{1,120,225 / 1000} * 0.20] and 448 [{1,120,225 / 1000} * 0.40]. 2.2.2 Alberta As of the 1st of July 2012, the total population in Alberta is 3,838,859 (Statistics Canada, 2012). Based on Alberta Health Services 2009 report, the treated prevalence rate of schizophrenia in Alberta is 71.64 per 100,000 individuals [{2,750*100,000} / 3,838,859]. It means that a total of 2,750 people in Alberta who are currently suffering from the symptoms of schizophrenia are receiving necessary treatment (Alberta Mental Health Board, 2007, p. 58). Similar to the case of Calgary, the incidence rate of schizophrenia in Alberta is not available to the public. Assuming that the incidence rate of schizophrenia in Canada is applicable to the case of Alberta, it means that the number of new schizophrenia cases in Alberta each year is between 768 [{3,838,859 / 1000} * 0.20] and 1,536 [{3,838,859 / 1000} * 0.40]. 2.2.3 Canada As of July 2012, the total population in Canada is 34,300,083 (CIA, 2012a). Depending on the type of measurement used in clinical observation, the Health Canada Editorial Board Mental Illnesses in Canada (2002, p. 50) reported that “the prevalence of schizophrenia in general population is estimated to vary between 0.2% and 2%”. To avoid confusion, the yearly prevalence rate of schizophrenia that is accepted in Canada is roughly 1% in general population (Mueser & McGurk, 2004; Health Canada Editorial Board Mental Illnesses in Canada, 2002, p. 50). It means that as of July 2012, roughly 343,000 people in Canada are currently suffering from schizophrenia [34,300,083 x 0.01]. The yearly incidence rate of schizophrenia in Canada is between 0.20 to 0.40 per 1000 population (Supina & Patten, 2006). Given the fact that the total population in Canada as of July 2012 is 34,300,083 (CIA, 2012a), it means that there will be 6,860 [{34,300,083 / 1000} * 0.20] to 13,720 [{34,300,083 / 1000} * 0.40] new cases of schizophrenia each year. 2.2.4 The World As of July 2012, the total world population is 7,021,836,029 (CIA, 2012b). The World Health Organization (WHO) reported that the prevalence rate of schizophrenia is approximately 7 per 1000 of the adult population between the age of 15 to 35 years old (World Health Organization, 2012a). The World Health Organization (2012a) also reported that as much as 24 million individuals around the world are suffering from schizophrenia but more than 50% of the affected individuals are not properly receiving care and treatment. The incidence rate of schizophrenia is as low as 3 per 10,000 (World Health Organization, 2012a). Since the total world population is 7,021,836,029 as of July 2012 (CIA, 2012b), the number of new cases of schizophrenia each year is only 2,106,550 or a little more than 2.1 million [{7,021,836,029 / 10,000} * 3]. Although there is no cure for schizophrenia, this particular type of mental illness is highly treatable and that treatment is more effective during the early stage of the disease. Since more than 50% of the affected individuals are not properly receiving care and treatment (World Health Organization, 2012a), the prevalence rate of schizophrenia around the world is significantly much higher as compared to the worldwide incidence rate. 2.3 Discussion The incidence and prevalence rate of schizophrenia varies within the local, provincial, national, and global levels. In most cases, the high the population would mean a higher incidence and prevalence rate of the said disease. For instance, if we compare the total population of Canada (34,300,083) with the total population of the world (7,021,836,029), the prevalence rate of schizophrenia in Canada is only 343,000 [34,300,083 x 0.01] as compared to the world’s prevalence rates of 24 million individuals. The World Health Organization clearly explained that even though there is no cure for schizophrenia, this particular type of mental illness is highly treatable (World Health Organization, 2012a). Specifically the provision of treatment is more effective during the early stage of schizophrenia. It only means that it is more difficult to treat severe schizophrenia that has long time been ignored. The incidence and prevalence rate of schizophrenia can serve as useful information with regards to how extensive schizophrenia is within the local, provincial, national, and global levels. The incidence rate of schizophrenia can also be used in studying the etiology of the said disease. The problem with not knowing the incidence rate of schizophrenia is that the new cases of schizophrenia may not receive immediate care and treatment from the mental health providers. Eventually, failure to treat new cases of schizophrenia could mean increasing its prevalence rate due to lack of medical and mental health intervention. Chapter 3 – Conclusion and Recommendations Prevalence rate is totally different from incidence rate in the sense that prevalence rate aims to measure the percentage of population that has already been diagnosed with a specific disease whereas the incidence rate aims to measure the possibility of developing new cases of disease within a given period of time (McGrath et al., 2008). As compared to the prevalence rate, the incidence rate of schizophrenia is more useful in terms of analyzing the etiology of the said disease. On the other hand, the prevalence rate gives us a broader idea on how many people have been diagnosed with schizophrenia not only within the local but also within the provincial, national, and global levels. Schizophrenia is a highly treatable mental illness. Therefore, the mental health practitioners should make use of its incidence rate as a guide in determining how many new cases of schizophrenia they should expect on a yearly basis. By doing so, the mental health practitioners can effectively diagnose and treat individuals with schizophrenia before it becomes more difficult to manage. References Alberta Health Services. (2006, March). Retrieved September 19, 2012, from Mental Health Services Provided by Physicians in Alberta: An Overview April 1, 2003 – March 31, 2004: http://www.albertahealthservices.ca/MentalHealthWellness/hi-mhw-physicians-report.pdf Alberta Mental Health Board. (2007, December 21). Retrieved September 19, 2012, from Mental Health Needs of Albertans: Select Factors and Findings: http://www.albertahealthservices.ca/MentalHealthWellness/hi-mhw-mental-health-needs-assessment-01-08.pdf Aleman, A., Kahn, R., & Selten, J. (2003). Sex differences in the risk of schizophrenia: evidence from meta-analysis. Archives of General Psychiatry, 60(6): 565-571. Cantor-Graae, E., & Selten, J. (2005). Schizophrenia and migration: a meta-analysis and review. Americal Journal of Psychiatry, 162(1):12-24. CIA. (2012a). Retrieved September 19, 2012, from Canada: Population: https://www.cia.gov/library/publications/the-world-factbook/geos/ca.html CIA. (2012b). Retrieved September 19, 2012, from World: Population: https://www.cia.gov/library/publications/the-world-factbook/geos/xx.html Fletcher, R., & Fletcher, S. (2005). Clinical Epidemiology: The Essentials. 4th Edition. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins. Goldner, E., Hsu, L., Waraich, P., et al. (2002). Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 47(9): 833-843. Health Canada Editorial Board Mental Illnesses in Canada. (2002, October). Retrieved September 19, 2012, from A Report on Mental Illnesses in Canada: http://www.cpa.ca/cpasite/userfiles/Documents/Practice_Page/reports_mental_illness_e.pdf Jablensky, A. (2003). Schizophrenia: the epidemiological horizon. In Hirsch S.R. & Weinberger D.R. (eds.) Schizophrenia. 2nd Edition. Oxford, United Kingdom: Blackwell Science. Kahn, A., & Fawcett, J. (2008). The Encyclopedia of Mental Health. 3rd Edition. New York, NY: Facts on File, Inc. McGrath, J., Saha, S., Chant, D., & Welham, J. (2008). Schizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality. Epidemiologic Reviews, 30(1): 67-76. McGrath, J., Saha, S., Welham, J., et al. (2004). A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Medicine, 2:13. doi:10.1186/1741-7015-2-13 Meltzer, H., Alphs, L., Green, A., Altamura, A., Anand, R., Bertoldi, A., et al. (2003). International Suicide Prevention Trial Study Group. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Archives of General Psychiatry, 60(1): 82-91. Mueser, K., & McGurk, S. (2004). Schizophrenia. Lancet, 363(9426): 2063-2072. NHS. (2010, November 18). Retrieved September 19, 2012, from Schizophrenia - Symptoms: http://www.nhs.uk/Conditions/Schizophrenia/Pages/Symptoms.aspx NIMH. (2012a). Retrieved September 19, 2012, from What are the symptoms of schizophrenia?: http://www.nimh.nih.gov/health/publications/schizophrenia/what-are-the-symptoms-of-schizophrenia.shtml NIMH. (2012b). Retrieved September 19, 2012, from When does schizophrenia start and who gets it?: http://www.nimh.nih.gov/health/publications/schizophrenia/when-does-schizophrenia-start-and-who-gets-it.shtml NIMH. (2012c). Retrieved September 12, 2012, from How is schizophrenia treated?: http://www.nimh.nih.gov/health/publications/schizophrenia/how-is-schizophrenia-treated.shtml Pedersen, C., & Mortensen, P. (2006). Are the cause(s) responsible for urban-rural differences in schizophrenia risk rooted in families or in individuals? American Journal of Epidemiology, 163(11): 971-978. Statistics Canada. (2012). Retrieved September 19, 2012, from Albertas population clock: http://www.statcan.gc.ca/ig-gi/pop-ab-eng.htm Supina, A., & Patten, S. (2006). Self-Reported Diagnoses of Schizophrenia and Psychotic Disorders May Be Valuable for Monitoring and Surveillance. Canadian Journal of Psychiatry, 51(4): 256-259. The City of Calgary. (2012). Retrieved September 19, 2012, from 2012 Civic Census Results Released: http://www.calgary.ca/CA/City-Clerks/Pages/Election-and-information-services/Civic-Census/Civic-Census.aspx?redirect=/census World Health Organization. (2012a). Retrieved September 12, 2012, from Schizophrenia: http://www.who.int/mental_health/management/schizophrenia/en/ Read More