Summary
Directly age standardized rates of first admission schizophrenia in Denmark (1991: 5.1 million inhabitants) decreased significantly with a slope of −0.16 and −0.13/100,000 inhabitants fifteen years and above for males and females respectively from 1971 to 1991 when examined by help of the Danish nation-wide psychiatric case register in the Institute of Psychiatric Demography, Aarhus. A control for changes in diagnostic delay/changing diagnostic patterns does not affect the findings. Various nosological factors might cause the decrease, e.g. changing structure in organization of treatment facilities, decreasing number of beds (50% in Denmark during the period investigated) and correlated with this: increasing suicide rates among pretreatment schizophrenics, increasing rates of schizophrenics not yet diagnosed in shelters for homeless and in institutions for criminals. The decrease might be genuine. In connection with this the theories about damage to the fetus during the gestation period are briefly discussed.
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References
Alarcon J de, Seagroatt V, Goldacre M (1990) Trends in schizophrenia. Lancet 335:852–853
Angst J (1991) Letter. Is schizophrenia disappearing? Introductory remarks of the Chief-Editor Eur Arch Psychiatry Clin Neurosci 240:373
Armitage P, Berry G (1987) Statistical methods in medical research. Second edition. Blackwell Scientific Publications. Oxford
Barr CE, Mednick SA, Munk-Jørgensen P (1990). Exposure to influenza epidemics during gestation and adult schizophrenia. Arch Gen Psychiatry 47:869–874
Brandt P (1987) Hjemløshed og psykisk lidelse. Ændringer i klientellet på institutioner for hjemløse gennem de sidste 25 år. (in Danish) Nord Psykiatr Tidsskr 41:295–301
Breslow NE, Day NE (1987) Statistical methods in cancer research. The design and analysis of cohort studies. IARC Scientific Publications, Lyon. No. 82
Castle D, Wessely S, Der G, Murray RM (1991) The incidence of operationally defined schizophrenia in Camberwell, 1965–84. Br J Psychiatry 159:790–794
Crow TJ, Done DJ, Johnstone EC (1992) Schizophrenia is not due to maternal influenza in the second (or other) trimester of pregnancy. Schizophrenia Research 6:99, special issue
Der G, Gupta S, Murray RM (1990) Is schizophrenia disappearing? Lancet 335:513–516
Dickson WE, Kendell RE (1986) Does maintenance lithium therapy prevent recurrences of mania under ordinary clinical conditions. Psychol Med 16:521–530
Dupont A (1983) A national psychiatric case register as a tool for mental health planning, research and administration: the Danish model. In: Laska EM, Gulbinat WH, Regier DA (eds) Information support to mental health programs. An international perspective. Human Sciences Press, New York, pp 257–274
Eagles JM, Whalley LJ (1985) Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969–78. Br J Psychiatry 146:151–154
Eagles JM, Hunter D, McCance C (1988) Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-east Scotland, 1969–1984. Br J Psychiatry 152:793–798
Fomegovic Z, Folnegovic-Smalc V, Kulcar Z (1990) The incidence of schizophrenia in Croatia. Br J Psychiatry 156:363–365
Hare EH (1974) The changing content of psychiatric illness. J Psychosem Res 18:283–289
Harrison G, Cooper JE, Cancarczyk R (1991) Changes in the administrative incidence of schizophrenia. Br J Psychiatry 159: 811–816
Häfner H, Gattaz WF (1991) Letter. Eur Arch Psychiatry Clin Neurosci 240:374–376
Institute of Psychiatric Demography (1976) Annual report (in Danish). Institute of Psychiatric Demography, Risskov
Institute of Psychiatric Demography (1990) Annual report (in Danish). Institute of Psychiatric Demography, Risskov
Isaac JI, Armat VC (1990) Madness in the streets. How psychiatry and the law abandoned the mentally ill. The Free Press, New York
Joyce PR (1987) Changing trends in first admissions and readmissions for mania and schizophrenia in New Zealand 1974 to 1984. Aust N Z J Psychiatry 21:82–86
Kendell RE, Kemp IW (1989) Maternal influenza in the etiology of schizophrenia. Arch Gen Psychiatry 46:878–882
Kramp P, Psykotiske lovovertrædere: kriminalistisk udvikling og behandlingsstruktur. Maanedsskrift for praktisk lægegerning (in Danish) (in press).
McNiel TF (1988) Obstetric factors and perinatal injuries. In: Tsuang MT, Simpson JC (eds) Handbook of schizophrenia, vol 3: Nosology, epidemiology and genetics. Elsevier Science Publisher, Amsterdam, pp 319–344
Mors O (1988) Increasing incidence of borderline states in Denmark from 1970–1985. Acta Psychiatr Scand 77:575–583
Mortensen PB, Munk-Jørgensen P, Strömgren E (1991) Letter. Eur Arch Psychiatry Clin Neurosci 240:374
Munk-Jørgensen P (1985) The schizophrenia diagnosis in Denmark. A register-based investigation. Acta Psychiatr Scand 72: 266–273
Munk-Jørgensen P (1986) Decreasing first-admission rates of schizophrenia among males in Denmark from 1970 to 1984. Changing diagnostic patterns? Acta Psychiatr Scand 73:645–650
Munk-Jørgensen P (1987) Why has the incidence of schizophrenia in Danish psychiatric institutions decreased since 1970? Acta Psychiatr Scand 75:62–68
Munk-Jørgensen P (1991) Fundamental principles of psychiatric registers and examples of their advantages. In: Sørensen T, Abrahamsen P, Torgersen S (eds). Psychiatric disorders in the social domain. Contribution to a scientific basis for understanding and action. Norwegian University Press, Oslo
Munk-Jørgensen P, Jørgensen P (1986) Decreasing rates of first-admission diagnoses of schizophrenia among females in Denmark 1970–84. Acta Psychiatr Scand 74:379–383
Munk-Jørgensen P, Flensted-Nielsen J, Brandt P, Krusell JB, Borg L, Hansen SS, Petersen B (1992) Hjemløse psykisk syge, en registerundersøgelse af klienter på herberg og forsorgshjem. (Psychiatric patients with no fixed abode. Registration of clients in hostels and care homes) (in Danish) Ugeskr Laeger 154: 1271–1275
Munk-Jørgensen P, Mortensen PB (1992) Incidence and other aspects of the epidemiology of schizophrenia in Denmark 1971–1987. Br J Psychiatry 161:489–495
Parker G, O'Donnell M, Walter S (1985) Changes in the diagnoses of the functional psychoses associated with the introduction of lithium. Br J Psychiatry 146:377–382
Parnas J, Schulsinger F, Teasdale TW, Schulsinger H, Feldman PM, Mednick SA (1982) Perinatal complications and clinical outcome within the schizophrenia spectrum. Br J Psychiatry 140:416–20
Sham PC, O'Callaghan E, Takei N, Murray GK, Hare EH, Murray RM (1992) Schizophrenia following pre-natal exposure to influenza epidemics between 1939 and 1960. Br J Psychiatry 160:461–466
Torrey EF, Bowler AE, Rawlings R (1992) Schizophrenia and the 1957 influenza epidemic. Schizophrenia Research 6:100, Special issue
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Munk-Jørgensen, P., Mortensen, P.B. Is schizophrenia really on the decrease?. Eur Arch Psychiatry Clin Nuerosci 242, 244–247 (1993). https://doi.org/10.1007/BF02189970
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DOI: https://doi.org/10.1007/BF02189970