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Published in: BMC Medical Informatics and Decision Making 3/2020

Open Access 01-07-2020 | Schizophrenia | Research

The psychosis analysis in real-world on a cohort of large-scale patients with schizophrenia

Authors: Wenyan Tan, Haicheng Lin, Baoxin Lei, Aihua Ou, Zehui He, Ning Yang, Fujun Jia, Heng Weng, Tianyong Hao

Published in: BMC Medical Informatics and Decision Making | Special Issue 3/2020

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Abstract

Background

With China experiencing unprecedented economic development and social change over the past three decades, Chinese policy makers and health care professionals have come to view mental health as an important outcome to monitor. Our study conducted an epidemiological study of psychosis in Guangdong province, with 20 million real-world follow-up records in the last decade.

Methods

Data was collected from Guangdong mental health information platform from 2010 to 2019, which had standardized disease registration and follow-up management for nearly 600,000 patients with six categories of mental diseases and 400,000 patients with schizophrenia. We conducted clinical staging for the disease course of the patients and divided the data with various factors into different stages of disease. Quantitative analysis was utilized to investigate the high relevant indicators to the disease. The results were projected on geography map for regional distribution analysis.

Results

The majority cases of mental disease incidence were between the age of 15 and 29, while the peak age for both male and female was between 20 to 24 years old. The disease course with the largest number of patients’ cases was between 5 to 10 years. The therapeutic effect of patients gradually decreased with the development of disease course, while the risk increased with the disease course. The analysis of influencing factors showed that poor economic conditions incurred higher risk scores, and good medication adherence was effective in improving treatment outcomes. In addition, receiving good education contributed to the reduction of the risk of schizophrenia and the improvement of the efficiency of early treatment. Through the analysis of regional distribution of schizophrenia disease, developed economic conditions and favorable resource conditions could promote the reduction of disease risk, while in economically backward regions, it often accompanied with lower therapeutic effect and higher disease risk.

Conclusions

Certain demographic factors had a relatively prominent impact on the therapeutic effect and risk of schizophrenia, such as high-quality medication adherence. Therapeutic effect and risk were highly correlated. Backward economic conditions often associated with poor efficacy and higher risk assessment, and the developed economy and better medical resource are beneficial for the treatment of psychotic.
Literature
1.
go back to reference Naber D, Hansen K, et al. Qualify: a randomized head-to-head study of aripiprazole once-monthly and paliperidone palmitate in the treatment of schizophrenia. Schizophr Res. 2015;168:498–504.PubMedCrossRef Naber D, Hansen K, et al. Qualify: a randomized head-to-head study of aripiprazole once-monthly and paliperidone palmitate in the treatment of schizophrenia. Schizophr Res. 2015;168:498–504.PubMedCrossRef
2.
4.
go back to reference Charlson FJ, Baxter AJ, et al. Excess mortality from mental, neurological and substance use disorders in the global burden of disease study 2010. Epidemiol Psychiatric Sci. 2015;24(2):121–40.CrossRef Charlson FJ, Baxter AJ, et al. Excess mortality from mental, neurological and substance use disorders in the global burden of disease study 2010. Epidemiol Psychiatric Sci. 2015;24(2):121–40.CrossRef
5.
go back to reference Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry. 2007;64(10):1123–31.PubMedCrossRef Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry. 2007;64(10):1123–31.PubMedCrossRef
6.
go back to reference Janoutová J, Janáčková P. et al, Epidemiology and risk factors of schizophrenia. 2016;37(1):1–8. Janoutová J, Janáčková P. et al, Epidemiology and risk factors of schizophrenia. 2016;37(1):1–8.
7.
go back to reference McGrath JJ. The Surprisingly Rich Contours of Schizophrenia Epidemiology. 2007;64:14–6. McGrath JJ. The Surprisingly Rich Contours of Schizophrenia Epidemiology. 2007;64:14–6.
8.
go back to reference MacMahon B, Pugh TF. Epidemiology: principles and methods. Boston: Little, Brown, and Company; 1970. MacMahon B, Pugh TF. Epidemiology: principles and methods. Boston: Little, Brown, and Company; 1970.
9.
go back to reference McGrath JJ, Mortensen PB, Whiteford HA. Pragmatic psychiatric epidemiology-if you Can’t count it, It Won’t Count. JAMA Psychiatry. 2018;75(2):111–2.PubMedCrossRef McGrath JJ, Mortensen PB, Whiteford HA. Pragmatic psychiatric epidemiology-if you Can’t count it, It Won’t Count. JAMA Psychiatry. 2018;75(2):111–2.PubMedCrossRef
10.
go back to reference Ran MS, Yang LH, et al. The family economic status and outcome of people with schizophrenia in Xinjin, Chengdu, China: 14-year follow-up study. Int J Soc Psychiatry. 2017;63(3):203–11.PubMedCrossRef Ran MS, Yang LH, et al. The family economic status and outcome of people with schizophrenia in Xinjin, Chengdu, China: 14-year follow-up study. Int J Soc Psychiatry. 2017;63(3):203–11.PubMedCrossRef
11.
go back to reference Jongsma HE, Turner G, Kirkbride JB, Jones PB. International incidence of psychotic disorders, 2002–17: a systematic review and meta-analysis. Lancet Public Health. 2019;4(5):e229–44.PubMedPubMedCentralCrossRef Jongsma HE, Turner G, Kirkbride JB, Jones PB. International incidence of psychotic disorders, 2002–17: a systematic review and meta-analysis. Lancet Public Health. 2019;4(5):e229–44.PubMedPubMedCentralCrossRef
12.
go back to reference Aleman A, Kahn RS, Selten JP. Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry. 2003;60(6):565–71.PubMedCrossRef Aleman A, Kahn RS, Selten JP. Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry. 2003;60(6):565–71.PubMedCrossRef
13.
go back to reference Kirkbride JB, Hameed Y, et al. The epidemiology of first-episode psychosis in early intervention in psychosis services: findings from the social epidemiology of psychoses in East Anglia [SEPEA] study. Am J Psychiatr. 2017;174(2):143–53.PubMedCrossRef Kirkbride JB, Hameed Y, et al. The epidemiology of first-episode psychosis in early intervention in psychosis services: findings from the social epidemiology of psychoses in East Anglia [SEPEA] study. Am J Psychiatr. 2017;174(2):143–53.PubMedCrossRef
14.
go back to reference Richardson L, Hameed Y, et al. Association of Environment with the risk of developing psychotic disorders in rural populations findings from the social epidemiology of psychoses in East Anglia study. JAMA Psychiatry. 2018;75(1):75–83.PubMedCrossRef Richardson L, Hameed Y, et al. Association of Environment with the risk of developing psychotic disorders in rural populations findings from the social epidemiology of psychoses in East Anglia study. JAMA Psychiatry. 2018;75(1):75–83.PubMedCrossRef
15.
go back to reference McGrath JJ, Susser ES. New directions in the epidemiology of schizophrenia. Med J Aust. 2009;190(4):S7–9.PubMed McGrath JJ, Susser ES. New directions in the epidemiology of schizophrenia. Med J Aust. 2009;190(4):S7–9.PubMed
16.
go back to reference Montgomery W, Liu L, et al. The personal, societal, and economic burden of schizophrenia in the People’s republic of China: implications for antipsychotic therapy. Clinicoecon Outcomes Res. 2013;5:407–18.PubMedPubMedCentralCrossRef Montgomery W, Liu L, et al. The personal, societal, and economic burden of schizophrenia in the People’s republic of China: implications for antipsychotic therapy. Clinicoecon Outcomes Res. 2013;5:407–18.PubMedPubMedCentralCrossRef
17.
go back to reference Charlson FJ, Ferrari AJ, et al. Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophr Bull. 2018;44(6):1195–203.PubMedPubMedCentralCrossRef Charlson FJ, Ferrari AJ, et al. Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophr Bull. 2018;44(6):1195–203.PubMedPubMedCentralCrossRef
19.
go back to reference Li XH, Song JC, et al. Urbanization and health in China, thinking at the national, local and individual levels. Environ Health. 2016;15:S32.CrossRef Li XH, Song JC, et al. Urbanization and health in China, thinking at the national, local and individual levels. Environ Health. 2016;15:S32.CrossRef
20.
go back to reference Huang YQ, Liu ZR, et al. The China mental health survey (CMHS): I. background, aims and measures. Soc Psychiatry Psychiatr Epidemiol. 2016;51(11):1559–69.PubMedCrossRef Huang YQ, Liu ZR, et al. The China mental health survey (CMHS): I. background, aims and measures. Soc Psychiatry Psychiatr Epidemiol. 2016;51(11):1559–69.PubMedCrossRef
21.
go back to reference Liu ZR, Huang YQ, et al. The China mental health survey: II. Design and field procedures. Soc Psychiatry Psychiatr Epidemiol. 2016;51(11):1547–57.PubMedCrossRef Liu ZR, Huang YQ, et al. The China mental health survey: II. Design and field procedures. Soc Psychiatry Psychiatr Epidemiol. 2016;51(11):1547–57.PubMedCrossRef
22.
go back to reference Long J, Huang G, et al. The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys. Acta Psychiatr Scand. 2014;130(4):244–56.PubMedCrossRef Long J, Huang G, et al. The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys. Acta Psychiatr Scand. 2014;130(4):244–56.PubMedCrossRef
23.
go back to reference Phillips MR, Zhang JX, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet. 2009;373(9680):13–9.CrossRef Phillips MR, Zhang JX, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet. 2009;373(9680):13–9.CrossRef
24.
go back to reference Shen YC, Zhang MY, et al. Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med. 2006:257–67. Shen YC, Zhang MY, et al. Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med. 2006:257–67.
25.
go back to reference Hu TW. Perspectives: an international review of the national cost estimates of mental illness, 1990–2003. J Ment Health Policy Econ. 2006;9(1):3–13.PubMed Hu TW. Perspectives: an international review of the national cost estimates of mental illness, 1990–2003. J Ment Health Policy Econ. 2006;9(1):3–13.PubMed
26.
go back to reference Galletly C, Castle D, et al. Royal Australian and new Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry. 2016;50(5):410–72.PubMedCrossRef Galletly C, Castle D, et al. Royal Australian and new Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry. 2016;50(5):410–72.PubMedCrossRef
27.
go back to reference Ochoa S, Usall J, Cobo J, et al. Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophr Res Treat. 2012;576369. Ochoa S, Usall J, Cobo J, et al. Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophr Res Treat. 2012;576369.
28.
go back to reference Higashi K, Medic G, et al. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Ther Adv Psychopharmacol. 2013;3(4):200–18.PubMedPubMedCentralCrossRef Higashi K, Medic G, et al. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Ther Adv Psychopharmacol. 2013;3(4):200–18.PubMedPubMedCentralCrossRef
29.
go back to reference Perkins DO. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry. 2002;63(12):1121–8.PubMedCrossRef Perkins DO. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry. 2002;63(12):1121–8.PubMedCrossRef
30.
go back to reference Zhai J, Guo XF, et al. An investigation of economic costs of schizophrenia in two areas of China. Int J Ment Heal Syst. 2013;7(1):26.CrossRef Zhai J, Guo XF, et al. An investigation of economic costs of schizophrenia in two areas of China. Int J Ment Heal Syst. 2013;7(1):26.CrossRef
31.
go back to reference Byrne M, Agerbo E, et al. Parental socio-economic status and risk of first admission with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2004;39(2):87–96.PubMedCrossRef Byrne M, Agerbo E, et al. Parental socio-economic status and risk of first admission with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2004;39(2):87–96.PubMedCrossRef
32.
go back to reference Scior K, Potts HW, et al. Awareness of schizophrenia and intellectual disability and stigma across ethnic groups in the UK. Psychiatry Res. 2013;208(2):125–30.PubMedCrossRef Scior K, Potts HW, et al. Awareness of schizophrenia and intellectual disability and stigma across ethnic groups in the UK. Psychiatry Res. 2013;208(2):125–30.PubMedCrossRef
33.
34.
go back to reference Huang YP, Wang Y, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–24.PubMedCrossRef Huang YP, Wang Y, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–24.PubMedCrossRef
35.
36.
go back to reference Dong KY. Medical insurance system evolution in China. China Econ Rev. 2009;20(4):591–7.CrossRef Dong KY. Medical insurance system evolution in China. China Econ Rev. 2009;20(4):591–7.CrossRef
37.
go back to reference Lee S, Guo WJ, et al. Impaired role functioning and treatment rates for mental disorders and chronic physical disorders in metropolitan China. Psychosom Med. 2009;71(8):886–93.PubMedCrossRef Lee S, Guo WJ, et al. Impaired role functioning and treatment rates for mental disorders and chronic physical disorders in metropolitan China. Psychosom Med. 2009;71(8):886–93.PubMedCrossRef
Metadata
Title
The psychosis analysis in real-world on a cohort of large-scale patients with schizophrenia
Authors
Wenyan Tan
Haicheng Lin
Baoxin Lei
Aihua Ou
Zehui He
Ning Yang
Fujun Jia
Heng Weng
Tianyong Hao
Publication date
01-07-2020
Publisher
BioMed Central
Keyword
Schizophrenia
DOI
https://doi.org/10.1186/s12911-020-1125-0

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