Abstract
Estimating the incidence and the prevalence of psychotic disorders in the province of Quebec has been the object of some interest in recent years as a contribution to the epidemiological study of the causes of psychotic disorders being carried out primarily in UK and Scandinavia. A number of studies have used administrative data from the Régie de l’assurance maladie du Québec (RAMQ) that includes nearly all Quebec citizens to obtain geographical and temporal prevalence estimates for the illness. However, there has been no investigation of the validity of RAMQ diagnoses for psychotic disorders, and without a measure of the sensitivity and the specificity of these diagnoses, it is impossible to be confident in the accuracy of the estimates obtained. This paper proposes the use of latent class analysis to ascertain the validity of a diagnosis of schizophrenia using RAMQ data.
Highlights
The link between urban living and psychosis has intrigued researchers since the first description of the phenomenon in the seminal studies of Faris and Dunham [1, 2] who found higher rates of schizophrenia in Chicago neighborhoods characterized by social isolation and disorganization but found no parallel difference for bipolar disorder
The first part of this paper examines how administrative databases have been used in Quebec and other provinces of Canada to study the prevalence and incidence of psychotic disorders. (Prevalence measures the number of cases of a disease at a single moment in time, while incidence measures the risk for a single individual of developing a disease during a given period.) We pay close attention to the question of the validity of the diagnosis recorded in the database
The Quebec health care system was not created for the purpose of conducting epidemiological studies, but the administrative data available through Régie de l’assurance maladie du Québec (RAMQ) provide a valuable opportunity to conduct epidemiological research
Summary
The link between urban living and psychosis has intrigued researchers since the first description of the phenomenon in the seminal studies of Faris and Dunham [1, 2] who found higher rates of schizophrenia in Chicago neighborhoods characterized by social isolation and disorganization but found no parallel difference for bipolar disorder. The first part of this paper examines how administrative databases have been used in Quebec and other provinces of Canada to study the prevalence and incidence of psychotic disorders. RAMQ data, in particular, have been used to estimate the prevalence and incidence of various diseases [35,36,37], as well as different forms of psychotic disorder in Quebec [11, 29, 30]. A study of the validity of a diagnosis for schizophrenia and depressive disorder from a Canadian administrative database in Saskatchewan was conducted by Rawson et al [28] They compared diagnoses from three sources of data and reported the percentage of agreement between each pair. A satisfactory validation of the diagnosis of schizophrenia in the RAMQ database is required, before one can be confident of using this data for epidemiological purposes
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