Incidence and Outcome of Schizophrenia Across the Globe

Abstract

Ten years ago, during the “IV Search for the Causes of Schizophrenia” meeting, one of the main issues regarding the epidemiology of schizophrenia was the meaning and implications of universality and uniformity in incidence rates for the disease in different places and cultures (Jablensky 1999; Eaton 1999). Most of the evidence upon which the interpretation of data and conclusions were based came from the “Ten Country Study”, coordinated by the World Health Organization (WHO) (Sartorius et al. 1986; Jablensky et al. 1992). In that study, also known as the “Determinants of Severe Mental Disorder” study (DOSMeD), incidence rate estimates were obtained for 8 of the 12 participating centres, two of which were from Chandigarh (urban and rural areas), in India. The study also generated relevant data on the outcome of schizophrenia in different cultures. Interpretation of the results from the “Ten Country Study” led to the widespread beliefs that the incidence of schizophrenia is similar across populations and cultures and that its prognosis is more favourable for persons who live in low- and middle-income countries (LAMICs) compared to those living in high-income countries, notions that can be seen in recent publications in the most prestigious scientific medical journals (e.g. Mueser and McGurk 2004).