Abstract
Introduction: The current study aimed to establish the lifetime prevalence of schizophrenia and other psychotic disorders, its sociodemographic correlates and association with physical disorders using data from the Singapore Mental Health Study (SMHS 2016).Methods: A two-phase design comprising population-level screening of psychotic symptoms using the World Health Organization Composite International Diagnostic Interview version 3.0 psychosis screen followed by clinical reappraisal based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria were used to establish the prevalence.Results: A total of 6,126 respondents completed the first phase of the study, giving a response rate of 69.5%. 5.2% (n = 326) of respondents endorsed at least one symptom in the psychosis screen. After the phase two clinical reappraisal interviews and adjusting for false-negative rate, the corrected prevalence of schizophrenia and other psychotic disorders was 2.3% (95% CI: 2.3–2.3%). The odds of having DSM-IV schizophrenia and other psychotic disorders was significantly higher among those of Malay ethnicity (OR = 3.9, 95% CI 1.4–11.0), and those who were unemployed (OR = 4.3, 95% CI 1.2–15.9). 80.4% of those with a psychotic disorder had consulted a doctor or a mental health professional for their symptoms.Conclusions: Our results indicate that approximately 2.3% of Singapore's community-dwelling adult population had a lifetime diagnosis of schizophrenia and other psychotic disorders. While the treatment gap of the disorder was relatively small, the severe nature of the disorder emphasizes the need for continued outreach and early diagnosis and treatment.
Highlights
The current study aimed to establish the lifetime prevalence of schizophrenia and other psychotic disorders, its sociodemographic correlates and association with physical disorders using data from the Singapore Mental Health Study (SMHS 2016)
The data were weighted to adjust for differential probability of selection of participants, non-response, and poststratified by age and ethnicity between the survey sample and the Singapore resident population of 2014 ensuring that the survey findings were representative of the Singapore adult population
Differences were noted in employment statistics as data from Singapore is limited to those aged 25–64 years, data for household incomes is different as there were some methodological differences (Table 1)
Summary
The current study aimed to establish the lifetime prevalence of schizophrenia and other psychotic disorders, its sociodemographic correlates and association with physical disorders using data from the Singapore Mental Health Study (SMHS 2016). The Hong Kong Mental Morbidity Survey (HKMMS) as well as the Health 2000 study in Finland using a two-phase design linking data from the survey with additional information (e.g., medical records), estimated the prevalence of any psychotic disorder to be 2.5 and 3.5%, respectively [4, 5]. The China Mental Health Survey used a two-phase design Those screening positive in the psychosis screen and a random sample of those with negative screening results underwent a second phase assessment by psychiatrists who used the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) Axis I disorders (SCID) (Columbia University), and the study established the lifetime prevalence of schizophrenia and other psychotic disorders to be 0.7% [6]. A recent systematic review and meta-analysis estimated that the pooled median point and 12-month prevalence of psychotic disorders was 3.9 and 4.0 per 1,000 persons, respectively, and the median lifetime prevalence was 7.5 per 1,000 persons [7]
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