Kebede D, Alem A, Shibre T, Negash A, Fekadu A, Fekadu D, Deyassa N, Jacobsson L, Kullgren G
Dept. of Community Health, Addis Ababa University, Addis Ababa, Ethiopia.
Soc Psychiatry Psychiatr Epidemiol. 2003 Nov;38(11):625-31. doi: 10.1007/s00127-003-0678-4.
There are reports on favourable course and outcome of schizophrenia in lowincome countries. The aim of the present study was to examine onset and clinical course of the illness in a community-based sample in rural Ethiopia based on crosssectional information.
A two-stage survey was carried out in Butajira-Ethiopia, a predominantly rural district. Altogether 68,378 individuals aged 15-49 years were CIDI-interviewed, of whom 2,159 were identified as cases according to the CIDI interview with regard to psychotic or affective disorders. Key informants identified another group of 719 individuals as being probable cases and a total of 2,285 individuals were SCAN-interviewed. The present paper reports on cases with schizophrenia.
There were 321 cases of schizophrenia giving an estimated lifetime prevalence of 4.7/1,000). Of the cases,83.2% (N = 267) were males. Mean age of first onset of psychotic symptoms for males was 23.8 (sd 8.6) compared to 21.0 (sd 7.8) for females (P = 0.037; 95 %CI 0.16-5.47). Over 80% had negative symptoms and over 67% reported continuous course of the illness. Less than 10% had a history of previous treatment with neuroleptic medication. About 7% were vagrants, 9 % had a history of assaultive behaviour,and 3.8% had attempted suicide. The male to female ratio was nearly 5:1.
This large community-based study differs from most previous studies in terms of higher male to female ratio, earlier age of onset in females and the predominance of negative symptoms.
有报告称低收入国家精神分裂症的病程和结局较好。本研究的目的是基于横断面信息，对埃塞俄比亚农村地区一个社区样本中该疾病的发病情况和临床病程进行研究。
在埃塞俄比亚主要为农村地区的布塔吉拉进行了两阶段调查。共有68378名15至49岁的个体接受了复合性国际诊断交谈表（CIDI）访谈，其中根据CIDI访谈中关于精神病性或情感性障碍的内容，有2159人被确定为病例。关键信息提供者又将另外719人确定为可能病例，共有2285人接受了神经精神病学临床评定量表（SCAN）访谈。本文报告了精神分裂症病例。
有321例精神分裂症病例，估计终生患病率为4.7/1000）。在这些病例中，83.2%（N = 267）为男性。男性首次出现精神病性症状的平均年龄为23.8岁（标准差8.6），女性为21.0岁（标准差7.8）（P = 0.037；95%CI 0.16 - 5.47）。超过80%有阴性症状，超过67%报告疾病呈持续性病程。不到10%有使用抗精神病药物治疗的既往史。约7%为流浪者，9%有攻击行为史，3.8%有自杀未遂史。男女比例接近5:1。
这项基于大型社区的研究在男女比例较高、女性发病年龄较早以及阴性症状占主导方面与大多数先前的研究不同。
