Department of Healthcare Development, Public Health Care Services, Stockholm County Council, Box 6909, 102 39, Stockholm, Sweden.
Department of Medicine, Clinical Epidemiology Unit T2, Centre for Pharmacoepidemiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, 17176, Sweden.
BMC Psychiatry. 2017 Dec 29;17(1):416. doi: 10.1186/s12888-017-1582-x.
This study investigated the prevalence of schizophrenia (ICD-10 F 20) and of other non-affective psychosis (NAP, ICD-10 F 21 - F 29) in Sweden. It further assessed health care use, comorbidity and medication for these patient groups. Most studies either have a study population of patients with strictly defined schizophrenia or a psychosis population of which strict schizophrenia cases form a smaller set. The present study permits comparison of the two mutually exclusive patient groups using data at the individual level in the diagnosis of non-affective psychosis, use of health care, medical treatment and comorbidity by diagnosis or medical treatment.
In 2012, data were extracted from a regional registry containing patient-level data on consultations, hospitalisations, diagnoses and dispensed drugs for the total population in the region of Stockholm (2.1 million inhabitants). The size of the total psychosis population was 18,769, of which 7284 had a diagnosis of schizophrenia. Crude prevalence rates and risk rates with 95% confidence intervals were calculated.
In 2012, the prevalence of schizophrenia and NAP was 3.5/1000 and 5.5/1000, respectively. Schizophrenia was most common among patients aged 50-59 years and NAP most common among patients aged 40-49 years. Schizophrenia patients used psychiatric health care more often than the NAP patients but less overall inpatient care (78.6 vs. 60.0%). The most prevalent comorbidities were substance abuse/dependence (7.9% in the schizophrenia group vs. 11.7% in the NAP group), hypertension (7.9 vs. 9.7%) and diabetes (6.9 vs. 4.8%). The parenteral form of long-acting injectable antipsychotics was more often dispensed to patients with schizophrenia (10 vs. 2%).
This study, analysing all diagnoses recorded in a large health region, confirmed prevalence rates found in previous studies. Schizophrenia patients use more psychiatric and less overall inpatient health care than NAP patients. Differences between the two patient groups in comorbidity and drug treatment were found. The registered rates of a substance abuse/dependence diagnosis were the most common comorbidity observed among the patients investigated. The observed differences between the schizophrenia and the NAP patients in health care consumption, comorbidity and drug treatment are relevant and warrant further studies.
本研究调查了瑞典精神分裂症（ICD-10 F20）和其他非情感性精神病（NAP，ICD-10 F21-F29）的患病率。它还评估了这些患者群体的医疗保健使用情况、合并症和药物治疗情况。大多数研究要么有一个严格定义为精神分裂症的患者群体，要么有一个精神病人群，其中严格的精神分裂症病例构成一个较小的子集。本研究允许使用个体层面的数据，在非情感性精神病的诊断、医疗保健使用、医疗治疗和按诊断或医疗治疗的合并症方面，对这两个相互排斥的患者群体进行比较。
2012 年，从一个包含斯德哥尔摩地区（210 万居民）患者咨询、住院、诊断和配药的个人层面数据的区域登记处提取数据。总精神病患者人数为 18769 人，其中 7284 人被诊断为精神分裂症。计算了粗患病率和风险率及 95%置信区间。
2012 年，精神分裂症和 NAP 的患病率分别为 3.5/1000 和 5.5/1000。精神分裂症在 50-59 岁的患者中最为常见，而 NAP 在 40-49 岁的患者中最为常见。精神分裂症患者比 NAP 患者更频繁地使用精神卫生保健，但总体住院治疗较少（78.6%比 60.0%）。最常见的合并症是物质滥用/依赖（精神分裂症组 7.9%，NAP 组 11.7%）、高血压（7.9%比 9.7%）和糖尿病（6.9%比 4.8%）。长效注射型抗精神病药的注射剂型更常开给精神分裂症患者（10%比 2%）。
这项分析了一个大型卫生区域所有记录诊断的研究，证实了之前研究中发现的患病率。与 NAP 患者相比，精神分裂症患者使用更多的精神卫生保健和更少的总体住院医疗保健。在合并症和药物治疗方面，这两个患者群体存在差异。在所调查的患者中，物质滥用/依赖的诊断是最常见的合并症。精神分裂症患者和 NAP 患者在医疗保健消费、合并症和药物治疗方面观察到的差异是相关的，值得进一步研究。
