Castillejos M C, Martín-Pérez C, Moreno-Küstner B
Departament of Personality, Assessment and Psychological Treatment, University of Málaga, Campus Teatinos, Málaga, Spain.
Andalusian Group of Psychosocial Research (GAP), Research group of the Ministry of Innovation, Science and Business of the Junta de Andalucía, code CTS-945. Andalucía, Spain.
Psychol Med. 2018 Oct;48(13):2101-2115. doi: 10.1017/S0033291718000235. Epub 2018 Feb 22.
Considering existing knowledge on the relationship between certain environmental factors and incidence rates of psychosis, we carried out a systematic review to provide a broad and updated picture of the incidences of different psychotic disorder subgroups worldwide and how some environmental factors influence these rates.
Studies with original data related to the incidence of psychosis (published between 2000 and 2015) were identified via searching electronic databases (CINAHL, MEDLINE, PSYCINFO, PUBMED, and SCOPUS). Data on the following risk factors were extracted: gender, urbanicity, immigration and socio-economic level. Descriptive appraisals of variation in incidence rates (IR) and incidence rate ratios (IRR), with a 95% confidence interval were calculated. In addition, a meta-analysis was performed to calculate IR pooled by diagnosis group and IRR pooled by diagnosis and gender, urbanity, immigration and socio-economic level, using a random effects model.
We identified 33 reports to analyse. Overall IR per 100 000 persons for non-affective psychoses (IR pooled = 22.53 (16.51-28.54)) were higher than affective psychoses (IR pooled = 7.12 (5.03-9.22)). There was an increase in rates of psychosis in men v. women (IRR pooled = 1.54 (1.37-1.72)), in urban v. rural areas (IRR pooled = 1.64 (1.38-1.95)), in immigrants v. natives (IRR pooled = 3.09 (2.74-3.49)), and in lower socio-economic level areas (IRR pooled = 1.78 (1.43-2.22)).
IR among different psychotic disorders was found to vary depending on gender, urbanicity, and immigration (as most of the previous literature focuses on non-affective psychosis or schizophrenia).
鉴于目前关于某些环境因素与精神病发病率之间关系的已有知识，我们进行了一项系统综述，以全面、更新地呈现全球不同精神病亚组的发病率情况，以及一些环境因素如何影响这些发病率。
通过检索电子数据库（CINAHL、MEDLINE、PSYCINFO、PUBMED和SCOPUS），识别出与2000年至2015年期间发表的精神病发病率相关的原始数据研究。提取了以下风险因素的数据：性别、城市化程度、移民情况和社会经济水平。计算了发病率（IR）和发病率比（IRR）变化的描述性评估，并给出95%置信区间。此外，采用随机效应模型进行荟萃分析，计算按诊断组汇总的IR以及按诊断、性别、城市化程度、移民情况和社会经济水平汇总的IRR。
我们确定了33份报告进行分析。非情感性精神病每10万人的总体发病率（汇总IR = 22.53（16.51 - 28.54））高于情感性精神病（汇总IR = 7.12（5.03 - 9.22））。男性与女性相比精神病发病率有所增加（汇总IRR = 1.54（1.37 - 1.72）），城市与农村地区相比（汇总IRR = 1.64（1.38 - 1.95）），移民与本地人相比（汇总IRR = 3.09（2.74 - 3.49）），以及社会经济水平较低地区（汇总IRR = 1.78（1.43 - 2.22））。
发现不同精神病之间的发病率因性别、城市化程度和移民情况而异（正如大多数先前文献聚焦于非情感性精神病或精神分裂症一样）。
