School of Public Health, The University of Queensland, Herston, Australia.
Queensland Centre for Mental Health Research, Wacol, Australia.
Schizophr Bull. 2018 Oct 17;44(6):1195-1203. doi: 10.1093/schbul/sby058.
The global burden of disease (GBD) studies have derived detailed and comparable epidemiological and burden of disease estimates for schizophrenia. We report GBD 2016 estimates of schizophrenia prevalence and burden of disease with disaggregation by age, sex, year, and for all countries.
We conducted a systematic review to identify studies reporting the prevalence, incidence, remission, and/or excess mortality associated with schizophrenia. Reported estimates which met our inclusion criteria were entered into a Bayesian meta-regression tool used in GBD 2016 to derive prevalence for 20 age groups, 7 super-regions, 21 regions, and 195 countries and territories. Burden of disease estimates were derived for acute and residual states of schizophrenia by multiplying the age-, sex-, year-, and location-specific prevalence by 2 disability weights representative of the disability experienced during these states.
The systematic review found a total of 129 individual data sources. The global age-standardized point prevalence of schizophrenia in 2016 was estimated to be 0.28% (95% uncertainty interval [UI]: 0.24-0.31). No sex differences were observed in prevalence. Age-standardized point prevalence rates did not vary widely across countries or regions. Globally, prevalent cases rose from 13.1 (95% UI: 11.6-14.8) million in 1990 to 20.9 (95% UI: 18.5-23.4) million cases in 2016. Schizophrenia contributes 13.4 (95% UI: 9.9-16.7) million years of life lived with disability to burden of disease globally.
Although schizophrenia is a low prevalence disorder, the burden of disease is substantial. Our modeling suggests that significant population growth and aging has led to a large and increasing disease burden attributable to schizophrenia, particularly for middle income countries.
全球疾病负担（GBD）研究已经得出了详细且可比的精神分裂症流行病学和疾病负担估计。我们报告了 GBD 2016 年对精神分裂症患病率和疾病负担的估计，这些估计按年龄、性别、年份和所有国家进行了细分。
我们进行了一项系统综述，以确定报告与精神分裂症相关的患病率、发病率、缓解率和/或超额死亡率的研究。符合我们纳入标准的报告估计数被输入到 GBD 2016 中使用的贝叶斯荟萃回归工具中，以得出 20 个年龄组、7 个超地区、21 个地区和 195 个国家和地区的患病率。通过将特定年龄、性别、年份和地点的患病率乘以代表这些状态下所经历的残疾的 2 个残疾权重，得出了精神分裂症急性和残留状态的疾病负担估计数。
系统综述共发现了 129 个单独的数据来源。2016 年全球年龄标准化点患病率估计为 0.28%（95%置信区间[CI]：0.24-0.31）。患病率在性别上没有差异。国家或地区之间的年龄标准化点患病率率差异不大。全球来看，1990 年有 1310 万（95%CI：1160-1480）例现患病例，到 2016 年上升至 2090 万（95%CI：1850-2340）例。精神分裂症导致全球疾病负担中 1340 万（95%CI：990-1670）残疾生命年。
尽管精神分裂症是一种低患病率疾病，但疾病负担很大。我们的模型表明，人口的大量增长和老龄化导致了与精神分裂症相关的巨大且不断增加的疾病负担，尤其是对中等收入国家而言。
