Department of Psychiatry, University of Cambridge, Cambridge, UK; PsyLife Group, Division of Psychiatry, University College London, London, UK.
Institute of Public Health, University of Cambridge, Cambridge, UK.
Lancet Public Health. 2019 May;4(5):e229-e244. doi: 10.1016/S2468-2667(19)30056-8.
The last comprehensive systematic review of the incidence of psychotic disorders was published in 2004. New epidemiological data from different settings now permit a broader understanding of global variation. We examined the variation in psychosis by demographic characteristics and study method.
For this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, PsycINFO, and bibliographies, and directly contacted first authors. We sought to obtain citations of original research published between Jan 1, 2002, and Dec 31, 2017, on incidence of non-organic adult-onset psychotic disorder. We included papers that were published or in grey literature and had no language restrictions. Data were extracted from published reports, where possible, by sex, age, and ethnic group. Quality of yield was assessed. Data were assessed using univariable random-effects meta-analysis and meta-regression. We registered our systematic review on PROSPERO, number CRD42018086800.
From 56 721 records identified, 177 met inclusion criteria. The pooled incidence of all psychotic disorders was 26·6 per 100 000 person-years (95% CI 22·0-31·7). Heterogeneity was high (I≥98·5%). Men were at higher risk of all psychotic disorders (incidence rate ratio 1·44 [1·27-1·62]) and non-affective disorders (1·60 [1·44-1·77]) than women, but not affective psychotic disorders (0·87 [0·75-1·00]). Ethnic minorities were also at excess risk of all psychotic disorders (1·75 [1·53-2·00]), including non-affective disorders (1·71 [1·40-2·09]). Meta-regression revealed that population registers reported higher rates of non-affective disorders (9·64 [2·72-31·82]), schizophrenia (2·51 [1·24-5·21]), and bipolar disorder (4·53 [2·41-8·51]) than first contact study designs.
We found marked variation in incidence of psychotic disorders by personal characteristics and place. Some geographical variation could be partially explained by differences in case ascertainment methods.
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上一次全面的精神病障碍发病率系统综述发表于 2004 年。目前来自不同环境的新的流行病学数据使我们能够更全面地了解全球差异。我们研究了人口统计学特征和研究方法对精神病发病率的影响。
为了进行这项系统综述和荟萃分析，我们检索了 PubMed、Embase、Web of Science、PsycINFO 和参考文献，并直接联系了第一作者。我们旨在获得 2002 年 1 月 1 日至 2017 年 12 月 31 日期间发表的关于非器质性成人起病的精神病障碍发病率的原始研究的参考文献。我们纳入了发表或在灰色文献中、没有语言限制的论文。在可能的情况下，我们从已发表的报告中提取了按性别、年龄和种族划分的数据。我们评估了研究结果的质量。我们使用单变量随机效应荟萃分析和荟萃回归来评估数据。我们在 PROSPERO 系统中注册了本系统综述，注册号为 CRD42018086800。
从 56721 条记录中，有 177 条符合纳入标准。所有精神病障碍的总发病率为 26.6/10 万人年（95% CI 22.0-31.7）。异质性很高（I≥98.5%）。与女性相比，男性患所有精神病障碍（发病率比 1.44 [1.27-1.62]）和非情感性障碍（1.60 [1.44-1.77]）的风险更高，但患情感性精神病障碍的风险较低（0.87 [0.75-1.00]）。少数民族也有较高的所有精神病障碍（1.75 [1.53-2.00]），包括非情感性障碍（1.71 [1.40-2.09]）发病风险。荟萃回归显示，人口登记报告的非情感性障碍（9.64 [2.72-31.82]）、精神分裂症（2.51 [1.24-5.21]）和双相情感障碍（4.53 [2.41-8.51]）发病率更高，而首次接触研究设计的发病率则较低。
我们发现精神病障碍的发病率因个人特征和地点而有明显差异。一些地理差异可能部分可以用病例检出方法的差异来解释。
我们发现个人特征和地点的差异与精神病障碍的发病率显著相关。一些地理差异部分可以通过病例检出方法的差异来解释。
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