Munk-Jørgensen P
Acta Psychiatr Scand. 1987 Jan;75(1):62-8. doi: 10.1111/j.1600-0447.1987.tb02752.x.
From The Danish Psychiatric Register five cohorts of all first-admitted patients to Danish psychiatric institutions from the years 1970, 1973, 1976, 1979, and 1980 have been followed, and trends in age-standardized rates of schizophrenia investigated. The first-admission rates have decreased in both sexes, significantly in males. In addition, the cumulated schizophrenia rates for the cohorts, including those of patients diagnosed as schizophrenics only at a later admission within periods of 2 and 5 years, decreased. This decrease is significant at 2 years of observation in both sexes and at 5 years in females. The decreasing first-admission rates might be explained partly by changes in diagnostic habits. The differential diagnoses of schizophrenia (paranoid states (ICD-8:297), paranoid reactive psychoses (298.3), unspecified psychoses (298.9 and 299), and borderline states (ICD-8 Danish version: 301.83] are increasingly used as first-admission diagnosis for patients later to be diagnosed as schizophrenic, possibly owing to a tendency to avoid the diagnosis of schizophrenia, when treatment of a patient is possible. A method of calculating the hospital incidence of schizophrenia approaching the real incidence better than the incidence of first-admission diagnoses is suggested.
我们对丹麦精神病学登记处中1970年、1973年、1976年、1979年和1980年首次入住丹麦精神病院的所有患者的五个队列进行了随访，并研究了精神分裂症年龄标准化发病率的趋势。男女的首次入院率均有所下降，男性下降显著。此外，这些队列的累积精神分裂症发病率，包括那些仅在2年和5年内的后续入院时被诊断为精神分裂症的患者的发病率，也有所下降。这种下降在观察2年时男女均显著，在观察5年时女性显著。首次入院率下降的部分原因可能是诊断习惯的改变。精神分裂症的鉴别诊断（偏执状态（国际疾病分类第八版：297）、偏执反应性精神病（298.3）、未特定的精神病（298.9和299）以及边缘状态（国际疾病分类第八版丹麦版本：301.83）越来越多地被用作后来被诊断为精神分裂症患者的首次入院诊断，这可能是由于在有可能对患者进行治疗时倾向于避免诊断为精神分裂症。本文提出了一种计算精神分裂症医院发病率的方法，该方法比首次入院诊断的发病率更接近实际发病率。
