Jacinto R P, Ding T, Stafford J, Baio G, Kirkbride J B
Division of Psychiatry, UCL, London, UK.
Department of Statistical Sciences, UCL, London, UK.
Ir J Psychol Med. 2023 Jul 31:1-13. doi: 10.1017/ipm.2023.35.
Despite a substantial epidemiological literature on the incidence of psychotic disorders in Ireland, no systematic review has previously been undertaken. Such evidence can help inform understanding of need for psychosis care.
We conducted a prospectively registered systematic review (PROSPERO: CRD42021245891) following PRISMA guidelines. We searched four databases (Medline, PsycInfo, Web of Science, Embase) for papers containing incidence data on non-organic psychotic disorders, in people 16-64 years, published between 1950 and 2021 in the general adult population. We conducted duplicate screening, risk of bias assessments, and extracted data to a standardised template. We undertook a narrative synthesis for each major diagnostic outcome. Random effects meta-analyses were conducted for comparisons with ≥5 incidence rates.
Our search yielded 1975 non-duplicate citations, of which 23 met inclusion criteria, containing incidence data ascertained between 1974 and 2016 (median study quality: 5/8; interquartile range: 4-6). Incidence of all psychotic disorders ( = 4 studies) varied from 22.0 (95%CI: 17.3-28.0) in Dublin to 34.1 per 100,000 person-years (95%CI: 31.0-37.5) in Cavan and Monaghan. The pooled incidence of schizophrenia ( = 6 studies, = 8 settings) was 20.0 per 100,000 person-years, though with imprecision around this estimate (95%CI: 10.6-37.5; : 97.6%). Higher rates of most outcomes were observed in men. There was consistent evidence of raised rates in more deprived and fragmented social environments, but no clear pattern by rural-urban status.
Patterns of incidence of psychotic disorders in Ireland are broadly consistent with the wider literature from the Global North. Findings could help identify populations at higher risk of psychosis in Ireland.
尽管爱尔兰有大量关于精神障碍发病率的流行病学文献，但此前尚未进行过系统综述。此类证据有助于了解对精神病护理的需求。
我们按照PRISMA指南进行了一项前瞻性注册的系统综述（PROSPERO：CRD42021245891）。我们在四个数据库（Medline、PsycInfo、科学网、Embase）中搜索了1950年至2021年间发表的、包含16 - 64岁普通成年人群中非器质性精神障碍发病率数据的论文。我们进行了重复筛选、偏倚风险评估，并将数据提取到标准化模板中。我们对每个主要诊断结果进行了叙述性综合分析。对发病率数据≥5个的比较进行了随机效应荟萃分析。
我们的搜索产生了1975条非重复引用，其中23条符合纳入标准，包含1974年至2016年间确定的发病率数据（研究质量中位数：5/8；四分位间距：4 - 6）。所有精神障碍的发病率（n = 4项研究）在都柏林为22.0（95%置信区间：17.3 - 28.0），在卡万和莫纳汉为每10万人年34.1（95%置信区间：31.0 - 37.5）。精神分裂症的合并发病率（n = 6项研究，k = 8个地区）为每10万人年20.0，不过该估计值存在不精确性（95%置信区间：10.6 - 37.5；I²：97.6%）。大多数结果在男性中发生率更高。有一致证据表明，在社会环境更贫困和碎片化程度更高的地区发病率上升，但城乡状况没有明显模式。
爱尔兰精神障碍的发病率模式与全球北方更广泛的文献大致一致。研究结果有助于识别爱尔兰精神病风险较高的人群。
