BACKGROUND: It is unclear whether the incidence of first episode psychoses is in decline. We had the opportunity to determine whether incidence had changed over a 20-year period in a single setting, and test whether this could be explained by demographic or clinical changes. METHODS: The entire population at-risk aged 16-54 in Nottingham over three time periods (1978-80, 1993-95 and 1997-99) were followed up. All participants presenting with an ICD-9/10 first episode psychosis were included. The remainder of the population at-risk formed the denominator. Standardized incidence rates were calculated at each time period with possible change over time assessed via Poisson regression. We studied six outcomes: substance-induced psychoses, schizophrenia, other non-affective psychoses, manic psychoses, depressive psychoses and all psychotic disorders combined. RESULTS: Three hundred and forty-seven participants with a first episode psychosis during 1.2 million person-years of follow-up over three time periods were identified. The incidence of non-affective or affective psychoses had not changed over time following standardization for age, sex and ethnicity. We observed a linear increase in the incidence of substance-induced psychosis, per annum, over time (incidence rate ratios: 1.15; 95% CI 1.05-1.25). This could not be explained by longitudinal changes in the age, sex and ethnic structure of the population at-risk. CONCLUSIONS: Our findings suggest psychotic disorders are not in decline, though there has been a change in the syndromal presentation of non-affective disorders, away from schizophrenia towards other non-affective psychoses. The incidence of substance-induced psychosis has increased, consistent with increases in substance toxicity over time, rather than changes in the prevalence or vulnerability to substance misuse. Increased clinical and popular awareness of substance misuse could also not be excluded.
BACKGROUND: It is unclear whether the incidence of first episode psychoses is in decline. We had the opportunity to determine whether incidence had changed over a 20-year period in a single setting, and test whether this could be explained by demographic or clinical changes. METHODS: The entire population at-risk aged 16-54 in Nottingham over three time periods (1978-80, 1993-95 and 1997-99) were followed up. All participants presenting with an ICD-9/10 first episode psychosis were included. The remainder of the population at-risk formed the denominator. Standardized incidence rates were calculated at each time period with possible change over time assessed via Poisson regression. We studied six outcomes: substance-induced psychoses, schizophrenia, other non-affective psychoses, manic psychoses, depressive psychoses and all psychotic disorders combined. RESULTS: Three hundred and forty-seven participants with a first episode psychosis during 1.2 million person-years of follow-up over three time periods were identified. The incidence of non-affective or affective psychoses had not changed over time following standardization for age, sex and ethnicity. We observed a linear increase in the incidence of substance-induced psychosis, per annum, over time (incidence rate ratios: 1.15; 95% CI 1.05-1.25). This could not be explained by longitudinal changes in the age, sex and ethnic structure of the population at-risk. CONCLUSIONS: Our findings suggest psychotic disorders are not in decline, though there has been a change in the syndromal presentation of non-affective disorders, away from schizophrenia towards other non-affective psychoses. The incidence of substance-induced psychosis has increased, consistent with increases in substance toxicity over time, rather than changes in the prevalence or vulnerability to substance misuse. Increased clinical and popular awareness of substance misuse could also not be excluded.
Authors: Baptiste Pignon; Franck Schürhoff; Grégoire Baudin; Andrea Tortelli; Aziz Ferchiou; Ghassen Saba; Jean-Romain Richard; Antoine Pelissolo; Marion Leboyer; Andrei Szöke Journal: Int J Methods Psychiatr Res Date: 2018-05-22 Impact factor: 4.035
Authors: Arjen L Sutterland; Jeanne Dieleman; Jitschak G Storosum; Bettie A C Voordouw; Jojanneke Kroon; Joris Veldhuis; Damiaan A J P Denys; Lieuwe de Haan; Miriam C J M Sturkenboom Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2013-01-23 Impact factor: 4.328
Authors: James B Kirkbride; Antonia Errazuriz; Tim J Croudace; Craig Morgan; Daniel Jackson; Jane Boydell; Robin M Murray; Peter B Jones Journal: PLoS One Date: 2012-03-22 Impact factor: 3.240
Authors: S Filatova; R Marttila; H Koivumaa-Honkanen; T Nordström; J Veijola; P Mäki; G M Khandaker; M Isohanni; E Jääskeläinen; K Moilanen; J Miettunen Journal: Epidemiol Psychiatr Sci Date: 2016-03-28 Impact factor: 6.892
Authors: Sherifat Oduola; Jayati Das-Munshi; Francois Bourque; Charlotte Gayer-Anderson; Jason Tsang; Robin M Murray; Tom K J Craig; Craig Morgan Journal: Psychol Med Date: 2019-11-19 Impact factor: 7.723