Comparison of 19th century and contemporary first admission rates.

2015 ◽  
pp. 45-89
Author(s):  
Herbert Goldhamer ◽  
Andrew W. Marshall
1995 ◽  
Vol 167 (4) ◽  
pp. 463-468 ◽  
Author(s):  
Ian Daly ◽  
Marcus Webb ◽  
Michael Kaliszer

BackgroundA previous cross-national epidemiological study of first admission rates in London and in Aarhus, Denmark, found that the incidence of mania was virtually identical for both centres. This study sought to examine the corresponding rate for a defined catchment area in Dublin, Ireland, and to establish whether the impression of a higher rate could be validated.MethodThe study combined a six-year retrospective review and one-year prospective collection of first-admission cases of mania from a defined catchment area. Diagnosis was according to ICD criteria and the Syndrome Check List of the Present State Examination (PSE). Cross-national comparisons were made using standardised incidence rate ratios (SIRs).ResultsThe crude incidence rate for Dublin in the age range 18–60 years was established at 4.5 per 100 000 per year. A comparison of SIRs for the three centres showed the Dublin rate to be higher than expected (P < 0.02). Age-specific analysis indicated that this increase came mainly from the age range 18–29 (χ2 = 9.08, P = 0.01).ConclusionsThe study confirmed the impression that the local incidence of mania in Dublin is higher than that reported from two other North European centres. A variation in rates from contrasting socioeconomic districts within the catchment area points to some caution in the interpretation of the results and suggests further study from wider catchment areas.


1991 ◽  
Vol 159 (6) ◽  
pp. 811-816 ◽  
Author(s):  
Glynn Harrison ◽  
J. E. Cooper ◽  
Richard Gancarczyk

First-admission rates to psychiatric hospitals, and data from certain psychiatric case registers suggest that there may have been a substantial decline in the administrative incidence of schizophrenia in recent years. However, data from the Nottingham case register show that rates for first-onset schizophrenia remained stable between 1975 and 1987. It is suggested that variations in trends between different parts of the UK may be partly explained by differences in the proportion of migrants and their children in the population at risk.


1993 ◽  
Vol 162 (2) ◽  
pp. 212-218 ◽  
Author(s):  
R. E. Kendell ◽  
D. E. Malcolm ◽  
W. Adams

Despite reports of falling first-admission rates for schizophrenia in the UK and other Western countries, it would be rash to conclude that the incidence of schizophrenia is falling. An attempt was made to tackle the many methodological problems and sources of bias influencing the relationship between admission rates and incidence in an analysis of inception rates for schizophrenia and other psychoses in Edinburgh between 1971 and 1989. However it was calculated, the inception rate for schizophrenia fell significantly, but because there was evidence that diagnostic criteria for schizophrenia had narrowed between 1971 and 1989, and because a substantial and changing proportion of recorded first admissions were not true first admissions, it was impossible to conclude that the incidence of schizophrenia had fallen. Changes in the incidence of psychiatric syndromes are difficult to establish, particularly in retrospect, and future studies must pay more attention to the many possible confounding influences.


1985 ◽  
Vol 146 (2) ◽  
pp. 151-154 ◽  
Author(s):  
John M. Eagles ◽  
Lawrence J. Whalley

SummaryAnnual age-standardised first admission rates from 1969–78 for Scottish mental hospitals were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Significant decreases were found in the diagnosis of schizophrenia (P <0.001) and, to a lesser extent, affective psychoses (P <0.01) and depressive neuroses (P <0.02). The incidence of paranoid states, reactive psychoses, and mania did not change significantly.Several factors possibly contributing to the decline in diagnoses of schizophrenia are discussed, but it is concluded that the figures probably reflect a genuine fall in incidence. The decline in the categories of affective disorder is likely to reflect trends towards increasing provision of community-based care.


1993 ◽  
Vol 163 (5) ◽  
pp. 620-626 ◽  
Author(s):  
John R. Geddes ◽  
Roger J. Black ◽  
Lawrence J. Whalley ◽  
John M. Eagles

Age-standardised rates were calculated for first admissions to hospital in Scotland with ICD-9 diagnoses of schizophrenia, affective psychoses, paranoid psychoses, reactive psychoses and depressive neuroses (ICD-9 295, 296, 297, 298 and 300.4) for the period 1969–88. First-admission rates for schizophrenia declined by an average of 3.3% per year in males and 4.4% per year in females over the period. The first-admission rate in males in 1988 was 8.4/100 000 (57% of 1969 rate) and in females was 4.8/100 000 (43% of 1969 rate). Rates for depressive neuroses, affective psychoses, reactive psychoses and combined psychoses also fell. Rates for mania rose, as did those for paranoid states in males. The decrease in first-admission rates is likely to reflect a true decrease in the incidence of schizophrenia over the period. The decline was unlikely to be accounted for by diagnostic change because there was no reciprocal increase in any other diagnosis sufficient to account for the change, and the rates for combined psychoses also decreased. There was evidence that rates for schizophrenia declined to a greater extent in younger age groups, especially in females. This could imply the presence of a birth cohort effect.


1989 ◽  
Vol 23 (4) ◽  
pp. 529-541 ◽  
Author(s):  
P. S. Sachdev

This paper compares psychiatric illness in the contemporary Maori with that in the non-Maori New Zealander. The ethnic data available are all from secondary sources. The limitations of this and the problems of achieving a satisfactory definition of “a Maori” are discussed. The data suggest that the Maori have a slightly greater risk of psychiatric hospitalization than the non-Maori. First admission rates for schizophrenia are higher for the Maori, as are the readmission rates. First admission rates for major affective illness are roughly comparable in the two groups, and those for neuroses and neurotic depression are lower in the Maori. Rates of admission for alcohol abuse, alcohol dependence and personality disorders are much higher for the Maori male aged 20–40 years and this group is at greatest risk of psychiatric hospitalization. A larger proportion of Maori are admitted involuntarily, especially under the Criminal Justice Act. The median stay in hospital is not longer for the Maori but their re-admissions are more frequent. The Maori have shown an increase in first psychiatric admission rates since the 1950s, with rapid increases in the early 60s and the 80s. The rates for psychotic disorders have been relatively constant and the most significant changes have been for alcohol abuse, alcohol dependence and personality disorders. The author relates this historical change to socioeconomic and politico-cultural factors, particularly the stress of rapid urbanization.


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