The Incidence of Schizophrenia in Nottingham

Attempts were made to identify, and include in a two-year follow-up study, every patient living in the catchment area of the Mapperley group of psychiatric hospitals in Nottingham (population 390 000) who made their first-ever contact with the psychiatric services for a potentially schizophrenic illness during a two-year period (1 August 1978 to 31 July 1980). Screening was based upon symptoms rather than diagnosis, covering both in-patient and out-patient services; a consensus diagnosis using ICD-9 was made by the project team. The Nottingham Psychiatric Case Register was used in a retrospective Leakage Study which added nine cases to the 99 identified by the screening procedures. Incidence rates are given for both broad and narrow concepts of schizophrenia, and for DSM-III diagnosis. The Nottingham incidence rates are similar to those reported from other UK centres, and are near the middle of the range found in the other collaborating centres in the WHO study on Determinants of Outcome of Severe Mental Disorders. At entry to the study, 27 patients were out-patients, and 11 were never admitted to hospital at any time in the two-year follow-up period. Reasons for believing that the Nottingham administrative incidence may be close to the incidence in the community are discussed.