By using precise methods in its diagnosis and a large, representative population, the incidence rate of schizophrenia seems consistent across the world for the last half-century.[1] Schizophrenia affects around 0.3–0.7% of people at some point in their life,[2] or 24 million people worldwide as of 2011 (about one of every 285).[3] Despite the received wisdom that schizophrenia occurs at similar rates worldwide, its prevalence varies across the world,[4] within countries,[5] and at the local and neighborhood level.[6] It causes approximately 1% of worldwide disability-adjusted life years (DALYs).[7] The rate of schizophrenia varies up to threefold depending on how it is defined.[2]
The prevalence of schizophrenia tends to be highest in Oceania, the Middle East, and Southeast Asia, while the nations of Australia, Japan, the United States, and Western Europe typically have low prevalence rates. Despite relative geographical proximity, the DALY rate of schizophrenia in Indonesia nearly doubles that of Australia (the nations with the highest and lowest respective rates).
The following tables record the age-standardised disability-adjusted life years rates per 100,000 inhabitants (recorded in 2004).[8]
|
|
|
Each year, one in 10,000 people age 12 to 60 develops schizophrenia. It occurs 1.4 times more frequently in males than females and typically appears earlier in men[7]—the peak ages of onset are 20–28 years for males and 26–32 years for females.[9] Onset in childhood is much rarer,[10] as is onset in middle- or old age.[11] Generally, the mean age of first admission for schizophrenics is between 25 and 35. Studies have suggested that lower income individuals tend to have their disorder diagnosed later after the onset of symptoms, relative to those of better economic standings. As a result, the lower social classes are more likely to be living with their illness untreated.[1]
It is generally accepted that women tend to present with schizophrenia anywhere between 4-10 years after their male counterparts[12]. However, using a broad criteria for diagnosing schizophrenia shows that males have a bimodal age of onset, with peaks at 21.4 years and 39.2 years old, while females have a trimodal age of onset with peaks at at 22.4, 36.6, and 61.5 years old[13]. This additional post-menopausal peak of late-onset schizophrenia in women calls into question the etiology of the disease and raises a debate about "subtypes" of schizophrenia, with men and women being susceptible to different types (see Causes of Schizophrenia). This is further supported by the variability in presentation of the disease between the genders. Other theories that may explain this difference include protective or predisposing factors in men or women that may render them more (or less) susceptible to the disease at different points in life. For example, estrogen may be a protective factor for women, as estradiol has been found to be effective in treating schizophrenia when added to antipsychotic therapy[14].