Abstract
Schizophrenia substantially contributes to the burden of mental disorders. Schizophrenia’s burden and epidemiological estimates in some countries have been published, but updated estimates of prevalence, incidence, and schizophrenia-related disability at the global level are lacking. Here, we present the data from and critically discuss the Global Burden of Diseases, Injuries, and Risk Factors Study data, focusing on temporal changes in schizophrenia’s prevalence, incidence, and disability-adjusted life years (DALYs) globally. From 1990 to 2019, schizophrenia raw prevalence (14.2 to 23.6 million), incidence (941,000 to 1.3 million), and DALYs (9.1 to 15.1 million) increased by over 65%, 37%, and 65% respectively, while age-standardized estimates remained stable globally. In countries with high socio-demographic index (SDI), both prevalence and DALYs increased, while in those with low SDI, the age-standardized incidence decreased and DALYs remained stable. The male/female ratio of burden of schizophrenia has remained stable in the overall population over the past 30 years (i.e., M/F = 1.1), yet decreasing from younger to older age groups (raw prevalence in females higher than males after age 65, with males having earlier age of onset, and females longer life expectancy). Results of this work suggest that schizophrenia’s raw prevalence, incidence, and burden have been increasing since 1990. Age-adjusted estimates did not reduce. Schizophrenia detection in low SDI countries is suboptimal, and its prevention/treatment in high SDI countries should be improved, considering its increasing prevalence. Schizophrenia sex ratio inverts throughout the lifespan, suggesting different age of onset and survival by sex. However, prevalence and burden estimates for schizophrenia are probably underestimated. GBD does not account for mortality from schizophrenia (and other mental disorders, apart from anorexia nervosa).
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Data availability
Data are publicly available at the Institute for Health Metrics and Evaluation (IHME) website (http://www.ghdx.healthdata.org/gbd-results-tool).
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All authors contributed and approved the study’s protocol. MS created the first draft of the manuscript. MS, DY, and SL analysed data. MS, JS, MF, and SC provided overall guidance. Finally, all authors read, edited, and approved the final version of the manuscript.
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MS received honoraria/has been consultant for AbbVie, Angelini, Lundbeck, Otsuka. CUC has been a consultant and/or advisor to or has received honoraria from: AbbVie, Acadia, Alkermes, Allergan, Angelini, Aristo, Boehringer-Ingelheim, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Darnitsa, Gedeon Richter, Hikma, Holmusk, IntraCellular Therapies, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedAvante-ProPhase, MedInCell, Merck, Mindpax, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Newron, Noven, Novo Nordisk,Otsuka, Pharmabrain, PPD Biotech, Recordati, Relmada, Reviva, Rovi, Seqirus, SK Life Science, Sunovion, Sun Pharma, Supernus, Takeda, Teva, and Viatris. He provided expert testimony for Janssen and Otsuka. He served on a Data Safety Monitoring Board for Compass, Lundbeck, Relmada, Reviva, Rovi, Supernus, and Teva. He has received grant support from Janssen and Takeda. He received royalties from UpToDate and is also a stock option holder of Cardio Diagnostics, Mindpax, LB Pharma and Quantic. MF received consulting fees & fees for non-CME/CE services from: Angelini, AstraZeneca, Boehringer Ingelheim, Bristol Meyers Squibb, Eli Lilly, GlaxoSmithKline, Innova Pharma, Lundbeck, Pfizer, Sanofi, Servier. All outside of the present work. SCo has received honoraria from the following non-profit associations: British Association for Psychopharmacology (BAP), Association for Child and Adolescent mental health (ACAMH), and Canadian ADHD Alliance Resource (CADDRA). SG received honoraria/has been consultant for Boehringer Ingelheim. Other authors have no conflict of interest o declare.
Ethical approval
We followed the standard procedure recommended registering additional publications from the GBD 2019 project after the publication of the capstone paper [9]. The Institutional Review Board approved our study at Yonsei University Health System for data use.
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Solmi, M., Seitidis, G., Mavridis, D. et al. Incidence, prevalence, and global burden of schizophrenia - data, with critical appraisal, from the Global Burden of Disease (GBD) 2019. Mol Psychiatry 28, 5319–5327 (2023). https://doi.org/10.1038/s41380-023-02138-4
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DOI: https://doi.org/10.1038/s41380-023-02138-4