Prevalence and course of schizophrenia in a Chinese rural area.

Institute of Mental Health, West China Hospital, West China Medical School of Sichuan University, Chengdu.
Australian and New Zealand Journal of Psychiatry (Impact Factor: 3.77). 09/2003; 37(4):452-7. DOI: 10.1046/j.1440-1614.2003.01203.x
Source: PubMed

ABSTRACT To assess the characteristics and factors affecting course of schizophrenia in a Chinese rural area.
An epidemiological investigation was conducted to identify all the patients with schizophrenia among 149 231 people in Xinjin County, Chengdu.
The total prevalence of schizophrenia was 4.13 per 1000 population. Males had an earlier mean age of onset (29.6 years) than females (32.3 years). Duration of illness before treatment and the total duration of illness were found to be significantly associated with level of remission. The status of treatment, family economy, housing, and families' care of patients had a significant effect on the clinical course of the illness.
Duration of illness before treatment may be an important predictor of course in schizophrenia. Early treatment for the patients may produce higher level of improvement in prognosis. Education intervention and community-based service are urgent priorities for these patients.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Transcultural studies suggest that the social outcome of schizophrenia might be better in developing countries than in industrialized ones. This study aims to check this hypothesis and attempted to identify prognostic indicators of schizophrenia among Tunisian patients. Methods This study included all the outpatients responding to DSM IV criteria of schizophrenia for at least five years, during the study period. The assessment tools were: an interview with the patients and their families, data from medical records and the Global Assessment of Functioning scale (GAF) applied for the premorbid period, at two years after onset, at five years, and during the interview (current assessment). The social outcome was assessed by marital and labour market status, social network, sexuality and the GAF score. The outcome was considered to be good, if the current GAF > 60, intermediate if GAF was between 31 and 60 and severe if GAF ≤ 30. The three prognostic subgroups were compared in order to look for prognostic indicators. Results Informed consent was obtained from 60 patients (85.7% of outpatients) and from 56 families. The sex-ratio was 4 (48 men/12 women), the mean age of patients was 39.3 years; the mean follow-up was 14.7 years ([5–45]). School level was six years primary school in the majority of cases, and the living conditions were poor in 48.3% of cases (n = 29). During the interview, only 21.6% (n = 13) of patients were married. The majority of patients, who were working before the first episode, had lost their job. 76.6% (n = 46) did not have any social contacts and only 23.3% (n = 14) had any sexual activity. Thus, the social outcome was good in 21% of patients, intermediate in 11.1% and severe in 67.9%. Most social indicators (GAF score, labour market status, social network) revealed a fairly similar progress: a significant decline between the premorbid period and two years after the onset. The course reached a plateau after two years. According to current GAF scores, outcome was good in 25% (n = 15) of cases, intermediate in 55% (n = 33) of them and severe in 20% (n = 12). Some indicators were found to be correlated with this outcome: patient related factors; late language development (correlated with intermediate prognosis [p = 0.03]); a comorbid axis II diagnosis (correlated with poorer outcome p = 0.04); a poor premorbid global functioning (higher premorbid GAF scores were correlated with a better outcome [p < 0.03]); family history related factors; consanguinity in parents (correlated with intermediate-severe prognosis [p = 0.04]); elderly father at birth (correlated with severe prognosis [p = 0.04]). Conclusion Even if these results are limited in their generalisation, this Tunisian sample argues that schizophrenia’s prognosis is not better in such a developing country.
    L Encéphale 06/2009; 35(3):234-240. DOI:10.1016/j.encep.2008.05.001 · 0.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Migration imposes stress and may contribute to the incidence of mental illness among natives of mainland China living overseas. Both cultural norms and service inadequacies may act as barriers to accessing needed mental health services.ObjectiveAssess New Zealand health providers' perspectives on the utilization of mental health services by immigrants from mainland China.MethodsA qualitative study in Christchurch, New Zealand involved in-depth interviews with nine mental health professionals with experience in providing services to Chinese clients. The interviews were transcribed and thematically analysed.ResultsFour main themes emerged from the interviews: (1) specific mental health concerns of Chinese migrants; (2) subgroups of migrants most likely to manifest mental health problems; (3) barriers to accessing services; and (4) the centrality of social support networks to the mental health of Chinese migrants.ConclusionsQualitative research with health providers in high-income countries who provide mental health services to the growing numbers of migrants from mainland China can identify areas where improved cultural sensitivity could increase both the utilization of mental health services by Chinese immigrants and the effectiveness of these services.
    12/2013; 25(6):375-82. DOI:10.3969/j.issn.1002-0829.2013.06.006
    This article is viewable in ResearchGate's enriched format
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article describes the personal, societal, and economic burden attributable to schizophrenia in the People's Republic of China and highlights the potential for effective outpatient treatment to reduce this burden given recent changes in the Chinese health care system. The importance of effective antipsychotic therapy in reducing the burden of schizophrenia is also examined. Published research on the burden, disability, management, and economic costs of schizophrenia in the People's Republic of China was examined in the context of the larger body of global research. Research written in English or Chinese and published before June 2012 was identified using PubMed, CNKI, and Wanfang Med database searches. The contribution of effective antipsychotic therapy in reducing the risk for relapse and hospitalization and improving patients' functioning is described. Schizophrenia imposes a substantial burden on Chinese society, with indirect costs accounting for the majority of the total cost. Functional impairment is high, leading to lost wages and work impairment. In the People's Republic of China, schizophrenia is the most common diagnosis among hospitalized psychiatric patients. Ongoing changes in the Chinese health care system may reduce some barriers to effective relapse prevention in schizophrenia and potentially reduce hospitalizations. The use of antipsychotics for acute episodes and maintenance treatment has been shown to decrease symptom severity and reduce the risk for relapse and hospitalization. However, discontinuing antipsychotic medication appears common and is a strong predictor of relapse. Cost-effectiveness research in the People's Republic of China is needed to examine the potential gains from improved outpatient antipsychotic treatment. Schizophrenia is a very costly mental illness in terms of personal, economic, and societal burden, both in the People's Republic of China and globally. When treated effectively, patients tend to persist longer with antipsychotic treatment, have fewer costly relapses, and have improved functioning. Further research examining the long-term effects of reducing barriers to effective treatments on the societal burden of schizophrenia in the People's Republic of China is needed.
    ClinicoEconomics and Outcomes Research 08/2013; 5:407-18. DOI:10.2147/CEOR.S44325
    This article is viewable in ResearchGate's enriched format

Full-text (2 Sources)

Available from
May 17, 2014