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Geographic Variations in the Prevalence of Schizophrenia

Geographic Variations in the Prevalence of Schizophrenia Abstract To the Editor.— Youssef et al1 claim to have demonstrated significant geographic variation in the prevalence of schizophrenia in a small rural county in Ireland. If this were indeed the case, extensive studies attempting to rigorously define the cause of the geographic variation would be imperative. We believe there is a serious weakness in their study, namely, the probable instability of the rates due to limited population sizes of the electoral divisions under study and the relatively rare rate of occurrence of schizophrenia. We think the authors have overstated their findings and we cannot agree that the study has demonstrated geographic variation in rates of schizophrenia, as claimed.Although the fit of the Poisson model of constant rates (×2=56.88, df=35, and P<.02) indicates that the observed variation in prevalence rates of schizophrenia among the 36 divisions is statistically significant, this variation mainly results from the References 1. Youssef HA, Kinsella A, Waddington JL. Evidence for geographical variations in the prevalence of schizophrenia in rural Ireland . Arch Gen Psychiatry . 1991;48:254-258.Crossref 2. Goodman AB, Lin S. On correlating individual census tract social indicators with rarely occurring morbidity or mortality rates . Eval program Plann . 1981;4:75-81.Crossref 3. Diehr P, Cain K, Connell F, Volinn E. What is too much variation?: the null hypothesis in small-area analysis . Health Serv Res . 1990;24: 741-771. 4. Sartorius N, Jablensky A, Korten A. Early manifestations and first-contact incidence of schizophrenia in different cultures . Psychol Med . 1986;16:909-928.Crossref 5. Rahav M, Goodman AB, Popper M, Lin S. Distribution of treated mental illness in the neighborhoods of Jerusalem . Am j Psychiatry . 1986; 143:1249-1254. 6. Goodman AB. Study of schizophrenia spectrum illness (SSI) in a homogeneous population . Schizophr Res . 1989;2:44.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Geographic Variations in the Prevalence of Schizophrenia

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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1992.01820110070013
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Youssef et al1 claim to have demonstrated significant geographic variation in the prevalence of schizophrenia in a small rural county in Ireland. If this were indeed the case, extensive studies attempting to rigorously define the cause of the geographic variation would be imperative. We believe there is a serious weakness in their study, namely, the probable instability of the rates due to limited population sizes of the electoral divisions under study and the relatively rare rate of occurrence of schizophrenia. We think the authors have overstated their findings and we cannot agree that the study has demonstrated geographic variation in rates of schizophrenia, as claimed.Although the fit of the Poisson model of constant rates (×2=56.88, df=35, and P<.02) indicates that the observed variation in prevalence rates of schizophrenia among the 36 divisions is statistically significant, this variation mainly results from the References 1. Youssef HA, Kinsella A, Waddington JL. Evidence for geographical variations in the prevalence of schizophrenia in rural Ireland . Arch Gen Psychiatry . 1991;48:254-258.Crossref 2. Goodman AB, Lin S. On correlating individual census tract social indicators with rarely occurring morbidity or mortality rates . Eval program Plann . 1981;4:75-81.Crossref 3. Diehr P, Cain K, Connell F, Volinn E. What is too much variation?: the null hypothesis in small-area analysis . Health Serv Res . 1990;24: 741-771. 4. Sartorius N, Jablensky A, Korten A. Early manifestations and first-contact incidence of schizophrenia in different cultures . Psychol Med . 1986;16:909-928.Crossref 5. Rahav M, Goodman AB, Popper M, Lin S. Distribution of treated mental illness in the neighborhoods of Jerusalem . Am j Psychiatry . 1986; 143:1249-1254. 6. Goodman AB. Study of schizophrenia spectrum illness (SSI) in a homogeneous population . Schizophr Res . 1989;2:44.Crossref

Journal

Archives of General Psychiatry – American Medical Association

Published: Nov 1, 1992

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