An analysis of the concept of schizophrenia and the mental illness in the medical research of the un
Potentially relevant papers in all languages were accessed in order to review the full text. Two or more of the authors checked all data used in the analysis. Data Extraction Once a study was included, data were extracted and entered into a three-level normalized database i. The substantial burden of disease is a reflection of two features of schizophrenia: a the disorder usually has its onset in early adulthood, and b despite optimal treatment, approximately two-thirds of affected individuals have persisting or fluctuating symptoms [ 3 ]. Multiple genes and different combinations of their polymorphic variants provide the genetic background, with a proportion of the transmitted genotypes remaining clinically unexpressed. Presentation and Analyses of the Data Key details of the included studies are presented in tables sorted by country, year of publication and first author Tables S4 , S5 , and S6. It can enhance support from family and friends. Next, as the second filter, the estimates were sorted into six main types: point 1 mo or less , period between 1 and 12 mo , lifetime, LMR, not otherwise specified NOS , and inpatient-census-derived data. Group of systematic schizophrenias Insidious onset, auditory and somatic hallucinations, delusions, early blunting of affect, continuous unremitting course, personality deterioration Paraphrenias Auditory hallucinosis, audible thoughts, thought broadcast, passivity experiences, delusional misidentifications, falsifications of memory Hebephrenias Extreme autistic withdrawal, flat affect, impoverished or disorganized speech and behaviour Catatonias Excessive parakinesias, mannerisms, verbigeration, posturing, stereotypies, mutism, auditory hallucinations II. Systematic reviews have prespecified methods for locating studies and for extracting and synthesizing the data. Many psychiatrists still see it as a useful clinical syndrome that helps define a group of people with clear health needs. For the time being, the clinical concept of schizophrenia is supported by empirical evidence that its multiple facets form a broad syndrome with non-negligible internal cohesion and a characteristic evolution over time. In this review we wish to draw attention to several characteristics of the distribution of estimates e. Among the discrete core studies see below , no study provided confidence limits to accompany the prevalence estimate. Results are presented as prevalence estimates per 1,
However, it should be noted that the boundaries chosen for epidemiological studies e. It can indicate they are experiencing an illness and not a personal failing. Based on the combined prevalence estimates for persons, we divided the estimates into quality score terciles.
Finally, methodological features can influence prevalence estimates. Thus, based on combined prevalence estimates, we compared the male:female ratio when the prevalence estimates were classified by the three economic categories.
It was the presence of the basic symptoms that, according to Bleuler, gave schizophrenia its distinctive diagnostic profile. More nuanced analyses reveal much higher numbers.
We applied a similar sorting algorithm as in our previous review of incidence of schizophrenia [ 1 ]. Some new interventions, such as the family-therapy based Open Dialogue approachshow promise for a wide range of people with schizophrenia diagnoses.
The group of participants with an illness selected, more frequently than the overall percentage, the fact that these illnesses are like any other Presentation and Analyses of the Data Key details of the included studies are presented in tables sorted by country, year of publication and first author Tables S4 , S5 , and S6. Of those surveyed, It was the presence of the basic symptoms that, according to Bleuler, gave schizophrenia its distinctive diagnostic profile. Multiple genes and different combinations of their polymorphic variants provide the genetic background, with a proportion of the transmitted genotypes remaining clinically unexpressed. We applied a similar sorting algorithm as in our previous review of incidence of schizophrenia [ 1 ]. Yet none of these variables has to date been definitively proven to possess the sensitivity and specificity expected of a diagnostic test. Among the discrete core studies see below , no study provided confidence limits to accompany the prevalence estimate. For example, if one study presented multiple overlapping estimates, the estimate based on the largest sample was preferred e. In addition, participants mentioned the excessive family burden that taking care of the patients or living with them entails 2. In addition, the demand for patient support 0. The aim of the present paper is to highlight aspects of the origin, evolution, and current state of the diagnostic concept of schizophrenia - ending with a speculation about its future prospects.
based on 53 review