- The key statistics are its prevalence, the age at which it first appears, differences by sex and ethnicity, and the recovery rates.
- Every figure here is an approximation, because it depends on who reaches a service and how a diagnosis is reached.
- About one in a hundred people are diagnosed with schizophrenia at some point in their life, and the number living with symptoms at any one moment is lower than that.
- Symptoms usually arrive between the late teens and the mid-twenties, so treatment often has to fit around education and a first job.
- Roughly one in five recover fully and about three in five improve a great deal, so most people diagnosed with schizophrenia get better to some degree.
Prevalence
Prevalence
How common a condition is in a population, given as the number or proportion of people who have it at a particular time.
- About one in a hundred people are diagnosed with schizophrenia at some point in their lifetime, which is several hundred thousand people in the UK.
- The number who have it at any one moment is lower, at well under one in a hundred, because many people recover or have long periods without symptoms.
- Depression is roughly ten times more common, at around one in ten.
- Rates are broadly similar across countries and cultures.
- Rates are somewhat higher in cities than in the countryside.
Age at first diagnosis
- Symptoms usually appear for the first time between the late teens and the mid-twenties.
- For men the peak is around twenty to twenty-five, and for women it tends to fall a few years later.
- Women also show a second, smaller peak after about forty-five.
- A first diagnosis in childhood is very rare, and a first diagnosis after sixty is uncommon.
- Symptoms therefore often arrive while a person is finishing education, starting work and forming relationships.
- NHS early intervention in psychosis teams exist because acting in the first few years improves the outcome.
Sex differences
- Men are diagnosed somewhat more often than women, at a ratio of roughly three men to every two women.
- Men are also diagnosed younger on average, by around three to five years.
- Men tend to show more negative symptoms such as avolition and flattened emotion, and to have a harder course overall.
- Women more often have a later start, better functioning beforehand, and a better response to treatment.
- Each of these patterns is an average across large samples, so it says nothing about any particular man or woman.
- A ratio of diagnoses also depends on who reaches a service, which is a separate question from who develops the condition.
Ethnicity and diagnosis rates
- In the UK, diagnosis rates are much higher among Black Caribbean and Black African people than among the white British population, with some studies reporting several times the rate.
- Black patients are also more likely to be detained under the Mental Health Act and less likely to be referred by a GP.
- One explanation is diagnostic bias, where a psychiatrist from a different cultural background reads unfamiliar speech or belief as a symptom.
- Another is social adversity, since racism, discrimination, poverty and living in a large city all raise the risk of psychosis.
- Diagnostic bias and social adversity are both thought to contribute to the gap.
- A higher rate of diagnosis in a group is not the same as a higher rate of the condition, because these figures are diagnosis rates and also reflect who reaches a service.
Recovery rates
Recovery rate
The proportion of people diagnosed with a condition who get better over a given period. For schizophrenia it usually separates those who recover fully from those who improve but keep some symptoms.
- About one in five people diagnosed with schizophrenia recover fully, often within around five years of a first episode.
- Roughly three in five improve a great deal but keep some symptoms, which may come back in relapses.
- About one in five continue to have troubling symptoms and need long-term support.
- Recovery is more likely when treatment starts early, medication is continued, and a person has family, housing and work around them.
- Recovery in this field means living the life a person wants, so someone can be described as recovered while still managing some symptoms.
- Only a minority face lifelong severe difficulty, and most people diagnosed with schizophrenia improve with treatment and support.
- These proportions come from follow-up studies of different lengths, which is why they stand as roughly one in five, three in five and one in five.
- Someone whose symptoms return has not fallen outside these figures, because relapse sits inside the middle group.
Turning this into marks
- When two statistics are asked for, make them genuinely separate rather than one figure restated.
- Give the actual figure, such as about one in a hundred over a lifetime, because writing that schizophrenia is rare does not secure the knowledge mark.
- Say which statistic the figure is, since a rate of diagnosis and a rate of recovery answer different questions.
- The mark most often lost is giving the lifetime prevalence figure when the question asked about recovery.
- About how common is schizophrenia over a lifetime, and how does that compare with depression?
- At what age does schizophrenia most often first appear, and how do men and women differ?
- Give the approximate ratio of men to women diagnosed.
- Give two reasons UK diagnosis rates differ between ethnic groups.
- State the three approximate recovery outcomes and their rough proportions.