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3.2.2 Key statistics of schizophrenia

  1. The key statistics are its prevalence, the age at which it first appears, differences by sex and ethnicity, and the recovery rates.
  2. Every figure here is an approximation, because it depends on who reaches a service and how a diagnosis is reached.
Key Idea
  • 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

Definition

Prevalence

How common a condition is in a population, given as the number or proportion of people who have it at a particular time.

  1. 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.
  2. 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.
  3. Depression is roughly ten times more common, at around one in ten.
  4. Rates are broadly similar across countries and cultures.
    1. Rates are somewhat higher in cities than in the countryside.

Age at first diagnosis

  1. Symptoms usually appear for the first time between the late teens and the mid-twenties.
  2. For men the peak is around twenty to twenty-five, and for women it tends to fall a few years later.
  3. Women also show a second, smaller peak after about forty-five.
  4. A first diagnosis in childhood is very rare, and a first diagnosis after sixty is uncommon.
  5. Symptoms therefore often arrive while a person is finishing education, starting work and forming relationships.
  6. NHS early intervention in psychosis teams exist because acting in the first few years improves the outcome.

Sex differences

  1. Men are diagnosed somewhat more often than women, at a ratio of roughly three men to every two women.
  2. Men are also diagnosed younger on average, by around three to five years.
  3. Men tend to show more negative symptoms such as avolition and flattened emotion, and to have a harder course overall.
  4. Women more often have a later start, better functioning beforehand, and a better response to treatment.
Note
  • 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

  1. 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.
  2. Black patients are also more likely to be detained under the Mental Health Act and less likely to be referred by a GP.
  3. One explanation is diagnostic bias, where a psychiatrist from a different cultural background reads unfamiliar speech or belief as a symptom.
  4. Another is social adversity, since racism, discrimination, poverty and living in a large city all raise the risk of psychosis.
  5. Diagnostic bias and social adversity are both thought to contribute to the gap.
Common Mistake
  • 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

Definition

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.

  1. About one in five people diagnosed with schizophrenia recover fully, often within around five years of a first episode.
  2. Roughly three in five improve a great deal but keep some symptoms, which may come back in relapses.
  3. About one in five continue to have troubling symptoms and need long-term support.
  4. Recovery is more likely when treatment starts early, medication is continued, and a person has family, housing and work around them.
  5. Recovery in this field means living the life a person wants, so someone can be described as recovered while still managing some symptoms.
  6. Only a minority face lifelong severe difficulty, and most people diagnosed with schizophrenia improve with treatment and support.
Note
  • 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

  1. When two statistics are asked for, make them genuinely separate rather than one figure restated.
  2. 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.
  3. Say which statistic the figure is, since a rate of diagnosis and a rate of recovery answer different questions.
  4. The mark most often lost is giving the lifetime prevalence figure when the question asked about recovery.
Self review
  • 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.
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Key statistics for schizophrenia describe how common it is, when it usually first appears, how diagnosis differs by sex and ethnicity, and what proportion of people recover or improve. Every figure is approximate because it depends partly on who reaches mental health services and how diagnosis is made.

Prevalence means how common a condition is in a population at a particular time. It may be reported as a proportion, such as one in a hundred, or as a number of people. Lifetime prevalence is the proportion of people who experience or have the condition at some point during their lives. It is different from the proportion who receive a diagnosis, because access to services and diagnostic practice can affect diagnosis rates.

The main figures to remember are a lifetime prevalence of about one in a hundred people, first symptoms usually appearing from the late teens to the mid-twenties, and a male-to-female diagnosis ratio of about three to two. Recovery outcomes are commonly summarised as one fifth, three fifths and one fifth.

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What is the approximate lifetime prevalence of schizophrenia?

3.2.2 Key statistics of schizophrenia Revision Guide

  1. GCSE
  2. /Psychology
  3. /3.2.2 Key statistics of schizophrenia

Revision notes for OCR GCSE Psychology 3.2.2 Key statistics of schizophrenia: explanations and worked examples.

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