Age-period-cohort analysis of the incidence of schizophrenia in Scotland

Psychol Med. 1996 Sep;26(5):963-73. doi: 10.1017/s0033291700035297.

Abstract

Studies examining a possible decline in the incidence of schizophrenia over the last two to three decades have paid little attention to the possible role of birth cohort effects. We collected data on a Scottish national sample of all schizophrenic patients, admitted for the first time between 1966 and 1990 (N = 11348; male = 6301). In an Age-Period-Cohort analysis, a full model, incorporating three factors, had a substantially better fit to the data than other models (especially, an Age-Period model), providing clear evidence of the presence of a cohort effect. After adjustment for the effects of age and period, there was a 55% reduction in the rate of schizophrenia in men and a 39% fall in the number of women over the 50-year birth period from 1923 to 1973. The marked decline in the first admission rates observed in Scotland cannot, however, be attributed entirely to this cohort effect. Rather, a greater proportion of the declining first admission rates (88%) is ascribed to the period effect (i.e. artefactual or causally related cross-sectional effects). Nevertheless, the fact that a birth-cohort effect accounts for part of the declining incidence, suggests that causal environmental factors operating early in life have been diminishing in intensity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Causality
  • Child
  • Cohort Effect
  • Cohort Studies
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Likelihood Functions
  • Linear Models
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Patient Admission / trends
  • Retrospective Studies
  • Schizophrenia / epidemiology*
  • Scotland / epidemiology
  • Sex Distribution
  • Time Factors