A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology

BACKGROUND: Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. METHODS: Studies with original data related to the incidence of schizophrenia (published 1965–2001) were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Between- and within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various methodological features. RESULTS: We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates), the distribution of rates was asymmetric and had a median value (10%–90% quantile) of 15.2 (7.7–43.0) per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%–90% quantile) was 1.40 (0.9–2.4). Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%–90% quantile) was 4.6 (1.0–12.8). Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e.g. overall quality, methods related to case finding, diagnostic confirmation and criteria, the use of age-standardization and age range). CONCLUSIONS: There is a wealth of data available on the incidence of schizophrenia. The width and skew of the rate distribution, and the significant impact of sex, urbanicity and migrant status on these distributions, indicate substantial variations in the incidence of schizophrenia

Spontaneous Alpha Power Lateralization Predicts Detection Performance in an Un-Cued Signal Detection Task

Focusing one's attention by external guiding stimuli towards a specific area of the visual field produces systematical neural signatures. One of the most robust is the change in topological distribution of oscillatory alpha band activity across parieto-occipital cortices. In particular, decreases in alpha activity over contralateral and/or increases over ipsilateral scalp sites, respect to the side of the visual field where attention was focused. This evidence comes mainly from experiments where an explicit cue informs subjects where to focus their attention, thus facilitating detection of an upcoming target stimulus. However, recent theoretical models of attention have highlighted a stochastic or non-deterministic component related to visuospatial attentional allocation. In an attempt to evidence this component, here we analyzed alpha activity in a signal detection paradigm in the lack of informative cues; in the absence of preceding information about the location (and time) of appearance of target stimuli. We believe that the unpredictability of this situation could be beneficial for unveiling this component. Interestingly, although total alpha power did not differ between Seen and Unseen conditions, we found a significant lateralization of alpha activity over parieto-occipital electrodes, which predicted behavioral performance. This effect had a smaller magnitude compared to paradigms in which attention is externally guided (cued). However we believe that further characterization of this spontaneous component of attention is of great importance in the study of visuospatial attentional dynamics. These results support the presence of a spontaneous component of visuospatial attentional allocation and they advance pre-stimulus alpha-band lateralization as one of its neural signatures