Epidemiology of Schizophrenia Essay
Medical experts view schizophrenia as the cancer of all mental illness. This is because it is possibly the most dangerous and devastating mental illness known to man. Today, about one in every 100 mature American suffers from schizophrenia. This translates to nearly 2.5 million people. At the present, the disease has no known cure and it can only be managed. Although schizophrenia can manifest itself in any age, majority of the schizophrenic people show signs in their early twenties. In most cases, males show the first signs of schizophrenia at an earlier stage compared to females but unlike most other mental illnesses, the disease is evenly distributed across gender (McGrath, et al. 2005).
Although there has been much research touching on this disease, the exact cause of schizophrenia is still unknown. However, researchers have found out through brain scans of individuals suffering from the disease that there are notable differences from a brain scan done on a person who does not have the diseases. However, the biggest cause of schizophrenia is believed to be genetic factor since the disease runs in families. There is also a belief among researchers that people develop schizophrenia due to the absence of some fundamental genes. In order to best understand the epidemiology of schizophrenia in the U.S., this paper will first seek to define epidemiology in order to make it easier to understand this disease in a better way. The paper will then proceed to define and illustrate the epidemiology triangle and give an illustration of how this is related to schizophrenia (Jablensky, 2003).
Epidemiology is the investigation of the occurrence, distribution, and causes of diseases among other health-affiliated situations in human beings. Additionally, epidemiology also deals with how the investigation of these factors can be utilized to promote better health and to prevent and manage health problems. In trying to address the issue of epidemiology, the focus is usually on the outcome of disease on a certain population rather than on individuals. Ideally, some certain diseases might prevalent in some areas while others are rare. Although the rare disease might be more deadly as compared to the prevalent one, epidemiology tends to give more emphasis on the prevalent disease since it affects many people (Hennekens, & Buring, 1987).
Ideally, the fact that epidemiology deals with the issue of frequency goes ahead to prove that it is a quantitative science. Epidemiology specifically deals with the rate of occurrence of diseases and supplementary health related conditions. The frequency of diseases is determined by morbidity and the rate of death. Ideally, epidemiology goes beyond the confines of the disease to cover other health related conditions because every human activity has a direct effect on health. Health related conditions are factors, which have a direct or indirect consequence or influence on human health (John, 2001).
When discussing distribution in epidemiology, the issue that is considered is the geographical distribution of infections, the circulation in relation to time, and distribution in the manner of the individuals that are affected in a certain region. In addition to distribution, epidemiology also examines the determinants issues, which are the determining factors on whether or not a person will contract an illness. Lastly, epidemiology seeks to investigate the issue of how the clinical investigations of the disease can be used to promote better health and to prevent and control related health problems (John, 2001).
In order to carry out an epidemiology of a certain disease, it is critical to examine how diseases are caused. Ideally, the cause of a disease means the events, conditions, characteristics or an amalgamation of all these factors, which plays a significant role in bringing out the disease. In examining the cause of any disease, the first thing to examine is the primary causes. Generally, primary causes are the factors, which are critical for an illness to happen. In order to make the examination of disease causes to sound more scientific, the term etiologic agent is used in place of the primary cause. For example, in the epidemiology of pulmonary tuberculosis, Mycobacterium tuberculosis is considered the etiologic agent or the main cause (Mausner, Bahn, 2010).
In addition to the primary causes in the examination of disease causes, the risk factors are also considered. Although risk factors might not be necessary for a disease to occur, the truth is that they have a significant role in the formation of diseases. Ideally, any factor that is linked with heightened incidence of a disease is a risk factor for the exposed population. In most cases, risk factors have an association to the agent but in other cases, they might have a direct relation to the population and the surroundings (Mausner, Bahn, 2010). The Epidemiologic Triangle
Fig 1.1 Diagrammatic Representation of the Epidemiologic Triangle Agent
The epidemiologic triangle shows the association among the agent, environment, and host in the incidence of disease. In this triangle, the agent is considered a factor whose existence or nonexistence, insufficiency or surplus is essential for a particular illness to happen. On the other hand, the environment incorporates all the outside factors, other than the agent that can affect health. These two factors are then classified according to whether they fit in the societal, bodily or genetic environments. Ideally, the societal environment covers a wide spectrum of factors including the education level, unemployment, and many other factors as pertains to political and the legal systems (Mausner, Bahn, 2010).
Epidemiology of Schizophrenia
According to statistics, an average of 1 percent of American adults suffers from schizophrenia at any given year thus bringing the figure to more than 2.5 million people. According to the World Health Organization (WHO), schizophrenia affects an average of 24 million people worldwide with the worldwide prevalence standing at 8 percent. Given that 2.5 million of these people live in the U.S., it is clear that the country has the highest cases of schizophrenic cases (Eaton, 1991).
Ideally, it is important to note that schizophrenia is fundamentally different from incidence of the disease. When talking about an incidence of 8 percent – 1 percent, this does not indicate the number of people diagnosed with schizophrenic cases in any given year. On the contrary, the prevalence rate refers to the average number of people who are suffering from schizophrenia at any given time thus demonstrating on how widespread the disease is.
On the other hand, the incidence rate depicts the number of people who are freshly diagnosed with schizophrenia at a specific time and it is used to gauge the possibility of contracting the disease. Since schizophrenia is considered a chronic disease meaning that sufferers stay with it for life, the prevalence rate is higher compared to incidence. According to statistics, the incidence rate of schizophrenia is about 3 in every ten thousand people and one of the three people is an American (Jablensky, 2000).
Diagnosis of Schizophrenia
Despite all the medical advances today, mental illness remains hard to diagnose. However, with schizophrenia being viewed as a serious condition, much research is being carried out to develop ways of diagnosing the disease before its manifestation. At the present time, the diagnosis is based on the presence of clinical indications. Unlike other diseases, a qualified psychiatrist or psychologist can only conduct schizophrenic diagnosis. Despite this, a person suspected to be suffering from schizophrenia is still subjected to laboratory tests in order to rule out the presence of other related medical disorders such as brain tumors (Eaton, 1991).
In the U.S., a person suspected to be schizophrenic is interviewed and observed by a healthcare professional and by the people around the individual in order to obtain a clear clinical image. If after ruling out the presence of other mental conditions the person still demonstrates signs of the disease, then a diagnosis of schizophrenia is specified. The biggest challenge of diagnosing schizophrenia in both the U.S. and elsewhere in the world is that the individual might be paranoid and hence become opposed to examination. In most cases, the individual does not think that he has a problem and this means that he/she does not seek medical attention without any prompting (Eaton, 1991).
Ideally, the incidence rate of schizophrenia in the U.S. differs significantly among various groups. Although the disease is believed to be present in nearly every group, this rate is believed to be higher among migrants. In addition to this, the disease is also believed to be higher among twins but this might be due to the genetic factor that the disease posits. By way of incidence estimates, the average estimate among migrant groups is close to 15.2 percent for every 100,000 migrants with the average among natives standing at about 10.2 percent for every100, 000 people.
This goes ahead to show that the disease is evenly distributed among Americans despite of race. Despite this, the various studies conducted to determine the incidence rates between migrants and Native Americans have shown significant differences. In the past, the disease was believed to be prevalent in urban centers but this belief has been discounted with the passage of time. The distribution of the incidence estimate does not also show any difference according to economic status (Eaton, 1991).
The prevalence rate of schizophrenia in the U.S. has been consistent across the various studies conducted over the years. Ideally, the lifetime prevalence rate stands at 5.0 per every 1,000 individuals. Overall, schizophrenia is believed to affect one in every a hundred Americans and this estimate is based on the data collected by government agencies on lifetime morbid risk data thus making it reliable (Jablensky, 2000).
Schizophrenia is believed to be one of the leading causes of death in America. Compared to the ordinary person, a schizophrenic person has a two-threefold increased possibility of dying. This risk in increased by the fact that schizophrenic people are most likely to commit suicide. However, schizophrenic people are still most likely to die due to the comorbid somatic conditions presented by the disease. In the last few years, the mortality rate of schizophrenia in the U.S. has been on the rise. This is because schizophrenic people do not share in the improved health enjoyed the rest of the society. The increased mortality rate could also have been increased by the increase of generic antipsychotic medicines that have flooded the American market (Jablensky, 2000).
Outcomes after Diagnosis
The statistics on the outcome of America citizens diagnosed with schizophrenia is not encouraging at all. According to researchers, 25 percent of people diagnosed with schizophrenia end up leading normal lives after ten years of living with the disease while 25 percent of those improve but still require personalized treatment. However, the remaining 50 percent end up hospitalized where 10 percent of those end up committing suicide (Brown, 2000).
Although there have been significant strides in diagnosing and treating schizophrenia cases in the U.S., the fact remains that so much still needs to be done. The government has been supporting legislations that seek to fund studies on the function of brain chemistry, brain enhancement, and genetic configurations and how these can be used to find a cure for this mental cancer. Doctors have also become adept at diagnosing the disease at an early stage although the drugs to treat the disease are still not as effective and this has hampered the efforts to control the disease in America (Brown, 2000).
In the conclusion, it must be stated that medical experts consider schizophrenia as the cancer among all the mental illness. This is because it is possibly the most dangerous and devastating mental illness in existence. Despite the numerous breakthroughs in medical science, the cause and cure for schizophrenia has not yet been found. Today, America is believed to be the leading country in the world in schizophrenia cases. Unlike other conditions, the incidence and prevalence rates are equal across the gender and the ethnic divide. Despite this, the prevalence rate of schizophrenia is believed to be higher among migrants as compared to Native Americans.
Brown, S. (2000). Excess Mortality of Schizophrenia: A Meta-Analysis. Br J Psychiatry 171: 502-508. Eaton, W. (1991). Update on the Epidemiology of Schizophrenia. Epidemiol Review 2: 105-126 Hennekens, C. and Buring, J.
(1987). Epidemiology in Medicine. Toronto: Little, Brown and Company.
Jablensky, A. (2000). Epidemiology of Schizophrenia: The Global Burden of Disease and Disability. Psychiatry Today 2 (250): 274-285. Jablensky, A. (2003). Schizophrenia: The Epidemiological Horizon. Oxford: Blackwell Science. John, M. (2001). A Dictionary of Epidemiology. London: Oxford University Press. Mausner, G. and Bahn, K. (2010). Introductory Text of Epidemiology. Second Edition. W. B. Saunders.
McGrath, J., Saha, S., et al. (2005). A Systematic Review of the Incidence of Schizophrenia; The Distribution of Rates and the Influence of Sex, Urbanicity, Migrant Status and Methodology. BMC Med 2, (13): 56-100.