The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases

Alfonso González-Valderrama; Hannah E Jongsma; Cristián Mena; Carmen Paz Castañeda; Rubén Nachar; Juan Undurraga; Nicolás Crossley; David Aceituno; Barbara Iruretagoyena; Carlos Gallardo; Pilar Mondaca; Matías Monje; Matías Irarrazaval; Cynthia Zavala; Lucia Valmaggia; James B Kirkbride

doi:10.1017/S0033291720002664

The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases

Alfonso González-Valderrama, Hannah E Jongsma, Cristián Mena, Carmen Paz Castañeda, Rubén Nachar, Juan Undurraga, Nicolás Crossley, David Aceituno, Barbara Iruretagoyena, Carlos Gallardo, Pilar Mondaca, Matías Monje, Matías Irarrazaval, Cynthia Zavala, Lucia Valmaggia, James B Kirkbride

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3 Citations (Scopus)

Abstract

BACKGROUND: Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time.

METHODS: We used national register data from Chile including all people, 10-65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20-F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest.

RESULTS: We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18-39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7-19.1]. Multilevel Poisson regression identified a strong age-sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0-59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4-30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed.

CONCLUSION: Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.

Original language	English
Pages (from-to)	1-10
Number of pages	10
Journal	Psychological Medicine
DOIs	https://doi.org/10.1017/S0033291720002664
Publication status	E-pub ahead of print - 6 Aug 2020

Keywords

Case register
Chile
South America
incidence
non-affective psychosis

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10.1017/S0033291720002664

Cite this

González-Valderrama, A., Jongsma, H. E., Mena, C., Castañeda, C. P., Nachar, R., Undurraga, J., Crossley, N., Aceituno, D., Iruretagoyena, B., Gallardo, C., Mondaca, P., Monje, M., Irarrazaval, M., Zavala, C., Valmaggia, L., & Kirkbride, J. B. (2020). The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases. Psychological Medicine, 1-10. Advance online publication. https://doi.org/10.1017/S0033291720002664

@article{030ed30006954affa0f5d2015c37ed86,

title = "The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases",

abstract = "BACKGROUND: Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time.METHODS: We used national register data from Chile including all people, 10-65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20-F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest.RESULTS: We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18-39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7-19.1]. Multilevel Poisson regression identified a strong age-sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0-59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4-30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed.CONCLUSION: Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.",

keywords = "Case register, Chile, South America, incidence, non-affective psychosis",

author = "Alfonso Gonz{\'a}lez-Valderrama and Jongsma, {Hannah E} and Cristi{\'a}n Mena and Casta{\~n}eda, {Carmen Paz} and Rub{\'e}n Nachar and Juan Undurraga and Nicol{\'a}s Crossley and David Aceituno and Barbara Iruretagoyena and Carlos Gallardo and Pilar Mondaca and Mat{\'i}as Monje and Mat{\'i}as Irarrazaval and Cynthia Zavala and Lucia Valmaggia and Kirkbride, {James B}",

year = "2020",

month = aug,

day = "6",

doi = "10.1017/S0033291720002664",

language = "English",

pages = "1--10",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

}

González-Valderrama, A, Jongsma, HE, Mena, C, Castañeda, CP, Nachar, R, Undurraga, J, Crossley, N, Aceituno, D, Iruretagoyena, B, Gallardo, C, Mondaca, P, Monje, M, Irarrazaval, M, Zavala, C, Valmaggia, L & Kirkbride, JB 2020, 'The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases', Psychological Medicine, pp. 1-10. https://doi.org/10.1017/S0033291720002664

TY - JOUR

T1 - The incidence of non-affective psychotic disorders in Chile between 2005 and 2018

T2 - results from a national register of over 30 000 cases

AU - González-Valderrama, Alfonso

AU - Jongsma, Hannah E

AU - Mena, Cristián

AU - Castañeda, Carmen Paz

AU - Nachar, Rubén

AU - Undurraga, Juan

AU - Crossley, Nicolás

AU - Aceituno, David

AU - Iruretagoyena, Barbara

AU - Gallardo, Carlos

AU - Mondaca, Pilar

AU - Monje, Matías

AU - Irarrazaval, Matías

AU - Zavala, Cynthia

AU - Valmaggia, Lucia

AU - Kirkbride, James B

PY - 2020/8/6

Y1 - 2020/8/6

N2 - BACKGROUND: Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time.METHODS: We used national register data from Chile including all people, 10-65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20-F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest.RESULTS: We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18-39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7-19.1]. Multilevel Poisson regression identified a strong age-sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0-59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4-30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed.CONCLUSION: Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.

AB - BACKGROUND: Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time.METHODS: We used national register data from Chile including all people, 10-65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20-F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest.RESULTS: We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18-39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7-19.1]. Multilevel Poisson regression identified a strong age-sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0-59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4-30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed.CONCLUSION: Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.

KW - Case register

KW - Chile

KW - South America

KW - incidence

KW - non-affective psychosis

UR - http://www.scopus.com/inward/record.url?scp=85089456425&partnerID=8YFLogxK

U2 - 10.1017/S0033291720002664

DO - 10.1017/S0033291720002664

M3 - Article

C2 - 32758314

SN - 0033-2917

SP - 1

EP - 10

JO - Psychological Medicine

JF - Psychological Medicine

ER -

The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases

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Keywords

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