Treated incidence of psychotic disorders in the multinational EU-GEI study

Hannah E. Jongsma; Charlotte Gayer-Anderson; Antonio Lasalvia; Diego Quattrone; Alice Mulè; Andrei Szöke; Jean Paul Selten; Caitlin Turner; Celso Arango; Ilaria Tarricone; Domenico Berardi; Andrea Tortelli; Pierre Michel Llorca; Lieuwe De Haan; Julio Bobes; Miguel Bernardo; Julio Sanjuán; José Luis Santos; Manuel Arrojo; Cristina Marta Del-Ben; Paulo Rossi Menezes; Robin M. Murray; Bart P. Rutten; Peter B. Jones; Jim Van Os; Craig Morgan; James B. Kirkbride; Ulrich Reininghaus; Marta Di Forti; Kathryn Hubbard; Stephanie Beards; Simona A. Stilo; Giada Tripoli; Mara Parellada; Pedro Cuadrado; José Juan Rodríguez Solano; Angel Carracedo; Enrique García Bernardo; Laura Roldán; Gonzalo López; Bibiana Cabrera; Esther Lorente-Rovira; Paz Garcia-Portilla; Javier Costas; Estela Jiménez-López; Mario Matteis; Marta Rapado; Emiliano González; Covadonga Martínez; Emilio Sánchez; The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) WP2 Group members include

doi:10.1001/jamapsychiatry.2017.3554

Treated incidence of psychotic disorders in the multinational EU-GEI study

Hannah E. Jongsma, Charlotte Gayer-Anderson, Antonio Lasalvia, Diego Quattrone, Alice Mulè, Andrei Szöke, Jean Paul Selten, Caitlin Turner, Celso Arango, Ilaria Tarricone, Domenico Berardi, Andrea Tortelli, Pierre Michel Llorca, Lieuwe De Haan, Julio Bobes, Miguel Bernardo, Julio Sanjuán, José Luis Santos, Manuel Arrojo, Cristina Marta Del-BenPaulo Rossi Menezes, Robin M. Murray, Bart P. Rutten, Peter B. Jones, Jim Van Os, Craig Morgan, James B. Kirkbride^*, Ulrich Reininghaus, Marta Di Forti, Kathryn Hubbard, Stephanie Beards, Simona A. Stilo, Giada Tripoli, Mara Parellada, Pedro Cuadrado, José Juan Rodríguez Solano, Angel Carracedo, Enrique García Bernardo, Laura Roldán, Gonzalo López, Bibiana Cabrera, Esther Lorente-Rovira, Paz Garcia-Portilla, Javier Costas, Estela Jiménez-López, Mario Matteis, Marta Rapado, Emiliano González, Covadonga Martínez, Emilio Sánchez, The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) WP2 Group members include

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Abstract

IMPORTANCE Psychotic disorders contribute significantly to the global disease burden, yet the latest international incidence study of psychotic disorders was conducted in the 1980s.

OBJECTIVES To estimate the incidence of psychotic disorders using comparable methods across 17 catchment areas in 6 countries and to examine the variance between catchment areas by putative environmental risk factors.

DESIGN, SETTING, AND PARTICIPANTS An international multisite incidence study (the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) was conducted from May 1, 2010, to April 1, 2015, among 2774 individuals from England (2 catchment areas), France (3 catchment areas), Italy (3 catchment areas), the Netherlands (2 catchment areas), Spain (6 catchment areas), and Brazil (1 catchment area) with a first episode of nonorganic psychotic disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20-F33) confirmed by the Operational Criteria Checklist. Denominator populations were estimated using official national statistics. EXPOSURES Age, sex, and racial/ethnic minority status were treated as a priori confounders. Latitude, population density, percentage unemployment, owner-occupied housing, and single-person households were treated as catchment area-level exposures.

MAIN OUTCOMES AND MEASURES Incidence of nonorganic psychotic disorders (ICD-10 codes F20-F33), nonaffective psychoses (ICD-10 codes F20-F29), and affective psychoses (ICD-10 codes F30-F33) confirmed by the Operational Criteria Checklist. RESULTS A total of 2774 patients (1196 women and 1578 men; median age, 30.5 years [interquartile range, 23.0-41.0 years]) with incident cases of psychotic disorders were identified during 12.9 million person-years at risk (crude incidence, 21.4 per 100 000 person-years; 95%CI, 19.4-23.4 per 100 000 person-years). A total of 2183 patients (78.7%) had nonaffective psychotic disorders. After direct standardization for age, sex, and racial/ethnic minority status, an 8-fold variation was seen in the incidence of all psychotic disorders, from 6.0 (95%CI, 3.5-8.6) per 100 000 person-years in Santiago, Spain, to 46.1 (95%CI, 37.3-55.0) per 100 000 person-years in Paris, France. Rates were elevated in racial/ethnic minority groups (incidence rate ratio, 1.6; 95%CI, 1.5-1.7), were highest for men 18 to 24 years of age, and were lower in catchment areas with more owner-occupied homes (incidence rate ratio, 0.8; 95%CI, 0.7-0.8). Similar patterns were observed for nonaffective psychoses; a lower incidence of affective psychoses was associated with higher area-level unemployment (incidence rate ratio, 0.3; 95%CI, 0.2-0.5).

CONCLUSIONS AND RELEVANCE This study confirmed marked heterogeneity in risk for psychotic disorders by person and place, including higher rates in younger men, racial/ethnic minorities, and areas characterized by a lower percentage of owner-occupied houses.

Original language	English
Pages (from-to)	36-46
Number of pages	11
Journal	JAMA Psychiatry
Volume	75
Issue number	1
Early online date	6 Dec 2017
DOIs	https://doi.org/10.1001/jamapsychiatry.2017.3554
Publication status	Published - 1 Jan 2018

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Jongsma, H. E., Gayer-Anderson, C., Lasalvia, A., Quattrone, D., Mulè, A., Szöke, A., Selten, J. P., Turner, C., Arango, C., Tarricone, I., Berardi, D., Tortelli, A., Llorca, P. M., De Haan, L., Bobes, J., Bernardo, M., Sanjuán, J., Santos, J. L., Arrojo, M., ... The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) WP2 Group members include (2018). Treated incidence of psychotic disorders in the multinational EU-GEI study. JAMA Psychiatry, 75(1), 36-46. https://doi.org/10.1001/jamapsychiatry.2017.3554

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title = "Treated incidence of psychotic disorders in the multinational EU-GEI study",

abstract = "IMPORTANCE Psychotic disorders contribute significantly to the global disease burden, yet the latest international incidence study of psychotic disorders was conducted in the 1980s. OBJECTIVES To estimate the incidence of psychotic disorders using comparable methods across 17 catchment areas in 6 countries and to examine the variance between catchment areas by putative environmental risk factors. DESIGN, SETTING, AND PARTICIPANTS An international multisite incidence study (the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) was conducted from May 1, 2010, to April 1, 2015, among 2774 individuals from England (2 catchment areas), France (3 catchment areas), Italy (3 catchment areas), the Netherlands (2 catchment areas), Spain (6 catchment areas), and Brazil (1 catchment area) with a first episode of nonorganic psychotic disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20-F33) confirmed by the Operational Criteria Checklist. Denominator populations were estimated using official national statistics. EXPOSURES Age, sex, and racial/ethnic minority status were treated as a priori confounders. Latitude, population density, percentage unemployment, owner-occupied housing, and single-person households were treated as catchment area-level exposures. MAIN OUTCOMES AND MEASURES Incidence of nonorganic psychotic disorders (ICD-10 codes F20-F33), nonaffective psychoses (ICD-10 codes F20-F29), and affective psychoses (ICD-10 codes F30-F33) confirmed by the Operational Criteria Checklist. RESULTS A total of 2774 patients (1196 women and 1578 men; median age, 30.5 years [interquartile range, 23.0-41.0 years]) with incident cases of psychotic disorders were identified during 12.9 million person-years at risk (crude incidence, 21.4 per 100 000 person-years; 95%CI, 19.4-23.4 per 100 000 person-years). A total of 2183 patients (78.7%) had nonaffective psychotic disorders. After direct standardization for age, sex, and racial/ethnic minority status, an 8-fold variation was seen in the incidence of all psychotic disorders, from 6.0 (95%CI, 3.5-8.6) per 100 000 person-years in Santiago, Spain, to 46.1 (95%CI, 37.3-55.0) per 100 000 person-years in Paris, France. Rates were elevated in racial/ethnic minority groups (incidence rate ratio, 1.6; 95%CI, 1.5-1.7), were highest for men 18 to 24 years of age, and were lower in catchment areas with more owner-occupied homes (incidence rate ratio, 0.8; 95%CI, 0.7-0.8). Similar patterns were observed for nonaffective psychoses; a lower incidence of affective psychoses was associated with higher area-level unemployment (incidence rate ratio, 0.3; 95%CI, 0.2-0.5). CONCLUSIONS AND RELEVANCE This study confirmed marked heterogeneity in risk for psychotic disorders by person and place, including higher rates in younger men, racial/ethnic minorities, and areas characterized by a lower percentage of owner-occupied houses.",

author = "Jongsma, {Hannah E.} and Charlotte Gayer-Anderson and Antonio Lasalvia and Diego Quattrone and Alice Mul{\`e} and Andrei Sz{\"o}ke and Selten, {Jean Paul} and Caitlin Turner and Celso Arango and Ilaria Tarricone and Domenico Berardi and Andrea Tortelli and Llorca, {Pierre Michel} and {De Haan}, Lieuwe and Julio Bobes and Miguel Bernardo and Julio Sanju{\'a}n and Santos, {Jos{\'e} Luis} and Manuel Arrojo and Del-Ben, {Cristina Marta} and Menezes, {Paulo Rossi} and Murray, {Robin M.} and Rutten, {Bart P.} and Jones, {Peter B.} and {Van Os}, Jim and Craig Morgan and Kirkbride, {James B.} and Ulrich Reininghaus and {Di Forti}, Marta and Kathryn Hubbard and Stephanie Beards and Stilo, {Simona A.} and Giada Tripoli and Mara Parellada and Pedro Cuadrado and Solano, {Jos{\'e} Juan Rodr{\'i}guez} and Angel Carracedo and Bernardo, {Enrique Garc{\'i}a} and Laura Rold{\'a}n and Gonzalo L{\'o}pez and Bibiana Cabrera and Esther Lorente-Rovira and Paz Garcia-Portilla and Javier Costas and Estela Jim{\'e}nez-L{\'o}pez and Mario Matteis and Marta Rapado and Emiliano Gonz{\'a}lez and Covadonga Mart{\'i}nez and Emilio S{\'a}nchez and {The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) WP2 Group members include}",

year = "2018",

month = jan,

day = "1",

doi = "10.1001/jamapsychiatry.2017.3554",

language = "English",

volume = "75",

pages = "36--46",

journal = "JAMA Psychiatry",

issn = "2168-622X",

publisher = "American Medical Association",

number = "1",

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Jongsma, HE, Gayer-Anderson, C, Lasalvia, A, Quattrone, D, Mulè, A, Szöke, A, Selten, JP, Turner, C, Arango, C, Tarricone, I, Berardi, D, Tortelli, A, Llorca, PM, De Haan, L, Bobes, J, Bernardo, M, Sanjuán, J, Santos, JL, Arrojo, M, Del-Ben, CM, Menezes, PR, Murray, RM, Rutten, BP, Jones, PB, Van Os, J , Morgan, C, Kirkbride, JB, Reininghaus, U , Di Forti, M , Hubbard, K , Beards, S , Stilo, SA , Tripoli, G, Parellada, M, Cuadrado, P, Solano, JJR, Carracedo, A, Bernardo, EG, Roldán, L, López, G, Cabrera, B, Lorente-Rovira, E, Garcia-Portilla, P, Costas, J, Jiménez-López, E, Matteis, M, Rapado, M, González, E, Martínez, C, Sánchez, E & The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) WP2 Group members include 2018, 'Treated incidence of psychotic disorders in the multinational EU-GEI study', JAMA Psychiatry, vol. 75, no. 1, pp. 36-46. https://doi.org/10.1001/jamapsychiatry.2017.3554

TY - JOUR

T1 - Treated incidence of psychotic disorders in the multinational EU-GEI study

AU - Jongsma, Hannah E.

AU - Gayer-Anderson, Charlotte

AU - Lasalvia, Antonio

AU - Quattrone, Diego

AU - Mulè, Alice

AU - Szöke, Andrei

AU - Selten, Jean Paul

AU - Turner, Caitlin

AU - Arango, Celso

AU - Tarricone, Ilaria

AU - Berardi, Domenico

AU - Tortelli, Andrea

AU - Llorca, Pierre Michel

AU - De Haan, Lieuwe

AU - Bobes, Julio

AU - Bernardo, Miguel

AU - Sanjuán, Julio

AU - Santos, José Luis

AU - Arrojo, Manuel

AU - Del-Ben, Cristina Marta

AU - Menezes, Paulo Rossi

AU - Murray, Robin M.

AU - Rutten, Bart P.

AU - Jones, Peter B.

AU - Van Os, Jim

AU - Morgan, Craig

AU - Kirkbride, James B.

AU - Reininghaus, Ulrich

AU - Di Forti, Marta

AU - Hubbard, Kathryn

AU - Beards, Stephanie

AU - Stilo, Simona A.

AU - Tripoli, Giada

AU - Parellada, Mara

AU - Cuadrado, Pedro

AU - Solano, José Juan Rodríguez

AU - Carracedo, Angel

AU - Bernardo, Enrique García

AU - Roldán, Laura

AU - López, Gonzalo

AU - Cabrera, Bibiana

AU - Lorente-Rovira, Esther

AU - Garcia-Portilla, Paz

AU - Costas, Javier

AU - Jiménez-López, Estela

AU - Matteis, Mario

AU - Rapado, Marta

AU - González, Emiliano

AU - Martínez, Covadonga

AU - Sánchez, Emilio

AU - The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) WP2 Group members include

PY - 2018/1/1

Y1 - 2018/1/1

N2 - IMPORTANCE Psychotic disorders contribute significantly to the global disease burden, yet the latest international incidence study of psychotic disorders was conducted in the 1980s. OBJECTIVES To estimate the incidence of psychotic disorders using comparable methods across 17 catchment areas in 6 countries and to examine the variance between catchment areas by putative environmental risk factors. DESIGN, SETTING, AND PARTICIPANTS An international multisite incidence study (the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) was conducted from May 1, 2010, to April 1, 2015, among 2774 individuals from England (2 catchment areas), France (3 catchment areas), Italy (3 catchment areas), the Netherlands (2 catchment areas), Spain (6 catchment areas), and Brazil (1 catchment area) with a first episode of nonorganic psychotic disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20-F33) confirmed by the Operational Criteria Checklist. Denominator populations were estimated using official national statistics. EXPOSURES Age, sex, and racial/ethnic minority status were treated as a priori confounders. Latitude, population density, percentage unemployment, owner-occupied housing, and single-person households were treated as catchment area-level exposures. MAIN OUTCOMES AND MEASURES Incidence of nonorganic psychotic disorders (ICD-10 codes F20-F33), nonaffective psychoses (ICD-10 codes F20-F29), and affective psychoses (ICD-10 codes F30-F33) confirmed by the Operational Criteria Checklist. RESULTS A total of 2774 patients (1196 women and 1578 men; median age, 30.5 years [interquartile range, 23.0-41.0 years]) with incident cases of psychotic disorders were identified during 12.9 million person-years at risk (crude incidence, 21.4 per 100 000 person-years; 95%CI, 19.4-23.4 per 100 000 person-years). A total of 2183 patients (78.7%) had nonaffective psychotic disorders. After direct standardization for age, sex, and racial/ethnic minority status, an 8-fold variation was seen in the incidence of all psychotic disorders, from 6.0 (95%CI, 3.5-8.6) per 100 000 person-years in Santiago, Spain, to 46.1 (95%CI, 37.3-55.0) per 100 000 person-years in Paris, France. Rates were elevated in racial/ethnic minority groups (incidence rate ratio, 1.6; 95%CI, 1.5-1.7), were highest for men 18 to 24 years of age, and were lower in catchment areas with more owner-occupied homes (incidence rate ratio, 0.8; 95%CI, 0.7-0.8). Similar patterns were observed for nonaffective psychoses; a lower incidence of affective psychoses was associated with higher area-level unemployment (incidence rate ratio, 0.3; 95%CI, 0.2-0.5). CONCLUSIONS AND RELEVANCE This study confirmed marked heterogeneity in risk for psychotic disorders by person and place, including higher rates in younger men, racial/ethnic minorities, and areas characterized by a lower percentage of owner-occupied houses.

AB - IMPORTANCE Psychotic disorders contribute significantly to the global disease burden, yet the latest international incidence study of psychotic disorders was conducted in the 1980s. OBJECTIVES To estimate the incidence of psychotic disorders using comparable methods across 17 catchment areas in 6 countries and to examine the variance between catchment areas by putative environmental risk factors. DESIGN, SETTING, AND PARTICIPANTS An international multisite incidence study (the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) was conducted from May 1, 2010, to April 1, 2015, among 2774 individuals from England (2 catchment areas), France (3 catchment areas), Italy (3 catchment areas), the Netherlands (2 catchment areas), Spain (6 catchment areas), and Brazil (1 catchment area) with a first episode of nonorganic psychotic disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20-F33) confirmed by the Operational Criteria Checklist. Denominator populations were estimated using official national statistics. EXPOSURES Age, sex, and racial/ethnic minority status were treated as a priori confounders. Latitude, population density, percentage unemployment, owner-occupied housing, and single-person households were treated as catchment area-level exposures. MAIN OUTCOMES AND MEASURES Incidence of nonorganic psychotic disorders (ICD-10 codes F20-F33), nonaffective psychoses (ICD-10 codes F20-F29), and affective psychoses (ICD-10 codes F30-F33) confirmed by the Operational Criteria Checklist. RESULTS A total of 2774 patients (1196 women and 1578 men; median age, 30.5 years [interquartile range, 23.0-41.0 years]) with incident cases of psychotic disorders were identified during 12.9 million person-years at risk (crude incidence, 21.4 per 100 000 person-years; 95%CI, 19.4-23.4 per 100 000 person-years). A total of 2183 patients (78.7%) had nonaffective psychotic disorders. After direct standardization for age, sex, and racial/ethnic minority status, an 8-fold variation was seen in the incidence of all psychotic disorders, from 6.0 (95%CI, 3.5-8.6) per 100 000 person-years in Santiago, Spain, to 46.1 (95%CI, 37.3-55.0) per 100 000 person-years in Paris, France. Rates were elevated in racial/ethnic minority groups (incidence rate ratio, 1.6; 95%CI, 1.5-1.7), were highest for men 18 to 24 years of age, and were lower in catchment areas with more owner-occupied homes (incidence rate ratio, 0.8; 95%CI, 0.7-0.8). Similar patterns were observed for nonaffective psychoses; a lower incidence of affective psychoses was associated with higher area-level unemployment (incidence rate ratio, 0.3; 95%CI, 0.2-0.5). CONCLUSIONS AND RELEVANCE This study confirmed marked heterogeneity in risk for psychotic disorders by person and place, including higher rates in younger men, racial/ethnic minorities, and areas characterized by a lower percentage of owner-occupied houses.

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DO - 10.1001/jamapsychiatry.2017.3554

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SP - 36

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JO - JAMA Psychiatry

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Treated incidence of psychotic disorders in the multinational EU-GEI study

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