Characterization of a group of schizophrenic in the Central Valley of Costa Rica
DOI:
https://doi.org/10.51481/amc.v50i3.379Keywords:
schizophrenia, best estimate diagnosis, Central Valley of Costa RicaAbstract
Justification and Aim: schizophrenia is a chronic illness with important social consequences. It is found in 1% of the world population. We describe the characteristics of schizophrenia in a sample of patients from the Central Valley of Costa Rica.
Methods: descriptive, transversal study of schizophrenic patients diagnosed with the best estimate diagnosis process based on DSMIV criteria.
Results: out of 260 schizophrenic subjects, 186 (71.5%) are males and 74 (28.5%) females, average age at interview is 38.95 years (SD: 11.37), lower in males (37.54 years, SD: 10.46) than females (42.49 (SD: 12.81, p<0.05), 44.96% are undifferentiated, 29.07% paranoid, 15.89% disorganized and 10.08% other subtypes. Average age of onset is 21.39 years (SD: 7.21) and age at first treatment 22.26 years (SD: 6.55) with no significant difference between males and females, 159 (85% of total males) have never been married compared to 47 (63% of total females) (p<0.05). Fifty four pointone percent of women are currently employed compared to 23.1% of males (p<0.05) even with similar 7.82 years of education (SD: 3.68). The number of hospitalizations is 5.49 (SD: 5.24), (p>0.05), those who are not married have a trend of more hospitalizations (17.25); 49.6% of the subjects have had at least one major depressive syndrome; 7.5% of males present alcohol abuse and 22.0% alcohol dependence; 7.7% have substance abuse and 7.3% substance dependence (p>0.05).
Discussion: our sample showed similar clinical and demographic characteristics to other populations. More than half of the sample had affective symptoms, depressive symptoms were the most frequent. Single males had the worse prognosis, lower employment rate and higher number of hospitalizations. Nonetheless, this finding could be explained by the economical organization of the household and the social role of males in our society.
Conclusions: schizophrenic males and females from the Central Valley of Costa Rica showed the same age of onset. In both groups, the most frequent schizophrenia type was undifferentiated with history of depressive symptoms. Males had higher unemployment rate, more substance use and more number of hospitalizations than females.
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References
Barbato A. Nations for mental health: Schizophrenia and public health. Geneva: World Health Organization Division of Mental Health and Prevention of Substance Abuse (MSA). 1998.
Escamilla M, Reus VI, Freimer NB. The genetics of bipolar disorder and schizophrenia. In: Rosenberg R, Prusiner S , DiMauri S , Barchi R , editors. The Molecular and Genetic Basis of Neurological Disease. 2nd edition. Boston, MA: Butterworth-Heineman 1997:1343-1362.
Risch N. Linkage strategies for genetically complex traits. I. Multilocus models. Am J Hum Genet 1990; 46: 222-228.
Levinson DF, Mahtani MM, Nancarrow DJ, Brown DM, Kruglyak L, Kirby A, et al. Genome scan of schizophrenia. Am J Psychiatry 1998;155: 741-750.
Cohen A, Patel V, Thara R, Gureje O. Questioning an axiom: better prognosis for schizophrenia in the developing world? Schizophr Bull 2007 Sep 28.
Tang YL, Gillespie CF, Epstein MP, Mao PX, Jiang F, Chen Q, et al. Gender differences in 542 Chinese inpatients with schizophrenia. Schizophr Res 2007 Dec;97(1-3):88-96.
Leung A, Chue P.Sex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand Suppl. 2000;401:3-38.
Handal N, Dodds JH. Statistics for initial admission for schizophrenia in hospitals in Costa Rica. Rev Panam Salud Publica 1997;1: 426-434.
Nicolini Sánchez H, López-Suero VF, Cruz Fuentes C, Fresan Orellana A. La genética de la esquizofrenia. In: Ortega Soto H , Valencia
Collazos M . Mexico DF, editors. La Genetica de la esquizofrenia, in Esquizofrenia Estado actual y perspectivas. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, 2001: 73-104.
Dassori AM, Miller AL, Saldana D: Schizophrenia among hispanics: epidemiology, phenomenology, course and outcome. Srchizophr Bull 1995; 21:303-312.
Karno M, Hough RL, Burnam MA, Escobar JI, Timbers DM, Santana F, et al. Lifetime prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles. Arch Gen Psychiatry 1987;44: 695-701.
Jeste ND, Moore DJ, Goldman SR, Bucardo J, Davila-Fraga W, Golshan S, et al. Predictors of everyday functioning among older Mexican Americans vs. Anglo-Americans with schizophrenia. J Clin Psychiatry 2005;66:1304-11.
Escobar JI, Randolph ET, Hill M. Symptoms of schizophrenia in Hispanic and Anglo veterans. Cult Med Psychiatry 1986;10:259-76.
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-76.
Dassori AM, Miller AL, Saldana D. Schizophrenia among hispanics: epidemiology, phenomenology, course, and outcome. Schizophr Bull 1995;21:303-12.
Mathews CA, Reus VI, Bejarano J, Escamilla MA, Fournier E, Herrera LD, et al. Genetic studies of neuropsychiatric disorders in Costa Rica: a model for the use of isolated populations. Psychiatr Genet 2004;14:13-23.
Escamilla MA, Spesny M, Reus VI, Gallegos A, Meza L, Molina J, et al. Use of linkage disequilibrium approaches to map genes for bipolar disorder in the Costa Rican population. Am J Med Genet 1996;67:244-53.
Leon PE, Raventos H, Lynch E, Morrow J, King MC. The gene for an inherited form of deafness maps to chromosome 5q31. Proc Natl Acad Sci USA 1992;89:5181-4.
Uhrhammer N, Lange E, Porras O, Naeim A, Chen X, Sheikhavandi S, et al. Sublocalization of an ataxia-telangiectasia gene distal to D11S384 by ancestral haplotyping in Costa Rican families. Am J Hum Genet 1995;57:103-11.
Shah AB, Chernov I, Zhang HT, Ross BM, Das K, Lutsenko S, et al. Identification and analysis of mutations in the Wilson disease gene (ATP7B): population frequencies, genotype-phenotype correlation, and functional analyses. Am J Hum Genet 1997;61:317-28.
Escamilla MA, McInnes LA, Service SK, Spesny M, Reus VI, Molina J, et al. Genome screening for linkage disequilibrium in a Costa Rican sample of patients with bipolar-I disorder: a follow-up study on chromosome 18. Am J Med Genet 2001;105:207-13.
Escamilla M, Raventos H, Almasy L, Montero P, Balderas T, Rodríguez S, et al. Linkage disequilibrium analysis of schizophrenia and schizoaffective disorder in the Costa Rican population: preliminary findings on chromosome 13. Am J Med Genet 2001;105:599.
Nurnberger JI Jr, Blehar MC, Kaufmann CA, York-Cooler C, Simpson SG, Harkavy-Friedman J, et al. Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatry 1994;51:849-59
Medina RA, Escamilla MA, Armas R, Levinson D, Dassori A, Contreras S, et al. Diagnostic reliability in a study of schizophrenic
(SC) subjects from the Costa Rican population. Am J Med Genet 2001; 105: 599.
Johnson, D.A.W. The Significance of depression in the prediction of relapse in chronic schizophrenia. Br J Psychiatry 1988;152: 320-3.
Birchwood M, Iqbal Z, Chadwick P, Upthegrove R. Psychological pathways to depression in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2005; 255:202 - 212.
Duke PJ, Pantelis C, McPhillips MA, Barnes TR. Comorbid nonalcohol substance misuse among people with schizophrenia: epidemiological study in central London. Br J Psychiatry 2001;179:509-13.
Duke PJ, Pantelis C, McPhillips MA, Barnes TR. Comorbid nonalcohol substance misuse among people with schizophrenia: epidemiological study in central London. Br J Psychiatry 2001; 179:509-13.
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