Onset and clinical course of schizophrenia in Butajira-Ethiopia--a community-based study.
BACKGROUND
There are reports on favourable course and outcome of schizophrenia in lowincome countries. The aim of the present study was to examine onset and clinical course of the illness in a community-based sample in rural Ethiopia based on crosssectional information.


METHODS
A two-stage survey was carried out in Butajira-Ethiopia, a predominantly rural district. Altogether 68,378 individuals aged 15-49 years were CIDI-interviewed, of whom 2,159 were identified as cases according to the CIDI interview with regard to psychotic or affective disorders. Key informants identified another group of 719 individuals as being probable cases and a total of 2,285 individuals were SCAN-interviewed. The present paper reports on cases with schizophrenia.


RESULTS
There were 321 cases of schizophrenia giving an estimated lifetime prevalence of 4.7/1,000). Of the cases,83.2% (N = 267) were males. Mean age of first onset of psychotic symptoms for males was 23.8 (sd 8.6) compared to 21.0 (sd 7.8) for females (P = 0.037; 95 %CI 0.16-5.47). Over 80% had negative symptoms and over 67% reported continuous course of the illness. Less than 10% had a history of previous treatment with neuroleptic medication. About 7% were vagrants, 9 % had a history of assaultive behaviour,and 3.8% had attempted suicide. The male to female ratio was nearly 5:1.


CONCLUSIONS
This large community-based study differs from most previous studies in terms of higher male to female ratio, earlier age of onset in females and the predominance of negative symptoms.
Kebede
D
D
Dept. of Community Health, Addis Ababa University, Addis Ababa, Ethiopia.
Alem
A
A
Shibre
T
T
Negash
A
A
Fekadu
A
A
Fekadu
D
D
Deyassa
N
N
Jacobsson
L
L
Kullgren
G
G
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D003906:Developing Countries; D018450:Disease Progression; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012423:Rural Health / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013406:Suicide, Attempted