Spatial analysis to identify hotspots of prevalence of schizophrenia.
BACKGROUND
The geographical distribution of mental health disorders is useful information for epidemiological research and health services planning.


OBJECTIVE
To determine the existence of geographical hotspots with a high prevalence of schizophrenia in a mental health area in Spain.


METHODS
The study included 774 patients with schizophrenia who were users of the community mental health care service in the area of South Granada. Spatial analysis (Kernel estimation) and Bayesian relative risks were used to locate potential hotspots. Availability and accessibility were both rated in each zone and spatial algebra was applied to identify hotspots in a particular zone.


RESULTS
The age-corrected prevalence rate of schizophrenia was 2.86 per 1,000 population in the South Granada area. Bayesian analysis showed a relative risk varying from 0.43 to 2.33. The area analysed had a non-uniform spatial distribution of schizophrenia, with one main hotspot (zone S2). This zone had poor accessibility to and availability of mental health services.


CONCLUSIONS
A municipality-based variation exists in the prevalence of schizophrenia and related disorders in the study area. Spatial analysis techniques are useful tools to analyse the heterogeneous distribution of a variable and to explain genetic/environmental factors in hotspots related with a lack of easy availability of and accessibility to adequate health care services.
Moreno
Berta
B
Faculty of Psychology, University of Málaga, Malaga, Spain. bertamk@uma.es
García-Alonso
Carlos R
CR
Negrín Hernández
Miguel A
MA
Torres-González
Francisco
F
Salvador-Carulla
Luis
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services / Q000600:supply & distribution; D003430:Cross-Sectional Studies; D005260:Female; D006287:Health Planning Guidelines; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012931:Social Environment; D013030:Spain / Q000453:epidemiology; D019371:Topography, Medical; D055815:Young Adult