Presentation Information
[O-9-03]The correlation between recovery in schizophrenia, macroeconomic and socio-cultural indices, a meta-analysis
Donato Zupin4,5,6,7, *Stefano Roberti1, Giulio Castelpietra3, Luca Pellegrini2, Giorgia D'Aulerio2, Valerio Camela3, Salma Mohellebi3, Umberto Albert2 (1.Università degli Studi di Udine(Italy), 2.Università degli Studi di Trieste(Italy), 3.Centre Neuchâtelois de Psychiatrie(Switzerland), 4.ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina)(Italy), 5.Transcultural Psychiatry Section, Italian Society of Psychiatry(Italy), 6.Italian Institute of Transcultural Mental Health(Italy), 7.World Association of Cultural Psychiatry(Italy))
Keywords:
schizophrenia,recovery,remission,socio-cultural indices,macroeconomic indices
One of the most debated results among those that emerged from the studies conducted by the World Health Organization since the late 1960s (IPSS, DOSMed, ISoS) is the apparent better prognosis of schizophrenia in developing countries compared to developed countries.
The cause of this result has never been identified with certainty, but among the possible explanations highlighted by the authors, cultural differences between the countries in which the studies were conducted were considered by the WHO as the most probable explanation. However, the lack of standardized systems to measure cultural differences between developing and developed countries makes it difficult to operationalize a systematic comparison.
In order to ensure greater standardization of the variables considered, we used macroeconomic indices of growth and industrialization as proxies for cultural differences between developing and developed countries, hypothesizing that rapid changes in the economy of a nation correlate with cultural changes in developing countries.
We therefore performed a systematic review and meta-analysis to compare the remission rates in schizophrenia (defined according to ICD or DSM criteria) and some of the main indices of wealth and economic, industrial and urban development determined according to internationally validated economic criteria.
The screening of the studies included 8822 articles and led to the inclusion of 22 studies that presented sufficient data to define the remission rate in schizophrenia according to the main definitions used in the literature.
From the initial analysis of the studies, two main significant results emerged: an inverse relationship between the remission rates and the greater per capita wealth of the nations and their urbanization and a significant positive correlation between a greater speed of economic development and a greater prevalence of remission in schizophrenia.
The cause of this result has never been identified with certainty, but among the possible explanations highlighted by the authors, cultural differences between the countries in which the studies were conducted were considered by the WHO as the most probable explanation. However, the lack of standardized systems to measure cultural differences between developing and developed countries makes it difficult to operationalize a systematic comparison.
In order to ensure greater standardization of the variables considered, we used macroeconomic indices of growth and industrialization as proxies for cultural differences between developing and developed countries, hypothesizing that rapid changes in the economy of a nation correlate with cultural changes in developing countries.
We therefore performed a systematic review and meta-analysis to compare the remission rates in schizophrenia (defined according to ICD or DSM criteria) and some of the main indices of wealth and economic, industrial and urban development determined according to internationally validated economic criteria.
The screening of the studies included 8822 articles and led to the inclusion of 22 studies that presented sufficient data to define the remission rate in schizophrenia according to the main definitions used in the literature.
From the initial analysis of the studies, two main significant results emerged: an inverse relationship between the remission rates and the greater per capita wealth of the nations and their urbanization and a significant positive correlation between a greater speed of economic development and a greater prevalence of remission in schizophrenia.