Recovery From Schizophrenia: Psychiatry And Political Economy

218 THE INCIDENCE OF SCHIZOPHRENIASUMMARY• Some diseases rise in incidence early in the process of industrial developmentand fall in frequency later; they are initially more common among the rich and,later, become more common among the poor. Schizophrenia seems to fit thispattern.• The Industrial Revolution appears to have been accompanied by an increase inthe occurrence of schizophrenia.• Schizophrenia may be becoming less prevalent in recent decades in theindustrial countries.• In pre-industrial settings schizophrenia is more prevalent in the upper castesand classes, but in the West the illness is more common in the poorer classes.• These shifts in the occurrence of schizophrenia may be a result of changes innutrition, obstetric complications and neonatal care that accompany theadvance of industrialization.• The risk of developing schizophrenia is greatest for the children of people whomigrate from poor countries to rich.• Labor-market stress may influence the timing of the onset of schizophrenia butprobably does not affect the incidence.• Although the prevalence of schizophrenia is lower in the Third World than inthe West, the incidence is not.• Women in the industrial world show a peak incidence of schizophrenia adecade later in life than men.• An educational program on the risk of obstetric complications as a cause ofschizophrenia could bring about a small decrease in the incidence of the illness.• Attempts to prevent schizophrenia by treating people at high risk prior todeveloping the illness offer little chance of success and carry a high probabilityof unintended negative consequences.