精神分裂症的终身患病率的中位风险值为 0.72%。[2]McGrath J, Saha S, Chant D, et al. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008;30:67-76.http://epirev.oxfordjournals.org/content/30/1/67.longhttp://www.ncbi.nlm.nih.gov/pubmed/18480098?tool=bestpractice.com 男女患病率比例为 1.4:1。[3]McGrath JJ. Myths and plain truths about schizophrenia epidemiology - the NAPE lecture 2004. Acta Psychiatr Scand. 2005 Jan;111(1):4-11.http://www.ncbi.nlm.nih.gov/pubmed/15636588?tool=bestpractice.com[4]Jablensky A, Sartorius N, Ernberg G, et al. Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl. 1992;20:1-97.http://www.ncbi.nlm.nih.gov/pubmed/1565705?tool=bestpractice.com 由于女性起病时间较晚,所以可能起病前社会功能水平较高。精神分裂症的发病率和患病率存在种族和地域的差异。[5]Gupta S, Murray RM. The relationship of environmental temperature to the incidence and outcome of schizophrenia. Br J Psychiatry. 1992 Jun;160:788-92.http://www.ncbi.nlm.nih.gov/pubmed/1617362?tool=bestpractice.com 由于内科疾病、事故及自杀等原因,精神分裂症患者的死亡率高于一般人群。[6]Mitchell AJ, Malone D. Physical health and schizophrenia. Curr Opin Psychiatry. 2006 Jul;19(4):432-7.http://www.ncbi.nlm.nih.gov/pubmed/16721177?tool=bestpractice.com[7]Fazel S, Wolf A, Palm C, et al. Violent crime, suicide, and premature mortality in patients with schizophrenia and related disorders: a 38-year total population study in Sweden. Lancet Psychiatry. 2014 Jun;1(1):44-54.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124855/http://www.ncbi.nlm.nih.gov/pubmed/25110636?tool=bestpractice.com
男性患者的起病年龄通常是<25 岁,女性患者是<35 岁。与春季或夏季相比,冬季出生的人更易患精神分裂症,但是这部分数据目前仍存在争议。[8]Torrey EF, Miller J, Rawlings R, et al. Seasonal birth patterns of neurological disorders. Neuroepidemiology. 2000 Jul-Aug;19(4):177-85.http://www.ncbi.nlm.nih.gov/pubmed/10859496?tool=bestpractice.com[9]McGrath JJ, Welham JL. Season of birth and schizophrenia: a systematic review and meta-analysis of data from the Southern Hemisphere. Schizophr Res. 1999 Feb 15;35(3):237-42.http://www.ncbi.nlm.nih.gov/pubmed/10093868?tool=bestpractice.com 此外,有报告指出,城市低收入人群的精神分裂症发病率高于农村高收入人群的。[3]McGrath JJ. Myths and plain truths about schizophrenia epidemiology - the NAPE lecture 2004. Acta Psychiatr Scand. 2005 Jan;111(1):4-11.http://www.ncbi.nlm.nih.gov/pubmed/15636588?tool=bestpractice.com 随着时间的推移,精神分裂症的发病率和患病率逐年增加。[10]Bota RG, Munro JS, Sagduyu K. Identification of the schizophrenia prodrome in a hospital-based patient population. Mo Med. 2005 Mar-Apr;102(2):142-6.http://www.ncbi.nlm.nih.gov/pubmed/15822365?tool=bestpractice.com 据报道,在移民人群中,此病的发病率较高,并且可持续到下一代。[11]Werbeloff N, Levine SZ, Rabinowitz J. Elaboration on the association between immigration and schizophrenia: a population-based national study disaggregating annual trends, country of origin and sex over 15 years. Soc Psychiatry Psychiatr Epidemiol. 2012 Feb;47(2):303-11.http://www.ncbi.nlm.nih.gov/pubmed/21286683?tool=bestpractice.com[12]Bourque F, van der Ven E, Malla A. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med. 2011 May;41(5):897-910.http://www.ncbi.nlm.nih.gov/pubmed/20663257?tool=bestpractice.com 10-18 岁人群中精神异常的患病率相对较低,约为 0.4%,但在因精神病原因而住院治疗的 10-18 岁的患者中,精神分裂症的所占比例为 25%,在青春期呈指数增长。[13]National Institute for Health and Care Excellence. Psychosis and schizophrenia in children and young people: recognition and management. October 2016 [internet publication].https://www.nice.org.uk/guidance/cg155
认知缺陷通常出现在精神分裂症症状发生之前,贯穿整个病程,且与预后功能密切相关。[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013.