A Systematic Review and Meta-analysis of the Prevalence of Schizophrenia in China From 2000 to 2020

doi:10.21203/rs.3.rs-2961280/v1

Background

The prevalence of schizophrenia is influenced by many factors.Understanding this change is of academic significance and scientific value.To understand the prevalence of schizophrenia and the trend of nearly twenty years in China, providing scientific basis for early prevention and treatment by meta-analysis.

Methods

A systematic literature retrieval was conducted by using Chinese database for the information about the prevalence of schizophrenia in China published from 2000 to 2020.The quality of literature was evaluated .The prevalence was analyzed by Revman5.2.

Results

Twenty-eight articles were included. The total sample size was 76273830. The prevalence of schizophrenia in China was 3.72 ‰ (95%: 3.30 ‰ - 4.22 ‰). Subgroup analysis showed that there was no significant difference in the prevalence of schizophrenia among cases with different genders(P>0.05) ,among rural and urban(P>0.05),between the years of the survey(P>0.05). The related age range of highest prevalence of schizophrenia was 35-64 years old.

Conclusions

The prevalence of schizophrenia in China is 3.72 ‰. The prevalence rate of Schizophrenia is no difference with genders,urbancity.There was no significant change in prevalence of schizophrenia in the last twenty years.The related age range of highest prevalence of schizophrenia was 35-64 years old.

Schizophrenia

Prevalence

Gender

Urbancity

Years

Age

Meta-analysis

Schizophrenia is a group of serious mental diseases with uncertainly etiology, different clinical manifestations, treatment response and course of disease. The clinical manifestations involve abnormalities in perception, thinking, emotion, cognition and behavior [1]. These manifestations are different in different patients and different periods of the same patient.Schizophrenia can be seen in various cultural and geographical regions. The incidence rate and prevalence rate of schizophrenia vary certainly from country to country，Goldner (2002) analyzed the data from 1980 to 2000 and found that the time point prevalence rate of schizophrenia was 0.34/100, the annual prevalence rate was 0.55/100, and the lifetime prevalence rate was 11.1/100,000 [2]. This may be the first comprehensive study on the prevalence of schizophrenia, a serious and common psychosis, which also raised some doubts about the data. In fact, the lifetime prevalence rate of schizophrenia in Asians is 2.5, It is much lower than that of 8.8 in non Asians [3].It shows that there may be geographical differences in the prevalence of schizophrenia.Therefore, 188 studies from 46 countries around the world were collected again. It was found that the median time point prevalence and lifetime prevalence of schizophrenia were 4.6 ‰ and 7.2 ‰ respectively [4]. The ratio of male to female is 1.4, and the ratio of immigrants born non natives to natives is 4.6 [5]. It shows that the prevalence data of schizophrenia may be affected by some non research techniques.。

The epidemiological survey of mental diseases in 12 regions in 1982 is one of the most cited literature in the epidemiological study of mental diseases in China. The study shows that the prevalence of schizophrenia ranks first among all mental diseases, with a time point prevalence of 4.75 ‰ and a lifetime prevalence of 5.69 ‰ [6].In 1993, another epidemiological survey was conducted in 7 of the above 12 regions, and it was found that the prevalence rate of schizophrenia still ranked first, with a time point prevalence rate of 5.31 ‰ and a lifetime prevalence rate of 6 ‰, Although there was an increase, there was no significant difference [7].In 2019, China released the previously completed CMHS（China Mental Health Survey）, which covers 31 provinces. It was found that the prevalence of schizophrenia is no longer the top of the list, but the highest is anxiety disorder, with a year prevalence rate of 4.98% and 7.57% in life prevalence rate.The time point prevalence rate of schizophrenia is 0.61% and the lifetime prevalence rate is 0.75%, indicating that changes over time lead to changes in the structure of mental diseases [8]. The survey also found that the prevalence of schizophrenia and other psychiatric disorders in rural areas (1.1%) was significantly higher than that in urban areas (0.1%)[8].

The change of epidemiological investigation of mental diseases involves many factors, such as the change of epidemiological methodology, the change of diagnostic criteria and so on.In the past few decades, China's economic development, ideas and lifestyle have undergone great changes. These factors may also change the spectrum of mental diseases[8].On the other hand, China has a large population, a wide region, many ethnic minorities and great regional cultural differences. Therefore, it is necessary to conduct a comprehensive analysis to evaluate the prevalence of schizophrenia, an important mental disease.Especially after 2000, in China, various provinces, cities and regions have carried out extensive epidemiological surveys of mental diseases and contributed a lot of valuable data . This has laid a good foundation for the comprehensive analysis of data.。

In this study, meta-analysis was used to comprehensively analyze the published literature on the prevalence of schizophrenia in various provinces of China, so as to understand the prevalence of schizophrenia in China.

1. Literature retrieval methods:

1.1This study was performed according to the recommendations of the Moose [17]. Two reviewers independently searched the database.The database includes all Chinese databases: Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG and Chinese Social Sciences Citation Index (VIP) databases . The retrieved database do not contain MEDLINE and EMBASE.

1.2 Search key words: “Schizophrenia or mental disorder or mental disease or psychosis” and “prevalence or epidemiology”

1.3 The search strategy:The search strategy was based on combinations. To retrieved all articles,we search papers by“Schizophrenia or mental disorder or mental disease” and “prevalence or epidemiology”, And then further screen the papers related.Last query was updated on Juan 1 2000 to Jun 30 2020.References of retrieved articles were cross-searched to identify any studies missed by the electronic search strategies.see Figure 1.

1.4 Inclusion and Exclusion Criteria

The two researchers reviewed the initial retrieved publications independently. The discrepancy was resolved through discussion by all reviewers. Studies that met the following criteria were included: ①Cross sectional study about prevalence of schizophrenia in Chinese mainland. ② There is a clear number of samples, the number of patients at the time point or the prevalence rate; ③ The diagnostic criteria of schizophrenia was recognized. The exclusion criteria were ① repeated publication or incomplete information; ② Survey of mental disorders in non Chinese mainland; ③ Unreasonable research design and wrong statistical methods; ④ The literature was published before 2000; ⑤ Non treatise literature.However, articles had incomplete or unidentified data were excluded, as well as abstracts, reviews, case reports, letters and duplicate publications.

1.5. Data collection and extraction: According to the characteristics of epidemiological investigation of mental diseases in China, most of them are led by provincial specialized hospitals. Therefore, the epidemiological data of a province are used only with provincial data published.If there is no epidemiological survey data of the a province, the epidemiological survey data of the provincial capital city are used for this analyzed. If no epidemiological survey data of provincial capital cities, the data of large and medium-sized cities was used for this analyzed.If many large and medium-sized cities have epidemiological survey data, those with most information was used for this analysis. If there is no epidemiological survey data in the province, capital city,large city,the data from a region shall be the representative data of the province.Data at the same regional level shall be collected from large samples.

1.6. Content of information collected:The two authors carried out data extraction together, and the extracted information is as follows: the first author's name, survey year, survey area, gender of survey population, diagnostic criteria of schizophrenia and prevalence of schizophrenia. Different opinions shall be settled through negotiation. If both parties cannot reach an agreement, it shall be judged by the third author.

1.7. Literature quality assessment:The cross-sectional research evaluation standard of Joanna Bridge Institute(JBI) about evidence-based nursing in Australia was used to evaluate the literature quality[9]. There were 10 items in total. According to the degree of compliance, the score was given: 0 was unqualified; 1. It is mentioned but not described in detail; 2 points are detailed and comprehensive description. If the total score is > 14 points, it is high quality, and if the total score is ≤ 14 points, it is low quality (Table 1).

2.Statistic analysis:All statistical analyses were performed using Statistical Analysis System software (Revman 5.2), and the P value for the overall effect <0.05 with two-tailed was considered statistically significant. The heterogeneity of all involved studies was assessed by I2. When it was lower than 50%, the studies with an acceptable heterogeneity were considered, and then the fixed-effects model with Mantel-Haenszel method was used; otherwise, a random effect model with the Der Simonian and Laird (DL) method was adopted.

3.Assessment of publication bias was investigated for each of the pooled study groups mainly by the Egger’s linear regression test. As supplement approach, the Begg’s rank correlation also was applied to assess the potential publication bias.

1.Study Characteristic

A total of 533 literature were obtained in the initial search of the included literature. According to the inclusion and exclusion criteria, 28 Chinese literature were finally included (Figure 1). The total sample size of the included literature was 76273830 see Table 1[10-37]. Only 16 of the 28 literature reported the number of people of different genders see Table 2, and 14 reported the number of people in rural and urban areas ,see Table 3.only 3 reported the number of people in different age group.

2.Prevalence of schizophrenia

Prevalence of schizophrenia in China: A heterogeneity test was conducted on 28 included literature, and the results showed that there was significant heterogeneity (I²= 100%, P = 0.000). So the random effect model is adopted . Meta analysis showed that the primary data result was 0.122 (95%: 0.115-0.130), which was used to convert by a formula. Finally, the time point prevalence of schizophrenia in China was 3.72 ‰ (95%: 3.30 ‰ - 4.22 ‰).See Figure 2.

3. Subtype analysis

3.1 Gender difference:The 16 of the 28 literature reported the number of people of different genders.The prevalence of schizophrenia in male was compared by random effect model due to I²=99.8%.But the no difference in prevalence of schizophrenia between male and female was found(P>0.05).See Table 4.

3.2 Urbanicity difference:12 of the 28 literature reported the number of people between 2000-2010.The 12 of the 28 literature reported the number of people between 2011-2020. The prevalence of schizophrenia in 2000-2010 period and 2011-2022 period was compared by random effect model due to I²=99.3-100%.But the difference in prevalence of schizophrenia in two different time slot was found(P>0.05).See Table 4.

3.3 Years difference:The 14 of the 28 literature reported the number of people of different urbanicity.The prevalence of schizophrenia in rural and urban area was compared by random effect model due to I²=99.6-99.9%.But the difference in prevalence of schizophrenia between rural and urban was found(P>0.05).See Table 4.

3.4 Age difference:3 of the 28 literature reported the number of people of different age range.The prevalence of schizophrenia in age of 15-24 years is 0.21‰,25-34 years is 0.38‰,35-44 years is 0.58‰,45-54 years is 0.87‰,55-64‰ years is 0.73‰,More 65 years is 0.48‰,which was significantly different(P<0.05).See Table 4.The heterogeneity was tested and I²=99.6-100% also was found.The random effect model was used to compare the difference among different age range.

4. Sensitivity analysis

The results showed that there was no significant change in the prevalence of schizophrenia at the time point after excluding any one literature, so the results of this meta-analysis were stable.

5. Test of publication bias

The egger test was used to test the publication bias, t = 0.65, P > 0.05, indicating that the difference was not statistically significant and there was no significant publication bias.

Schizophrenia is a disabling group of brain disorders characterized by symptoms such as hallucinations, delusions, disorganized communication, poor planning, reduced motivation, and blunted affect. While the incidence of the disorder is relatively low (median value 15.2 per 100,000 persons per year), the condition is one of the major contributors to the global burden of disease . The substantial burden of disease is a reflection of two features of schizophrenia: (a) the disorder usually has its onset in early adulthood, and (b) despite optimal treatment, approximately two-thirds of affected individuals have persisting or fluctuating symptoms [5].In Chinese psychiatric hospitals, nearly half of the hospitalized patients are schizophrenic patients. Therefore, understanding the prevalence and regularity of schizophrenia is conducive to the prevention and treatment of schizophrenia.There is a wealth of data available on the prevalence of schizophrenia—a total of 154815 estimates from 28 studies in China were identified in this systematic review. These estimates were drawn from 28 province in China, and were based on an estimated 76273830 potentially overlapping prevalent cases.

This study comprehensively and systematically analyzed the epidemiological data of schizophrenia in China by means of meta-analysis.The results showed that the time point prevalence rate of schizophrenia in China was 3.72 ‰ (95%: 3.30 ‰ - 4.22 ‰). These estimates are congruent with an earlier review of 188 studies by Saha [4], who reported an overall prevalence estimate of 3.3 ‰(1.3‰-8.2‰) by meta-analysis and also congruent with last review narrative review of 42 studies by Global Health Epidemiology Reference Group,who reported an overall prevalence estimate of 3.9 ‰ in 1990 by meta-analysis of China data[9/38].But it is lower than the time point prevalence rate of 5.44 ‰ in report by Long, who reported an overall prevalence estimate of 5.44‰ by meta-analysis of mainland China data[39]

.

The result from comprehensive analysis of systematic review is different from epidemiological data.The last result from CMHS was reported by Huang[8],who reported time point prevalence rate of schizophrenia is 6.1‰,which is higher 5.31 ‰ at 1993 in China[ 8].This result not only was higher than the highest rate of 5.04 ‰ in Henan province[23 ],but also higher than that 4.0-5.2‰ of South Korea in Asian[40].And it is similar to prevalence of schizophrenia varied from 0.6% to 1.9% in the United States[41].These difference may be related to race, region, economic and cultural level, as well as the improvement of cognition and diagnostic methods of schizophrenia.But result from systematic review and meta-analysis was comprehensive and systematic.

The results of this study show that there is no difference in the prevalence of schizophrenia between men and women in China, which is similar to two meta-analysis of other result [38,39] and congruent with another studies[2,3,4,5].The epidemiological survey find also no sex differences were observed in prevalence of schizophrenia[42]. The incidence rate of male schizophrenia is higher than that of females, and the median ratio is 1.4:1. McGrath find incidence rate of male schizophrenia is higher than that of females, and the median ratio is 1.4:1 ,but the no difference in prevalence between male and female was found by meta-analysis of 55 studies[5].They explain that part of the reason is that schizophrenia incidence rate in men is higher than that in women, and the mortality rate in men is higher than that in women[43,44].

This study also shows that there is no difference in the prevalence of schizophrenia between rural and urban areas in China, which is congruent with some studies[4,5],but different from other study by Long,who reported 6.6‰ in urban was higher than 4.73‰ in rural[39]. However, with the popularization of the disease and the increase of awareness rate, the stigma of schizophrenia in rural areas decreases, which makes the disease found and treated early. It may also be related to the improvement of treatment level and cultural level.In fact, neither investigation nor systematic analysis has found no difference in urban and rural of prevalence of schizophrenia[4,39].In the previous epidemiological survey,the urban sites had significantly higher prevalence of schizophrenia than rural by Shi[18].And Long also fond that 5.15‰ in urban is higher than 4.44 ‰ in rural[38]. At present,there were too few pure rural sites to make the direct urban versus rural comparison . Contrary to our expectations, the prevalence of schizophrenia did not differ according to urbanicity. While still

result suggests that mixed urban/rural sites have higher prevalence estimates than pure urban and rural sites, this study found, in fact, that there was no significant difference between urban, rural, and mixed sites[5]. Perhaps the inclusion of many sites from the

developing world in this review has confounded the expected urban/rural gradient. This will be examined in more detail in future analyses.

Changes in the years will cause changes in the prevalence of diseases, which is true for most mental disorders. Schizophrenia, as a serious mental illness, does not seem to show such a difference. This study found that the prevalence of schizophrenia was increasing from 2000-2010 to 2011-2020. This is congruent with two epidemiological survey about prevalence of schizophrenia in 1982 and 1993 in China,with slight increasing of 4.75‰ in 1982 and 5.31‰ in 1993,without statistic significance.But in another Chinese systematic review,3.9‰ in 1990 ,5.7‰ in 2000,in 8.3‰ in 2010 of schizophrenic prevalence in urban is increasing according to years[39]. But our result have not difference according to years.There was no significant difference between the two different time periods, indicating that there was no significant change in the prevalence of schizophrenia in recent 20 years.

The global age-standardized point prevalence of schizophrenia in 2016 was estimated to be 0.28% (95% uncertainty interval [UI]: 0.24-0.31)[13/42]. This result is an important conclusion of this study. Different from most systematic analysis on the prevalence of schizophrenia [1,2,4,5,6,7,39], this study systematically evaluated the prevalence of schizophrenia in different age groups. And difference in prevalence of schizophrenia was found, it strengthened the concept and theory that there is age-effect in the prevalence of schizophrenia. The highest prevalence of schizophrenia show that 35-44 years is 0.58‰,45-54 years is 0.87‰,55-64‰ years is 0.73‰.Because within studies,age-adjusted estimates were higher than crude estimates by 17%-138%[1], which suggested that age-adjusted estimates of prevalence of schizophrenia may exist obvious variation[42].The main age range of risk for schizophrenia is 20 to 35 years. It is still unclear whether schizophrenia-like late-onset psychoses (for example, late paraphrenia) after age 60 should be classified as schizophrenia either psychopathologically or etiologically. In 75% of cases, first admission is preceded by a prodromal phase with a mean length of 5 years and a psychotic prephase of one year's duration. On average, women fall ill 3 to 4 years later than men and show a second peak of onset around menopause. Consequently, late-onset schizophrenia are more frequent and more severe in women than in men. The sex difference in age of onset is smaller in cases with a high genetic load and greater in cases with a low genetic load[45].

The advantage of the study is that it systematically evaluates the prevalence of schizophrenia in China, provides reference for the prevalence of schizophrenia in China, and also provides basis for relevant departments to jointly allocate health resources and formulate relevant health policies.

In addition to the shortcomings of meta-analysis itself, this study also has several deficiencies: Firstly, the number of subgroup analysis literature on factors such as diagnostic methods, publication years and sampling methods of schizophrenia is too small, so there is a lack of effective trend research, and the impact of other factors such as age of onset on the prevalence rate is not fully considered. Secondly,The study only assessed and analyzed the prevalence at time point, but did not study and analyze the year prevalence and lifetime prevalence, which is due to the failure to report the lifetime prevalence in the relevant literature. Thirdly, Among the results of meta-analysis of prevalence at the time point of this study, I²= 100%, with high heterogeneity, suggesting that the research results need to be carefully considered.Lastly,The thoroughness of literature search may affect the results of analysis. The literature used in our search and analysis is Chinese literature, but it does not include the English literature of published Chinese data, such as the newly published CMHS.

MEDLINE=The National Library of Medicine

EMBASE=Excerpta Medical Database

CBM=Chinese Biomedical Database

CNKI=China Nationa lKnowledge Infrastructure

CSSCI=Chinese Social Sciences Citation Index (VIP)

CMHS=China Mental Health Survey

JBI=Joanna evidence-based nursing center

1. Ethics approval and consent to participate

Not Available

2.Consent to publication

All authors agree to publish our paper and no conflict in any interests.

3.Availability of data and material.

See Table1

4.Competing interests

There were not any financial and non-financial competing interests.

5.Funding

This study was supported by Peak Subject of Psychiatry,Tongde Hospital of Zhejiang Province(PSP2023-003)

6.Author’s contribution

Our authors have different contributions to this article. Dr JHY and Dr CHH participated in collection of data and the writing of the article, THJ and Dr SFL assessed the quality of researched papers. Dr THJ complete most statistic analysis.All authors reviewed all researched paper. Prof JWD and Dr SFL participated in the design , statistical processing and the final revision of the article.Dr SFL participated in final revision of the article.

7.Acknowledgment

We thank Prof Chen Wei(Shaw hospital of Zhejiang University) give us study idea and Mr Wang Zhiqiang(Tsinghua University) help us in literature retrieval . We thank Ms Ren Xin(Zhejiang Province Mental Health Center) help us in part of statistic.We thanks Prof Ma Yongchun(Zhejiang Province Mental Health Center) in final revision of the article.

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Table 1.Primary Data Information For Systematic Review and in Quality Evaluation in 28 Studies

Author	Year	Province or Region	n	N	Quality evaluation
Yan F	2017	Beijing	100	16032	16
Zhang TC	2016	Tianjin	76	32666	15
Li KQ	2007	Hebei	106	20716	17
Xu LH	2009	Shanxi（Datong）	98	14679	14
Wang Z	2017	Liaoning	91	19733	18
An N	2016	Heilongjiang	4287	2038835	13
Lu PL	2017	Shanghai(Minhang)	4282	2539500	15
Zhang ML	2004	Jiangsu（Wuxi）	48	11940	19
Shi QC	2005	Zhejiang	43	14639	19
Wang SJ	2002	Anhui（Fuyang）	137	33332	16
Fang X	2011	Fujian	49	9986	15
Chen HL	2002	jiangxi	92	15939	16
Zhang SD	2012	Shandong	151	22718	15
Wang CH	2020	Henan	124	23846	18
Dai W	2013	Hubei（Jingmen）	7379	2877844	17
Wang DX	2018	Hunan	539	72999	16
Zhao ZH	2009	Guangdong（Guangzhou）	35	7418	15
Wei B	2010	Guangxi	151	18219	15
Liu DM	2013	Sichuan（Yibin）	96	11227	16
*Deng XF	2003	Sichuan（Leshan）	28	4573	18
Qiao Q	2015	Guizhou（Guiyang）	4091	4451700	16
Ruan Z	2010	Yunnan（Kunming）	2	5033	18
Wei G	2008	Tiebat	18	5375	14
Zhang C	2018	Shaanxi	97299	37647761	15
Zhao WL	2015	Gansu	34509	25772379	16
Song ZQ	2010	Qinghai	20	11178	18
Wang Q	2012	Ningxia（Yinchuan）	964	570939	18
Gao LL	2010	Xinjiang（Shihezi）	28	7197	13
Total			154815	76273830

*For subtype analysis

Table 2 Primary Data Information For Gender in 16 Studies

Author	Year	Province or Region	n（male）	N(male)	n（female）	N（female）
Li KQ	2007	Hebei	44	10343	62	10373
Wang Z	2017	Liaoning	48	8732	43	11010
Shi QC	2005	Zhejiang	23	7176	20	7463
Wang SJ	2002	Anhui（Fuyang）	119	17458	40	15874
Fang X	2011	Fujian	25	5079	24	4907
Chen HL	2002	Jiangxi	58	8008	66	7931
Zhang SD	2012	Shandong	73	10457	78	12261
Wang CH	2020	Henan	54	11865	70	11981
Zhao ZH	2009	Guangdong（Guangzhou)）	19	3226	16	4192
Wei B	2010	Guangxi	98	9196	80	9023
Deng XF	2003	Sichuan（Leshan）	13	2308	16	2265
Qiao Q	2015	Guizhou（Guiyang）	2424	2291400	1667	2160300
Ruan Z	2010	Yunnan（Kunming）	14	2416	15	2617
Wei G	2008	Tiebat	9	2705	11	2670
Song ZQ	2010	Qinghai	11	5652	9	5526
Wang Q	2012	Ningxia（Yinchuan）	479	280218	485	290721
Total			3511	2676239	2702	2559114

Table 3.Primary Data Information For Rural and Urban in 14 Studies

Author	Year	Province or Region	n（rural）	N（rural）	n（urban）	N(urban)
Wang Z	2017	Liaoning	55	11144	36	8589
Zhang MZ	2004	Jiangsu（Wuxi）	22	6585	26	5355
Shi QC	2005	Zhejiang	35	9815	8	4824
Wang SJ	2002	Anhui（Fuyang）	70	21700	89	11632
Fang X	2011	Fujian	40	6240	9	3746
Zhang SD	2012	Shandong	110	17058	41	5660
Wang CH	2020	Henan	83	14034	41	9812
Zhao ZH	2009	Guangdong（Guangzhou）	12	1874	23	5544
Wei B	2010	Guangxi	103	11191	75	7028
Deng XF	2003	Sichuan（Leshan）	16	2490	13	2083
Qiao Q	2015	Guizhou（Guiyang）	2197	1312000	1894	3139700
Wei G	2008	Tiebat	14	3826	6	1549
Song ZQ	2010	Qinghai	16	8546	4	2632
Wang Q	2012	Ningxia（Yinchuan）	193	83358	771	487581
			2966	1509861	3036	3695735

Table 4 meta analysis results of Chinese schizophrenia subgroup

item	Numbers of study involved	Sample	Number of cases suffered from schizophrenia	I²(%)	Test of heterogeneity P value	Comparison between groups
Gender						P>0.05
Male	16	2676239	3511	99.8	<0.05
Female	16	2548741	2702	99.8	<0.05

Area						P>0.05
Rural	14	1509861	2966	99.6	<0.05
Urban	14	3208154	3036	99.9	<0.05

Years						P>0.05
2000-2010	12	165665	778	99.3	<0.05
2011-2020	15	76108165	154037	100	<0.05

Age*						P<0.05
15-24	3	27077407	2206	100	<0.05
25-34	3	27077407	5839	99.7	<0.05
35-40	3	27077407	8912	99.6	<0.05
45-54	3	27077407	10751	100	<0.05
55-64	3	27077407	6027	100	<0.05
≧65	3	27077407	4711	100	<0.05

*The prevalence of schizophrenia in age of 15-24 years is 0.21‰,25-34 years is 0.38‰,35-44 years is 0.58‰,45-54 years is 0.87‰,55-64‰ years is 0.73‰,More 65 years is 0.48‰,which was significantly different.

No competing interests reported.

A Systematic Review and Meta-analysis of the Prevalence of Schizophrenia in China From 2000 to 2020

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Abstract

Figures

BACKGROUND

METHODS

RESULTS

DISCUSSION

Abbreviations

Declarations

References

Tables

Additional Declarations

Status:

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