Myths and plain truths about schizophrenia epidemiology - the NAPE lecture 2004

Objective: Science needs to constantly match research models against the data. With respect to the epidemiology of schizophrenia, the widely held belief that the incidence of schizophrenia shows little variation may no longer be supported by the data. The aims of this paper are (i) to explore data-vs.-belief mismatch with respect to the incidence of schizophrenia, and (ii) to speculate on the causes and consequences of such discrepancies. Method: Based on a recently published systematic review of the incidence of schizophrenia, the distribution of incidence rates around the world was examined. In order to examine if the incidence of schizophrenia differed by sex, male vs. female risk ratios were generated. Results: The distribution of incidence rates for schizophrenia is asymmetrical with many high rates skewing the distribution. Based on the central 80% of rates, the incidence of schizophrenia varies in a five-fold range (between 7.7 and 43.0 per 100 000). Males have a significantly higher incidence of schizophrenia compared with females (median male to female risk ratio = 1.4), and this difference could not be accounted for by diagnostic criteria or age range. Conclusion: The beliefs that (i) the incidence of schizophrenia does not vary between sites and (ii) males and females are equally affected, may have persisted because of an unspoken deeper belief that schizophrenia is an egalitarian and exceptional disorder. Our ability to generate productive hypotheses about the aetiology of schizophrenia rests on an accurate appraisal of the data. Beliefs not supported by data should be identified and relabelled as myths.

Atmospheric boundary layer development over a narrow coastal plain during onshore flow

A study of the structure of the daytime atmospheric boundary layer during onshore flow over a narrow coastal plain is presented. The main emphasis of the study is on the nature and causes of heating and cooling observed in the boundary layer temperature profiles. Measurements included vertical temperature profiles above at least two sites derived from radiosondes and aircraft, as well as surface estimates of radiative and sensible heat fluxes. Surface meteorological and pilot balloon data were also available, providing further evidence of short-term changes in atmospheric boundary layer structure. The Manawatu case was representative of autumnal anticyclonic conditions with weak pressure gradients, and illustrated typical diurnal development of a convective boundary layer over a coastal plain bordered by mountain ranges, with a transition from a stable nocturnal situation to a well-mixed profile in the afternoon. The profiles show surface input of heat propagating upwards through the boundary layer during the day, as well as entrainment of heat at the top associated with shear induced turbulence and/or penetrative convection. Applying a one-dimensional model, estimates of boundary layer heat budget components were obtained for four time periods during the day. Later periods were affected by cumulus cloud development at the top of the boundary layer, resulting in significant changes in individual components. Input of sensible heat from the surface decreased, while the addition of heat to the boundary layer from both cloud condensation and advection increased.