{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:52:04Z","timestamp":1791435124632,"version":"4.3.3"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Directorate General of Health Services","id":[{"id":"https:\/\/ror.org\/05xkzd182","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Non-Communicable Disease Control"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Hypothesis<\/jats:title>\n                    <jats:p>Schizophrenia contributes significantly to the global burden of disease; however, the data from low- and middle-income countries (LMICs) remain limited. Bangladesh, characterized by distinct sociodemographic and nutritional risk patterns, provides a critical context for understanding the epidemiology of schizophrenia in such settings. We hypothesized that the prevalence of schizophrenia would be higher among individuals residing in rural areas and those with lower levels of education and economic status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We conducted a cross-sectional, nationwide household (HH) survey as part of the Bangladesh National Mental Health Survey 2019. A stratified, multi-stage random sampling approach was used to recruit 7270 adults aged 18\u00a0years and older. Participants were initially screened using the 24-item Self-Reporting Questionnaire. Those screening positive underwent diagnostic assessment by trained psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Results<\/jats:title>\n                    <jats:p>The weighted prevalence of schizophrenia among adults was 0.6% (95% confidence interval: 0.4%-0.9%). Multivariate analyses revealed that schizophrenia was significantly associated with unemployment, a family history of mental illness, a family history of suicidal behavior and being divorced or separated. The prevalence did not differ between age, sex, residence (urban vs. rural), income, or educational level. Among individuals diagnosed with schizophrenia, 39.3% had received treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides the first nationwide HH survey data on schizophrenia in Bangladesh, identifying familial and marital disruptions as key correlates. These findings challenge commonly held assumptions about urbanicity and socioeconomic disadvantage as risk factors in LMIC contexts and highlight the urgent need to address the treatment gap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/schbul\/sbaf195","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T12:07:43Z","timestamp":1759925263000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, Correlates, and Treatment Gap of Schizophrenia Among Adults in Bangladesh: Findings From a Nationwide Household Survey"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8800-8669","authenticated-orcid":false,"given":"Ahsan Aziz","family":"Sarkar","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Pabna Mental Hospital , Pabna 6602 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Faruq","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Popular Medical College Hospital , Dhaka 1209 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Tariqul","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Sher-E-Bangla Medical College Hospital , Barisal 8200 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helal Uddin","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faridpur Medical College , Faridpur 7800 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niaz Mohammad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Child, Adolescent & Family Psychiatry, National Institute of Mental Health , Dhaka 1207 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munshi Mohammad Jalal","family":"Uddin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, National Institute of Neurosciences and Hospital , Dhaka 1207 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"2026100800425948600_ref1","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.1371\/journal.pmed.0020141","article-title":"A systematic review of the prevalence of schizophrenia","volume":"2","author":"Saha","year":"2005","journal-title":"PLoS Med"},{"key":"2026100800425948600_ref2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/S2215-0366(17)30078-0","article-title":"Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis","volume":"4","author":"Hjorth\u00f8j","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"2026100800425948600_ref3","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1093\/schbul\/sby058","article-title":"Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016","volume":"44","author":"Charlson","year":"2018","journal-title":"Schizophr Bull"},{"key":"2026100800425948600_ref4","doi-asserted-by":"publisher","first-page":"MS21078COM5","DOI":"10.4088\/JCP.MS21078COM5","article-title":"The epidemiology and global burden of schizophrenia","volume":"84","author":"Velligan","year":"2023","journal-title":"J Clin Psychiatry"},{"key":"2026100800425948600_ref5","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.neubiorev.2016.03.017","article-title":"A review of vulnerability and risks for schizophrenia: beyond the two hit hypothesis","volume":"65","author":"Davis","year":"2016","journal-title":"Neurosci Biobehav Rev"},{"key":"2026100800425948600_ref6","volume-title":"National Micronutrient Survey, Bangladesh 2019-2020","author":"Global Alliance for Improved Nutrition (GAIN), Institute of Public Health Nutrition (IPHN), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), United Nations Children\u2019s Fund (UNICEF)","year":"2022"},{"key":"2026100800425948600_ref7","doi-asserted-by":"publisher","first-page":"e0307257","DOI":"10.1371\/journal.pone.0307257","article-title":"The role of parental education and occupation on undernutrition among children under five in Bangladesh: a rural-urban comparison","volume":"19","author":"Nahar","year":"2024","journal-title":"PLoS One"},{"key":"2026100800425948600_ref8","doi-asserted-by":"publisher","first-page":"e1931","DOI":"10.1016\/S2214-109X(23)00432-1","article-title":"The burden of diseases and risk factors in Bangladesh, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"11","author":"GBD 2019 Bangladesh Burden of Disease Collaborators","year":"2023","journal-title":"Lancet Glob Health"},{"key":"2026100800425948600_ref9","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1002\/wps.21054","article-title":"Moving away from the scarcity fallacy: three strategies to reduce the mental health treatment gap in LMICs","volume":"22","author":"Ndetei","year":"2023","journal-title":"World Psychiatry"},{"key":"2026100800425948600_ref10","volume-title":"National Mental Health Survey 2019","author":"Alam","year":"2021"},{"key":"2026100800425948600_ref11","volume-title":"A User\u2019s Guide to the Self Reporting Questionnaire (SRQ)","author":"Beusenberg","year":"1994"},{"key":"2026100800425948600_ref12","first-page":"9","article-title":"Prevalence, medical care, awareness and attitudes towards mental illness in Bangladesh","volume":"20","author":"Firoz","year":"2006","journal-title":"Bangladesh J Psychiatry"},{"key":"2026100800425948600_ref13","first-page":"56","article-title":"The validation of the Bengali version of the self-rating questionnaire (SRQ)","volume":"30","author":"Chowdhury","year":"2003","journal-title":"Indian J Clin Psychol"},{"key":"2026100800425948600_ref14","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th edn."},{"key":"2026100800425948600_ref15","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1056\/NEJMra1808803","article-title":"Schizophrenia","volume":"381","author":"Marder","year":"2019","journal-title":"N Engl J Med"},{"key":"2026100800425948600_ref16","doi-asserted-by":"publisher","first-page":"5319","DOI":"10.1038\/s41380-023-02138-4","article-title":"Incidence, prevalence, and global burden of schizophrenia - data, with critical appraisal, from the global burden of disease (GBD) 2019","volume":"28","author":"Solmi","year":"2023","journal-title":"Mol Psychiatry"},{"key":"2026100800425948600_ref17","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_836_23","article-title":"Schizophrenia spectrum disorders in India: a population-based study","volume":"65","author":"Hegde","year":"2023","journal-title":"Indian J Psychiatry"},{"key":"2026100800425948600_ref18","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1007\/BF00788182","article-title":"Outcome of marriage in schizophrenia","volume":"32","author":"Thara","year":"1997","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"2026100800425948600_ref19","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1093\/schbul\/sbw159","article-title":"Familial aggregation and heritability of schizophrenia and co-aggregation of psychiatric illnesses in affected families","volume":"43","author":"Chou","year":"2017","journal-title":"Schizophr Bull"},{"key":"2026100800425948600_ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/s0920-9964(97)00092-3","article-title":"Seasonality of births in schizophrenia and bipolar disorder: a review of the literature","volume":"28","author":"Torrey","year":"1997","journal-title":"Schizophr Res"},{"key":"2026100800425948600_ref21","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/j.mehy.2011.02.019","article-title":"Season of birth in schizophrenia: a maternal-fetal chronobiological hypothesis","volume":"76","author":"Schwartz","year":"2011","journal-title":"Med Hypotheses"},{"key":"2026100800425948600_ref22","doi-asserted-by":"publisher","first-page":"e100823","DOI":"10.1136\/gpsych-2022-100823","article-title":"A glimpse of gender differences in schizophrenia","volume":"35","author":"Li","year":"2022","journal-title":"Gen Psychiatr"},{"key":"2026100800425948600_ref23","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1016\/S0140-6736(04)17061-X","article-title":"Suicide and the unique prevalence pattern of schizophrenia in mainland China: a retrospective observational study","volume":"364","author":"Phillips","year":"2004","journal-title":"Lancet."},{"key":"2026100800425948600_ref24","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1093\/schbul\/sbs096","article-title":"Meta-analysis of the association of urbanicity with schizophrenia","volume":"38","author":"Vassos","year":"2012","journal-title":"Schizophr Bull"},{"key":"2026100800425948600_ref25","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1093\/schbul\/sbm032","article-title":"Socioeconomic status at birth is associated with risk of schizophrenia: population-based multilevel study","volume":"33","author":"Werner","year":"2007","journal-title":"Schizophr Bull"},{"key":"2026100800425948600_ref26","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/s0920-9964(96)00119-3","article-title":"Is a child's risk of early onset schizophrenia increased in the highest social class?","volume":"23","author":"M\u00e4kikyr\u00f6","year":"1997","journal-title":"Schizophr Res"},{"key":"2026100800425948600_ref27","volume-title":"Community and Schizophrenia: An Epidemiological Analysis","author":"Dunham","year":"1965"},{"key":"2026100800425948600_ref28","volume-title":"mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings: Mental Health Gap Action Programme (mhGAP). Version 2.0","author":"World Health Organization","year":"2016"},{"key":"2026100800425948600_ref29","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1177\/0020764017730849","article-title":"Rural-urban differences in accessing mental health treatment in patients with psychosis","volume":"63","author":"Thirthalli","year":"2017","journal-title":"Int J Soc Psychiatry"},{"key":"2026100800425948600_ref30","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1017\/S0033291713001943","article-title":"Barriers to mental health treatment: results from the WHO World Mental Health surveys","volume":"44","author":"Andrade","year":"2014","journal-title":"Psychol Med"}],"container-title":["Schizophrenia Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article-pdf\/52\/5\/sbaf195\/65049135\/sbaf195.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article-pdf\/52\/5\/sbaf195\/65049135\/sbaf195.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:43:42Z","timestamp":1791434622000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article\/doi\/10.1093\/schbul\/sbaf195\/8307414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,8,20]]}},"URL":"https:\/\/doi.org\/10.1093\/schbul\/sbaf195","relation":{},"ISSN":["0586-7614","1745-1701"],"issn-type":[{"value":"0586-7614","type":"print"},{"value":"1745-1701","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2025,10,31]]},"article-number":"sbaf195"}}