The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis

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dc.contributor.authorCrossley N.A.
dc.contributor.authorAlliende L.M.
dc.contributor.authorIruretagoyena B.
dc.contributor.authorMena C.
dc.contributor.authorRamirez-Mahaluf J.P.
dc.contributor.authorTepper A.
dc.contributor.authorVasquez J.
dc.contributor.authorMcGuire P.
dc.contributor.authorCzepielewski L.S.
dc.contributor.authorGama C.S.
dc.contributor.authorAceituno D.
dc.contributor.authorCastaneda C.P.
dc.contributor.authorGonzalez-Valderrama A.
dc.contributor.authorUndurraga J.
dc.contributor.authorDiaz C.
dc.contributor.authorFonseca L.
dc.contributor.authorMachado V.
dc.contributor.authorGadelha A.
dc.contributor.authorBressan R.
dc.contributor.authorHernandez C.E.
dc.contributor.authorVargas-Upegui C.
dc.contributor.authorLopez-Jaramillo C.
dc.contributor.authorGomez-Cruz G.
dc.contributor.authorKobayashi-Romero L.F.
dc.contributor.authorMoncada-Habib T.
dc.contributor.authorde la Fuente-Sandoval C.
dc.contributor.authorArango C.
dc.contributor.authorBarch D.M.
dc.contributor.authorCarter C.
dc.contributor.authorCorrell C.U.
dc.contributor.authorFreimer N.B.
dc.contributor.authorEvans-Lacko S.
dc.contributor.authorUndurraga E.
dc.date.accessioned2024-01-10T12:37:13Z
dc.date.available2024-01-10T12:37:13Z
dc.date.issued2022
dc.description.abstract© 2022 Elsevier LtdBackground: Educational attainment is associated with wellbeing and health, but patients with schizophrenia achieve lower levels of education than people without. Several effective interventions can ameliorate this situation. However, the magnitude of the education gap in schizophrenia and its change over time are unclear. We aimed to reconstruct the trajectories of educational attainment in patients with schizophrenia and, if reported, their healthy comparator controls. Methods: We did a systematic review and meta-analysis including all studies reporting on patients with schizophrenia (of mean age ≥18 years) and describing the number of years of education of the participants, with or without healthy controls. There were no other design constraints on studies. We excluded studies that included only patients with other schizophrenia spectrum disorders and studies that did not specify the number of years of education of the participants. 22 reviewers participated in retrieving data from a search in PubMed and PsycINFO (Jan 1, 1970, to Nov 24, 2020). We estimated the birth date of participants from their mean age and publication date, and meta-analysed these data using random-effects models, focusing on educational attainment, the education gap, and changes over time. The primary outcome was years of education. The protocol was registered on PROSPERO (CRD42020220546). Findings: From 32 593 initial references, we included 3321 studies reporting on 318 632 patients alongside 138 675 healthy controls (170 941 women and 275 821 men from studies describing sex or gender; data on ethnicity were not collected). Patients’ educational attainment increased over time, mirroring that of controls. However, patients with schizophrenia in high-income countries had 19 months less education than controls (–1·59 years, 95% CI –1·66 to –1·53; p<0·0001), which is equivalent to a Cohen's d of –0·56 (95% CI –0·58 to –0·54) and implies an odds ratio of 2·58 for not completing 12 years of education (ie, not completing secondary education) for patients compared with controls. This gap remained stable throughout the decades; the rate of change in number of total years of education in time was not significant (annual change: 0·0047 years, 95% CI –0·0005 to 0·0099; p=0·078). For patients in low-income and middle-income countries, the education gap was significantly smaller than in high-income countries (smaller by 0·72 years, 0·85 to 0·59; p<0·0001), yet there was evidence that this gap was widening over the years, approaching that of high-income countries (annual change: –0·024 years, –0·037 to –0·011; p=0·0002). Interpretation: Patients with schizophrenia have faced persistent inequality in educational attainment in the last century, despite advances in psychosocial and pharmacological treatment. Reducing this gap should become a priority to improve their functional outcomes. Funding: Ciencia y Tecnología para el Desarrollo (CYTED) to the Latin American Network for the Study of Early Psychosis (ANDES).
dc.description.funderANID-FONDECYT
dc.description.funderFundación Familia Alonso
dc.description.funderMadrid Regional Government
dc.description.funderPrograma Iberoamericano de Ciencia y Tecnología para el Desarrollo
dc.description.funderUS National Institutes of Health
dc.description.funderFundación Alicia Koplowitz
dc.description.funderEuropean Union H2020 Program
dc.description.funderFONDECYT
dc.description.funderCONACyT
dc.description.funderInstituto de Salud Carlos III
dc.description.funderSpanish Ministry of Science and Innovation
dc.description.funderCIBERSAM
dc.description.funderCYTED
dc.description.funderERDF
dc.description.funderInnovative Medicines Initiative 2
dc.description.funderSistema Nacional de Investigadores
dc.description.funderAgencia Nacional de Investigación y Desarrollo
dc.fechaingreso.objetodigital2024-04-25
dc.format.extent573 páginas
dc.fuente.origenScopus
dc.identifier.doi10.1016/S2215-0366(22)00121-3
dc.identifier.eissn22150374
dc.identifier.issn22150366
dc.identifier.pubmedid35717966
dc.identifier.scopusidSCOPUS_ID:85132219139
dc.identifier.urihttps://doi.org/10.1016/S2215-0366(22)00121-3
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/76788
dc.information.autorucInterdisciplinarias; Undurraga Fourcade, Eduardo Andres; S/I; 12868
dc.issue.numero7
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final573
dc.pagina.inicio565
dc.publisherElsevier Ltd
dc.relation.ispartofThe Lancet Psychiatry
dc.revistaThe Lancet Psychiatry
dc.rightsacceso restringido
dc.titleThe enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis
dc.typeartículo
dc.volumen9
sipa.codpersvinculados12868
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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