Prevalence, Correlates, and Treatment Gap of Schizophrenia Among Adults in Bangladesh: Findings From a Nationwide Household Survey.

BACKGROUND AND HYPOTHESIS: 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.

STUDY

DESIGN

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 years 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.

STUDY

RESULTS

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.

CONCLUSIONS

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.