RESEARCH Open Access Schizophrenia in Thailand: prevalence and burden of disease Pudtan Phanthunane 1,2* , Theo Vos 1,2* , Harvey Whiteford 2,3 , Melanie Bertram 1,2 , Pichet Udomratn 4 Abstract Background: A previous estimate of the burden of schizophrenia in Thailand relied on epidemiological estimates from elsewhere. The aim of this study is to estimate the prevalence and disease burden of schizophrenia in Thailand using local data sources that recently have become available. Methods: The prevalence of schizophrenia was estimated from a community mental health survey supplemented by a count of hospital admissions. Using data from recent meta-analyses of the risk of mortality and remission, we derived incidence and average duration using DisMod software. We used treated disability weights based on patient and clinician ratings from our own local survey of patients in contact with mental health services and applied methods from Australian Burden of Disease and cost-effectiveness studies. We applied untreated disability weights from the Global Burden of Disease (GBD) study. Uncertainty analysis was conducted using Monte Carlo simulation. Results: The prevalence of schizophrenia at ages 15-59 in the Thai population was 8.8 per 1,000 (95% CI: 7.2, 10.6) with a male-to-female ratio of 1.1-to-1. The disability weights from local data were somewhat lower than the GBD weights. The disease burden in disability-adjusted life years was similar in men (70,000; 95% CI: 64,000, 77, 000) and women (75,000; 95% CI: 69,000, 83,000). The impact of using the lower Thai disability weights on the DALY estimates was small in comparison to the uncertainty in prevalence. Conclusions: Prevalence of schizophrenia was more critical to an accurate estimate of burden of disease in Thailand than variations in disability weights. Background Schizophrenia is one of the most severe and disabling mental illnesses. It is not a common disease. However, it has significant health, economic, and social conse- quences. In adults, the median prevalence from a sys- tematic review was 3.3 per 1,000, ranging from 1.3 for the 10 th percentile to 8.2 for the 90 th percentile [1]. In 2001, schizophrenia ranked among the top 10 leading causes of years lived with disability (YLD) worldwide [2,3]. In Thailand in 1999, it was the eighth and ninth leading cause of YLD in men and women, respectively, responsible for 5% of disability from all causes [4]. Mea- sured in disability-adjusted life years (DALYs), it ranked as the third-largest mental disorder after depression and anxiety disorders [4]. Apart from the significant health consequences, the health care costs of schizophrenia are also high and fre- quently underestimated. The World Health Organiza- tion (WHO) estimates the direct health care costs of schizophrenia in Western countries range between 1.6% and 2.6% of total health care expenditures [5]. In Tai- wan, schizophrenia accounted for 1.2% of national health care expenditures [6]. To the best of our knowl- edge, there are no studies reporting the cost of schizo- phrenia in Thailand. The burden of schizophrenia in Thailand has not been well-established. The main reason was a lack of popula- tion-based epidemiological data. The disease parameters used for the 1999 Thai Burden of Disease study, such as prevalence estimates and relative risk of death, were extrapolated from international studies [4]. Recently, more empirical data, including data from systematic * Correspondence: pudtan.phanthunane@uqconnect.edu.au; t.vos@sph.uq. edu.au 1 Setting Priorities Using Information on Cost-Effectiveness (SPICE) project, Ministry of Public Health, Nonthaburi, Thailand Full list of author information is available at the end of the article Phanthunane et al. Population Health Metrics 2010, 8:24 http://www.pophealthmetrics.com/content/8/1/24 © 2010 Phanthunane et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.