The prevalence of schizophrenia in Brazil: social vulnerability as a key consideration for care and policy

Recent studies have highlighted variability in schizophrenia prevalence according to sociodemographic and environmental factors. Brazil lacks updated, nationally representative data. This study aimed to estimate the lifetime prevalence of schizophrenia in Brazil using a representative national sample and to examine associations with sociodemographic factors such as sex, age, income, education, and geographic region.

Data were analyzed from adult respondents (aged = 18 years) of the 2019 National Health Survey, which employed a multistage, clustered sampling strategy representing the Brazilian population (n=159,171,311). Schizophrenia diagnosis was self-reported. Weighted analyses, bivariate and multivariable logistic regression models were used to examine associations between sociodemographic factors and schizophrenia diagnosis.

The estimated lifetime prevalence of self-reported schizophrenia was 0.34%. In multivariable analyses, the prevalence was higher among men, individuals aged 40-59, those with lower income, urban residents, those living without a partner, and the unemployed. A clear gradient was observed for education in bivariate analysis, with a higher prevalence among those with lower attainment (0.75%); however, this was not significant in the multivariable model.

Schizophrenia is observed across all regions of Brazil, affecting approximately 547,202 individuals. Findings on social determinants replicate previous results. The overrepresentation of socially vulnerable groups underscores the need to address social determinants of health and implement supportive policies.