Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey

Abstract BackgroundEstimating the prevalence of schizophrenia in the general population remains a challenge worldwide, as well as in Japan. Few studies have estimated schizophrenia prevalence in the Japanese population and have often relied on reports from hospitals and self-r...

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Main Authors: Pichsinee Choomung, Yupeng He, Masaaki Matsunaga, Kenji Sakuma, Taro Kishi, Yuanying Li, Shinichi Tanihara, Nakao Iwata, Atsuhiko Ota
Format: Article
Language:English
Published: JMIR Publications 2025-01-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e66330
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author Pichsinee Choomung
Yupeng He
Masaaki Matsunaga
Kenji Sakuma
Taro Kishi
Yuanying Li
Shinichi Tanihara
Nakao Iwata
Atsuhiko Ota
author_facet Pichsinee Choomung
Yupeng He
Masaaki Matsunaga
Kenji Sakuma
Taro Kishi
Yuanying Li
Shinichi Tanihara
Nakao Iwata
Atsuhiko Ota
author_sort Pichsinee Choomung
collection DOAJ
description Abstract BackgroundEstimating the prevalence of schizophrenia in the general population remains a challenge worldwide, as well as in Japan. Few studies have estimated schizophrenia prevalence in the Japanese population and have often relied on reports from hospitals and self-reported physician diagnoses or typical schizophrenia symptoms. These approaches are likely to underestimate the true prevalence owing to stigma, poor insight, or lack of access to health care among respondents. To address these issues, we previously developed an artificial neural network (ANN)–based schizophrenia classification model (SZ classifier) using data from a large-scale Japanese web-based survey to enhance the comprehensiveness of schizophrenia case identification in the general population. In addition, we also plan to introduce a population-based survey to collect general information and sample participants matching the population’s demographic structure, thereby achieving a precise estimate of the prevalence of schizophrenia in Japan. ObjectiveThis study aimed to estimate the prevalence of schizophrenia by applying the SZ classifier to random samples from the Japanese population. MethodsWe randomly selected a sample of 750 participants where the age, sex, and regional distributions were similar to Japan’s demographic structure from a large-scale Japanese web-based survey. Demographic data, health-related backgrounds, physical comorbidities, psychiatric comorbidities, and social comorbidities were collected and applied to the SZ classifier, as this information was also used for developing the SZ classifier. The crude prevalence of schizophrenia was calculated through the proportion of positive cases detected by the SZ classifier. The crude estimate was further refined by excluding false-positive cases and including false-negative cases to determine the actual prevalence of schizophrenia. ResultsOut of 750 participants, 62 were classified as schizophrenia cases by the SZ classifier, resulting in a crude prevalence of schizophrenia in the general population of Japan of 8.3% (95% CI 6.6%-10.1%). Among these 62 cases, 53 were presumed to be false positives, and 3 were presumed to be false negatives. After adjustment, the actual prevalence of schizophrenia in the general population was estimated to be 1.6% (95% CI 0.7%-2.5%). ConclusionsThis estimated prevalence was slightly higher than that reported in previous studies, possibly due to a more comprehensive disease classification methodology or, conversely, model limitations. This study demonstrates the capability of an ANN-based model to improve the estimation of schizophrenia prevalence in the general population, offering a novel approach to public health analysis.
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spelling doaj-art-4f0ad34bf4ba4b61818b3fe1a455078a2025-02-05T21:17:25ZengJMIR PublicationsJMIR Formative Research2561-326X2025-01-019e66330e6633010.2196/66330Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional SurveyPichsinee Choomunghttp://orcid.org/0009-0006-1297-877XYupeng Hehttp://orcid.org/0000-0003-3162-0176Masaaki Matsunagahttp://orcid.org/0000-0001-7942-1446Kenji Sakumahttp://orcid.org/0000-0001-8830-0179Taro Kishihttp://orcid.org/0000-0002-9237-2236Yuanying Lihttp://orcid.org/0000-0002-4059-6406Shinichi Taniharahttp://orcid.org/0000-0002-4419-2070Nakao Iwatahttp://orcid.org/0000-0003-3189-6076Atsuhiko Otahttp://orcid.org/0000-0001-6452-1823 Abstract BackgroundEstimating the prevalence of schizophrenia in the general population remains a challenge worldwide, as well as in Japan. Few studies have estimated schizophrenia prevalence in the Japanese population and have often relied on reports from hospitals and self-reported physician diagnoses or typical schizophrenia symptoms. These approaches are likely to underestimate the true prevalence owing to stigma, poor insight, or lack of access to health care among respondents. To address these issues, we previously developed an artificial neural network (ANN)–based schizophrenia classification model (SZ classifier) using data from a large-scale Japanese web-based survey to enhance the comprehensiveness of schizophrenia case identification in the general population. In addition, we also plan to introduce a population-based survey to collect general information and sample participants matching the population’s demographic structure, thereby achieving a precise estimate of the prevalence of schizophrenia in Japan. ObjectiveThis study aimed to estimate the prevalence of schizophrenia by applying the SZ classifier to random samples from the Japanese population. MethodsWe randomly selected a sample of 750 participants where the age, sex, and regional distributions were similar to Japan’s demographic structure from a large-scale Japanese web-based survey. Demographic data, health-related backgrounds, physical comorbidities, psychiatric comorbidities, and social comorbidities were collected and applied to the SZ classifier, as this information was also used for developing the SZ classifier. The crude prevalence of schizophrenia was calculated through the proportion of positive cases detected by the SZ classifier. The crude estimate was further refined by excluding false-positive cases and including false-negative cases to determine the actual prevalence of schizophrenia. ResultsOut of 750 participants, 62 were classified as schizophrenia cases by the SZ classifier, resulting in a crude prevalence of schizophrenia in the general population of Japan of 8.3% (95% CI 6.6%-10.1%). Among these 62 cases, 53 were presumed to be false positives, and 3 were presumed to be false negatives. After adjustment, the actual prevalence of schizophrenia in the general population was estimated to be 1.6% (95% CI 0.7%-2.5%). ConclusionsThis estimated prevalence was slightly higher than that reported in previous studies, possibly due to a more comprehensive disease classification methodology or, conversely, model limitations. This study demonstrates the capability of an ANN-based model to improve the estimation of schizophrenia prevalence in the general population, offering a novel approach to public health analysis.https://formative.jmir.org/2025/1/e66330
spellingShingle Pichsinee Choomung
Yupeng He
Masaaki Matsunaga
Kenji Sakuma
Taro Kishi
Yuanying Li
Shinichi Tanihara
Nakao Iwata
Atsuhiko Ota
Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey
JMIR Formative Research
title Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey
title_full Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey
title_fullStr Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey
title_full_unstemmed Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey
title_short Estimating the Prevalence of Schizophrenia in the General Population of Japan Using an Artificial Neural Network–Based Schizophrenia Classifier: Web-Based Cross-Sectional Survey
title_sort estimating the prevalence of schizophrenia in the general population of japan using an artificial neural network based schizophrenia classifier web based cross sectional survey
url https://formative.jmir.org/2025/1/e66330
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