Burden, Incidence, and Spatial Distribution of Schizophrenia in Ecuador (2010–2021): A Nationwide Hospital Discharge Analysis

Schizophrenia is a chronic mental disorder affecting approximately 1% of the global population and imposing a significant economic and social burden. In Ecuador, comprehensive data on its incidence, burden, and spatial distribution are scarce. This study aims to estimate the hospital-diagnosed incidence, disease burden, and spatial patterns of schizophrenia in Ecuador using national hospital discharge records from 2010 to 2021. A retrospective observational study was conducted using publicly available hospital discharge records from the Instituto Nacional de Estadística y Censos (INEC). Schizophrenia cases were identified using ICD-10 codes F20–F29. Incidence rates per 100,000 population were estimated with 95% Poisson confidence intervals. Disability-Adjusted Life Years (DALYs) were calculated under three scenarios: no discounting or age weighting, 3%-time discounting, and both. Spatial clusters were identified using SATSCAN software v10.1.2. A total of 10,542 schizophrenia cases were recorded between 2010 and 2021, with an overall incidence rate of 5.36 per 100,000 population (95% CI: 5.26–5.46). Incidence significantly decreased over time ( p = 0.029). The estimated burden ranged from 153.05 to 289.78 DALYs per 100,000. High-incidence clusters were identified in Guayas and Pichincha provinces. This study provides the first nationwide assessment of schizophrenia in Ecuador, offering critical insights for health policy development, resource allocation, and improved care strategies.