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Geographic Variations in the Prevalence of Schizophrenia-Reply

John L. Waddington, PhD, DSc; Hanafy A. Youssef, MRCPsych; Anthony Kinsella, MSc, FIS
Arch Gen Psychiatry. 1992;49(11):907-908. doi:10.1001/archpsyc.1992.01820110071014.
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In Reply.—  Few areas of epidemiologic research are so liable to provoke controversy as that of putative disease clustering; as espoused in a recent editorial, "Disease clusters provide for passion, amusement and despair."1 Protagonists usually fall into one of two camps: that of the proponent, or that of the "cluster buster"1,2; we note that Lin and Goodman adopt the eclectic position of seeking both to "bust" our Irish cluster and to champion their own cluster of Ashkenazi Jews. Their comments raise a number of technical, theoretical, and conceptual points for discussion.Lin and Goodman do not question our basic finding3 that the overall variation in prevalence rates for schizophrenia over 36 contiguous District Electoral Divisions, constituting one half of a rural Irish county, deviates significantly from a homogeneous Poisson process model for random occurrences in space. If this model is a reasonable approximation, there should be no trend


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