Sex and age distribution of schizophrenia admissions at a psychiatric hospital in Morocco (2011-2024).

Background: Schizophrenia is a severe psychiatric disorder with a significant social and economic burden, yet epidemiological data on schizophrenia in Morocco remain scarce, particularly regarding long-term patterns of admissions. Objective: Our study aims to describe the temporal trends in schizophrenia admissions at Ar Razi Psychiatric Hospital in the Salé-Rabat region of Morocco from 2011 to 2024 and to analyze variations in admissions by age and sex. Methods: We conducted a retrospective descriptive study using aggregated annual statistical registers from Ar Razi University Psychiatric Hospital (Salé, Morocco) from 2011 to 2024. The registers record, for each calendar year, the number of admissions cross-tabulated by sex (Male, Female) and by age range (0-14, 15-60, 61+ years), with admissions further classified as either first-ever presentations ("new") or returning patients previously seen for the same diagnosis ("old"). The unit of analysis is the admission, and the same patient may contribute admissions in more than one calendar year. Descriptive statistics were computed for sex, age range, and admission type. Annual male and female admission counts were compared using the Wilcoxon signed-rank test. Results: Over the study period, the registers recorded 13,564 schizophrenia admissions at Ar Razi, of which 5028 (37.1%) were first-ever presentations and 8536 (62.9%) were returning patients. Of all admissions, 10,488 (77.3%) were of male and 3076 (22.7%) of female patients, giving an overall male-to-female admission ratio of 3.41. The annual ratio ranged from 2.32 (2018) to 4.59 (2011), and was greater than 2 in every year. The 15-60-year age group accounted for 12,976 admissions (95.7%), with 230 (1.7%) in the 0-14 group and 358 (2.6%) in the 61+ group. The male-to-female ratio was substantially higher at the extremes of age (229:1 in 0-14; 9.85:1 in 61+) than in the 15-60 group (3.27:1). Total admissions declined to 840 in 2013 and to 616 in 2020 (-41.1% relative to 2019), then rose to a peak of 1226 in 2023. Conclusion: Schizophrenia hospitalizations in the Salé-Rabat region predominantly affect males in early to middle adulthood. The observed fluctuations highlight the impact of social, cultural, and external factors such as the COVID-19 pandemic on hospitalization rates. These findings describe patterns of psychiatric hospital use rather than population-level prevalence or incidence, and they are consistent with hypotheses about gender-related barriers to psychiatric care in Morocco. They support the need for targeted mental health policies addressing stigma, sex disparities in access, and continuity of care during public-health emergencies.