Spyridonidis, Spyros;
Dykxhoorn, Jennifer;
Hollander, Anna-Clara;
Dalman, Christina;
Kirkbride, James B;
(2022)
Neighborhood-level predictors of age-at-first-diagnosis of psychotic disorders: a Swedish register-based cohort study.
Schizophrenia Bulletin Open
10.1093/schizbullopen/sgac045.
(In press).
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Abstract
The relationship between neighborhood-level factors and the incidence of psychotic disorders is well established. However, it is unclear whether neighborhood characteristics are also associated with age-at-first-diagnosis of these disorders. We used linked Swedish register data to identify a cohort of persons first diagnosed with an ICD-10 non-affective or affective psychotic disorder (F20-33) between 1997 and 2016. Using multilevel mixed-effect linear modelling, we investigated whether neighborhood deprivation and population density at birth were associated with age-at-first diagnosis of a psychotic disorder. Our final cohort included 13,440 individuals, with a median age-at-first-diagnosis of 21.8 years for women (interquartile range [IQR]: 19.0-25.5) and 22.9 years for men (IQR: 20.1-26.1; p<.0001). In an unadjusted model, we found no evidence of an association between neighborhood deprivation and age-at-first-diagnosis of psychotic disorder (p=.07). However, after multivariable adjustment, age-at-first-diagnosis increased by .13 years (95% CI: .05 to .21; p=.002) for a one standard deviation increase in neighborhood deprivation. This was equivalent to a later diagnosis of 47 days (95% CI: 18 to 77). We found no evidence of a different relationship for non-affective versus affective psychoses (LRT χ2(1) = .14; p=.71). Population density was not associated with age-at-first-diagnosis in unadjusted (p=.81) or adjusted (p=.85) models. Later age-at-first-diagnosis for individuals born in more deprived neighborhoods suggests structural barriers to accessing equitable psychiatric care.
| Type: | Article |
|---|---|
| Title: | Neighborhood-level predictors of age-at-first-diagnosis of psychotic disorders: a Swedish register-based cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/schizbullopen/sgac045 |
| Publisher version: | https://doi.org/10.1093/schizbullopen/sgac045 |
| Language: | English |
| Additional information: | This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
| Keywords: | epidemiology, longitudinal, age-at-onset, deprivation, population density, schizophrenia |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10151953 |
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