Kirkbride, JB;
Jones, PB;
Ullrich, S;
Coid, JW;
(2014)
Social deprivation, inequality, and the neighborhood-level incidence of psychotic syndromes in East London.
Schizophrenia Bulletin
, 40
(1)
169 - 180.
10.1093/schbul/sbs151.
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Abstract
Although urban birth, upbringing, and living are associated with increased risk of nonaffective psychotic disorders, few studies have used appropriate multilevel techniques accounting for spatial dependency in risk to investigate social, economic, or physical determinants of psychosis incidence. We adopted Bayesian hierarchical modeling to investigate the sociospatial distribution of psychosis risk in East London for DSM-IV nonaffective and affective psychotic disorders, ascertained over a 2-year period in the East London first-episode psychosis study. We included individual and environmental data on 427 subjects experiencing first-episode psychosis to estimate the incidence of disorder across 56 neighborhoods, having standardized for age, sex, ethnicity, and socioeconomic status. A Bayesian model that included spatially structured neighborhood-level random effects identified substantial unexplained variation in nonaffective psychosis risk after controlling for individual-level factors. This variation was independently associated with greater levels of neighborhood income inequality (SD increase in inequality: Bayesian relative risks [RR]: 1.25; 95% CI: 1.04-1.49), absolute deprivation (RR: 1.28; 95% CI: 1.08-1.51) and population density (RR: 1.18; 95% CI: 1.00-1.41). Neighborhood ethnic composition effects were associated with incidence of nonaffective psychosis for people of black Caribbean and black African origin. No variation in the spatial distribution of the affective psychoses was identified, consistent with the possibility of differing etiological origins of affective and nonaffective psychoses. Our data suggest that both absolute and relative measures of neighborhood social composition are associated with the incidence of nonaffective psychosis. We suggest these associations are consistent with a role for social stressors in psychosis risk, particularly when people live in more unequal communities.
| Type: | Article |
|---|---|
| Title: | Social deprivation, inequality, and the neighborhood-level incidence of psychotic syndromes in East London |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/schbul/sbs151 |
| Publisher version: | http://dx.doi.org.10.1093/schbul/sbs151 |
| Language: | English |
| Additional information: | © The Author 2012. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Bayesian modeling, deprivation, epidemiology, inequality, psychosis, schizophrenia, social environment, urban, Adolescent, Adult, African Continental Ancestry Group, Female, Humans, Incidence, London, Male, Middle Aged, Psychotic Disorders, Residence Characteristics, Risk, Social Environment, Socioeconomic Factors, Syndrome, Urban Population, Young Adult |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1417956 |
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