NDLI: Social Deprivation, Inequality, and the Neighborhood-Level Incidence of Psychotic Syndromes in East London

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Social Deprivation, Inequality, and the Neighborhood-Level Incidence of Psychotic Syndromes in East London

Content Provider	PubMed Central
Author	Kirkbride, James B. Jones, Peter B. Ullrich, Simone Coid, Jeremy W.
Copyright Year	2012
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.
Related Links	http://dx.doi.org/10.1093/schbul/sbs151
Ending Page	180
Page Count	12
Starting Page	169
File Format	PDF
ISSN	17451701
e-ISSN	17451701
Journal	Schizophrenia Bulletin
Issue Number	1
Volume Number	40
Language	English
Publisher	Oxford University Press
Publisher Date	2014-01-01
Access Restriction	Open
Rights Holder	Oxford University Press
Subject Keyword	Schizophrenia Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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