A comparison of neighbourhood level variation and risk factors for affective versus non-affective psychosis.
Aetiology
Psychosis
Social determinants
Journal
Schizophrenia research
ISSN: 1573-2509
Titre abrégé: Schizophr Res
Pays: Netherlands
ID NLM: 8804207
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
24
04
2020
revised:
11
01
2022
accepted:
18
05
2022
medline:
6
6
2023
pubmed:
14
6
2022
entrez:
13
6
2022
Statut:
ppublish
Résumé
Studies typically highlight area level variation in the incidence of non-affective but not affective psychoses. We compared neighbourhood-level variation for both types of disorder, and the specific effects of neighbourhood urbanicity and ethnic density, using Danish national registry data. Population based cohort (2,224,464 people) followed from 1980 to 2013 with neighbourhood exposure measured at age 15 and incidence modelled using multilevel Poisson regression. Neighbourhood variation was similar for both disorders with an adjusted median risk ratio of 1.37 (95% CI 1.34-1.39) for non-affective psychosis and 1.43 (1.38-1.49) for affective psychosis. Associations with neighbourhood urbanicity differed: living in the most compared to the least urban quintile at age 15 was associated with a minimal increase in subsequent affective psychosis, IRR 1.13 (1.01-1.27) but a substantial increase in rates of non-affective psychosis, IRR 1.66 (1.57-1.75). Mixed results were found for neighbourhood ethnic density: for Middle Eastern migrants there was an increased average incidence of both affective, IRR 1.54 (1.19-1.99), and non-affective psychoses, 1.13 (1.04-1.23) associated with each decrease in ethnic density quintile, with a similar pattern for African migrants, but for European migrants ethnic density appeared to be associated with non-affective psychosis only. While overall variation and the effect of neighbourhood ethnic density were similar for both types of disorder, associations with urbanicity were largely confined to non-affective psychosis. This may reflect differences in aetiological pathways although the mechanism behind these differences remains unknown.
Sections du résumé
BACKGROUND
Studies typically highlight area level variation in the incidence of non-affective but not affective psychoses. We compared neighbourhood-level variation for both types of disorder, and the specific effects of neighbourhood urbanicity and ethnic density, using Danish national registry data.
METHODS
Population based cohort (2,224,464 people) followed from 1980 to 2013 with neighbourhood exposure measured at age 15 and incidence modelled using multilevel Poisson regression.
RESULTS
Neighbourhood variation was similar for both disorders with an adjusted median risk ratio of 1.37 (95% CI 1.34-1.39) for non-affective psychosis and 1.43 (1.38-1.49) for affective psychosis. Associations with neighbourhood urbanicity differed: living in the most compared to the least urban quintile at age 15 was associated with a minimal increase in subsequent affective psychosis, IRR 1.13 (1.01-1.27) but a substantial increase in rates of non-affective psychosis, IRR 1.66 (1.57-1.75). Mixed results were found for neighbourhood ethnic density: for Middle Eastern migrants there was an increased average incidence of both affective, IRR 1.54 (1.19-1.99), and non-affective psychoses, 1.13 (1.04-1.23) associated with each decrease in ethnic density quintile, with a similar pattern for African migrants, but for European migrants ethnic density appeared to be associated with non-affective psychosis only.
CONCLUSIONS
While overall variation and the effect of neighbourhood ethnic density were similar for both types of disorder, associations with urbanicity were largely confined to non-affective psychosis. This may reflect differences in aetiological pathways although the mechanism behind these differences remains unknown.
Identifiants
pubmed: 35697569
pii: S0920-9964(22)00192-X
doi: 10.1016/j.schres.2022.05.015
pmc: PMC10259518
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
126-132Subventions
Organisme : Medical Research Council
ID : MR/K021494/1
Pays : United Kingdom
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The study authors have nothing to disclose.
Références
Schizophr Bull. 2014 Jan;40(1):169-80
pubmed: 23236081
Schizophr Bull. 2016 Dec 29;43(2):283-286
pubmed: 28039422
Schizophr Bull. 2012 Nov;38(6):1118-23
pubmed: 23015685
JAMA Psychiatry. 2018 Jan 1;75(1):36-46
pubmed: 29214289
Br J Psychiatry. 2016 May;208(5):435-40
pubmed: 26678865
Schizophr Bull. 2017 Oct 21;43(6):1176-1189
pubmed: 29045744
Epidemiol Rev. 2008;30:84-100
pubmed: 18669521
Arch Gen Psychiatry. 2003 Dec;60(12):1209-15
pubmed: 14662553
Schizophr Res. 2018 May;195:501-505
pubmed: 28969931
Soc Psychiatry Psychiatr Epidemiol. 2006 Sep;41(9):679-85
pubmed: 16819565
Psychol Med. 2018 Sep;48(12):2054-2072
pubmed: 29239292
Psychol Med. 1998 Jul;28(4):871-9
pubmed: 9723142
Scand J Public Health. 2011 Jul;39(7 Suppl):95-8
pubmed: 21775363
Schizophr Res. 2017 Dec;190:82-87
pubmed: 28318842
Stat Med. 2018 Feb 20;37(4):572-589
pubmed: 29114926
Psychol Med. 2014 Oct;44(13):2713-26
pubmed: 25066181
Schizophr Bull. 2014 Mar;40 Suppl 2:S138-46
pubmed: 24371326
Clin Psychol Rev. 2005 Dec;25(8):1043-75
pubmed: 16140445
Am J Psychiatry. 2017 Nov 1;174(11):1075-1085
pubmed: 27978770
Psychol Med. 2008 Aug;38(8):1083-94
pubmed: 17988420
Psychol Med. 2007 Oct;37(10):1413-25
pubmed: 17472758
Nature. 2010 Nov 11;468(7321):203-12
pubmed: 21068828
JAMA Psychiatry. 2014 May;71(5):573-81
pubmed: 24806211
Epidemiol Rev. 2004;26:53-62
pubmed: 15234947
Soc Psychiatry Psychiatr Epidemiol. 2007 Jun;42(6):438-45
pubmed: 17473901
Neurotox Res. 2002 Aug-Sep;4(5-6):427-436
pubmed: 12754157
JAMA Psychiatry. 2018 Jul 1;75(7):678-686
pubmed: 29799917
Br J Psychiatry. 2016 Aug;209(2):107-13
pubmed: 26989099
Schizophr Res. 2000 Jun 16;43(2-3):117-23
pubmed: 10858630
Schizophr Res. 2009 May;110(1-3):33-9
pubmed: 19345565
JAMA Psychiatry. 2016 Oct 01;73(10):1015-1022
pubmed: 27580483
Soc Sci Med. 1986;23(10):945-61
pubmed: 3493535
J Clin Psychiatry. 2007 Nov;68(11):1673-81
pubmed: 18052560
Schizophr Bull. 2014 May;40(3):504-15
pubmed: 24567502
Bipolar Disord. 2006 Jun;8(3):242-7
pubmed: 16696825
Schizophr Res. 2004 Dec 1;71(2-3):405-16
pubmed: 15474912
Scand J Public Health. 2011 Jul;39(7 Suppl):54-7
pubmed: 21775352
Soc Psychiatry Psychiatr Epidemiol. 2015 Nov;50(11):1713-22
pubmed: 26311534
Bipolar Disord. 2013 May;15(3):306-13
pubmed: 23531096
Scand J Public Health. 2011 Jul;39(7 Suppl):22-5
pubmed: 21775345
JAMA Psychiatry. 2018 Jan 1;75(1):75-83
pubmed: 29188295
Soc Psychiatry Psychiatr Epidemiol. 2015 Jul;50(7):1039-55
pubmed: 25660551
Acta Psychiatr Scand. 2020 Feb;141(2):172
pubmed: 31953856
Psychiatry Clin Neurosci. 2016 Oct;70(10):424-433
pubmed: 27233969
J Epidemiol Community Health. 2006 Apr;60(4):290-7
pubmed: 16537344
Br J Psychiatry. 2012 Jul;201(1):11-9
pubmed: 22753852
Br J Psychiatry. 2005 Feb;186:126-31
pubmed: 15684235
Schizophr Res. 2004 Apr 1;67(2-3):143-55
pubmed: 14984873