Urbanicity and rates of untreated psychotic disorders in three diverse settings in the Global South.
Epidemiology
global mental health
incidence
psychosis
schizophrenia
urbanicity
Journal
Psychological medicine
ISSN: 1469-8978
Titre abrégé: Psychol Med
Pays: England
ID NLM: 1254142
Informations de publication
Date de publication:
16 Jan 2023
16 Jan 2023
Historique:
entrez:
16
1
2023
pubmed:
17
1
2023
medline:
17
1
2023
Statut:
aheadofprint
Résumé
Extensive evidence indicates that rates of psychotic disorder are elevated in more urban compared with less urban areas, but this evidence largely originates from Northern Europe. It is unclear whether the same association holds globally. This study examined the association between urban residence and rates of psychotic disorder in catchment areas in India (Kancheepuram, Tamil Nadu), Nigeria (Ibadan, Oyo), and Northern Trinidad. Comprehensive case detection systems were developed based on extensive pilot work to identify individuals aged 18-64 with previously untreated psychotic disorders residing in each catchment area (May 2018-April/May/July 2020). Area of residence and basic demographic details were collected for eligible cases. We compared rates of psychotic disorder in the more We found evidence of higher overall rates of psychosis in more urban areas within the Trinidadian catchment area (IRR: 3.24, 95% CI 2.68-3.91), an inverse association in the Nigerian catchment area (IRR: 0.68, 95% CI 0.51-0.91) and no association in the Indian catchment area (IRR: 1.18, 95% CI 0.93-1.52). When restricting to recent onset cases, we found a modest positive association in the Indian catchment area. This study suggests that urbanicity is associated with higher rates of psychotic disorder in some but not all contexts outside of Northern Europe. Future studies should test candidate mechanisms that may underlie the associations observed, such as exposure to violence.
Sections du résumé
BACKGROUND
BACKGROUND
Extensive evidence indicates that rates of psychotic disorder are elevated in more urban compared with less urban areas, but this evidence largely originates from Northern Europe. It is unclear whether the same association holds globally. This study examined the association between urban residence and rates of psychotic disorder in catchment areas in India (Kancheepuram, Tamil Nadu), Nigeria (Ibadan, Oyo), and Northern Trinidad.
METHODS
METHODS
Comprehensive case detection systems were developed based on extensive pilot work to identify individuals aged 18-64 with previously untreated psychotic disorders residing in each catchment area (May 2018-April/May/July 2020). Area of residence and basic demographic details were collected for eligible cases. We compared rates of psychotic disorder in the more
RESULTS
RESULTS
We found evidence of higher overall rates of psychosis in more urban areas within the Trinidadian catchment area (IRR: 3.24, 95% CI 2.68-3.91), an inverse association in the Nigerian catchment area (IRR: 0.68, 95% CI 0.51-0.91) and no association in the Indian catchment area (IRR: 1.18, 95% CI 0.93-1.52). When restricting to recent onset cases, we found a modest positive association in the Indian catchment area.
CONCLUSIONS
CONCLUSIONS
This study suggests that urbanicity is associated with higher rates of psychotic disorder in some but not all contexts outside of Northern Europe. Future studies should test candidate mechanisms that may underlie the associations observed, such as exposure to violence.
Identifiants
pubmed: 36645027
doi: 10.1017/S0033291722003749
pii: S0033291722003749
pmc: PMC10600928
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-9Subventions
Organisme : Medical Research Council
ID : MC_PC_MR/S008179/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/P025927/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/X022242/1
Pays : United Kingdom
Investigateurs
Adejoke Agboola
(A)
Kulandaiyesu Amaldoss
(K)
Jothi Ramadoss Aynkaran
(JR)
Abirami Balashanmugam
(A)
Darielle Bharath-Khan
(D)
Premalatha Chockalingam
(P)
Kruthika Devanathan
(K)
Olawoye Fadahunsi
(O)
Subhashini Gopal
(S)
Olufemi Idowu
(O)
Donella Jadoo
(D)
Triplicane Chakravarthy Ramesh Kumar
(TCR)
Elysse Marcellin
(E)
Clement Obuene
(C)
Akin Ojagbemi
(A)
Bamise Olayiwola
(B)
Seyi Owoeye
(S)
Padmavati Ramachandran
(P)
Elena Raymond
(E)
Karthick Samikannu
(K)
Grace Sooknanan
(G)
Lauren Subnaik
(L)
Diana Williams
(D)
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