The Role of Social Deprivation and Cannabis Use in Explaining Variation in the Incidence of Psychotic Disorders: Findings From the EU-GEI Study.
epidemiology
etiology
social determinants of health
social inequality
substance use
Journal
Schizophrenia bulletin
ISSN: 1745-1701
Titre abrégé: Schizophr Bull
Pays: United States
ID NLM: 0236760
Informations de publication
Date de publication:
24 May 2024
24 May 2024
Historique:
medline:
24
5
2024
pubmed:
24
5
2024
entrez:
24
5
2024
Statut:
aheadofprint
Résumé
Recent findings suggest the incidence of first-episode psychotic disorders (FEP) varies according to setting-level deprivation and cannabis use, but these factors have not been investigated together. We hypothesized deprivation would be more strongly associated with variation in FEP incidence than the prevalence of daily or high-potency cannabis use between settings. We used incidence data in people aged 18-64 years from 14 settings of the EU-GEI study. We estimated the prevalence of daily and high-potency cannabis use in controls as a proxy for usage in the population at-risk; multiple imputations by chained equations and poststratification weighting handled missing data and control representativeness, respectively. We modeled FEP incidence in random intercepts negative binomial regression models to investigate associations with the prevalence of cannabis use in controls, unemployment, and owner-occupancy in each setting, controlling for population density, age, sex, and migrant/ethnic group. Lower owner-occupancy was independently associated with increased FEP (adjusted incidence rate ratio [aIRR]: 0.76, 95% CI: 0.61-0.95) and non-affective psychosis incidence (aIRR: 0.68, 95% CI: 0.55-0.83), after multivariable adjustment. Prevalence of daily cannabis use in controls was associated with the incidence of affective psychoses (aIRR: 1.53, 95% CI: 1.02-2.31). We found no association between FEP incidence and unemployment or high-potency cannabis use prevalence. Sensitivity analyses supported these findings. Lower setting-level owner-occupancy and increased prevalence of daily cannabis use in controls independently contributed to setting-level variance in the incidence of different psychotic disorders. Public health interventions that reduce exposure to these harmful environmental factors could lower the population-level burden of psychotic disorders.
Sections du résumé
BACKGROUND AND HYPOTHESIS
OBJECTIVE
Recent findings suggest the incidence of first-episode psychotic disorders (FEP) varies according to setting-level deprivation and cannabis use, but these factors have not been investigated together. We hypothesized deprivation would be more strongly associated with variation in FEP incidence than the prevalence of daily or high-potency cannabis use between settings.
STUDY DESIGN
METHODS
We used incidence data in people aged 18-64 years from 14 settings of the EU-GEI study. We estimated the prevalence of daily and high-potency cannabis use in controls as a proxy for usage in the population at-risk; multiple imputations by chained equations and poststratification weighting handled missing data and control representativeness, respectively. We modeled FEP incidence in random intercepts negative binomial regression models to investigate associations with the prevalence of cannabis use in controls, unemployment, and owner-occupancy in each setting, controlling for population density, age, sex, and migrant/ethnic group.
STUDY RESULTS
RESULTS
Lower owner-occupancy was independently associated with increased FEP (adjusted incidence rate ratio [aIRR]: 0.76, 95% CI: 0.61-0.95) and non-affective psychosis incidence (aIRR: 0.68, 95% CI: 0.55-0.83), after multivariable adjustment. Prevalence of daily cannabis use in controls was associated with the incidence of affective psychoses (aIRR: 1.53, 95% CI: 1.02-2.31). We found no association between FEP incidence and unemployment or high-potency cannabis use prevalence. Sensitivity analyses supported these findings.
CONCLUSIONS
CONCLUSIONS
Lower setting-level owner-occupancy and increased prevalence of daily cannabis use in controls independently contributed to setting-level variance in the incidence of different psychotic disorders. Public health interventions that reduce exposure to these harmful environmental factors could lower the population-level burden of psychotic disorders.
Identifiants
pubmed: 38788048
pii: 7681791
doi: 10.1093/schbul/sbae072
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : European Community's Seventh Framework Program
ID : HEALTH-F2-2010-241909
Organisme : São Paulo Research Foundation
ID : 2012/0417-0
Organisme : University Medical Centre Groningen
ID : 18-41
Organisme : NIHR UCLH BRC
Organisme : Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III
Organisme : European Union
Organisme : European Commission
Organisme : European Union-NextGenerationEU
ID : PMP21/00051
Organisme : CIBERSAM
Organisme : Madrid Regional Government (B2017/BMD-3740 AGES-CM-2)
Organisme : European Union Structural Funds
Organisme : European Union Seventh Framework Program
Organisme : European Union H2020 Program
Organisme : Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2
ID : 101034377
Organisme : Project AIMS-2-TRIALS
ID : 777394
Organisme : Horizon Europe
Organisme : National Institute of Mental Health of the National Institutes of Health
ID : 1U01MH124639-01
Organisme : Fundación Familia Alonso
Organisme : Fundación Alicia Koplowitz
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.