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Neighbourhood characteristics and the incidence of first-episode psychosis and duration of untreated psychosis

Published online by Cambridge University Press:  05 February 2016

B. O'Donoghue ,
J. P. Lyne ,
L. Renwick ,
A. Lane ,
K. Madigan ,
A. Staines ,
E. O'Callaghan  and
M. Clarke
B. O'Donoghue*
Affiliation:
The Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
J. P. Lyne
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland North Dublin Mental Health Services, Beaumont Road, Dublin, Republic of Ireland
L. Renwick
Affiliation:
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
A. Lane
Affiliation:
Department of Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland
K. Madigan
Affiliation:
DETECT, Early Intervention for Psychosis Service, Blackrock, Dublin, Republic of Ireland
A. Staines
Affiliation:
School of Nursing and Human Services, Dublin City University, Dublin, Republic of Ireland
E. O'Callaghan*
Affiliation:
Department of Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland DETECT, Early Intervention for Psychosis Service, Blackrock, Dublin, Republic of Ireland
M. Clarke
Affiliation:
Department of Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland DETECT, Early Intervention for Psychosis Service, Blackrock, Dublin, Republic of Ireland
*
*Address for correspondence: B. O'Donoghue, MRCPsych Ph.D., University of Melbourne, Melbourne, VIC, Australia. (Email: briannoelodonoghue@gmail.com)
†Deceased.
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Abstract

Background

The incidence of psychotic disorders varies between geographical areas and it has been hypothesized that neighbourhood-level factors may influence this variation. It is also plausible that the duration of untreated psychosis (DUP) is associated with neighbourhood characteristics. The aims of this study were to determine whether the incidence of first-episode psychosis (FEP) and the DUP are associated with the level of social deprivation, fragmentation, social capital and population density.

Method

All individuals with a FEP from a geographical defined catchment area over a 5-year period were included. Age-standardized incidence rates were calculated for each neighbourhood factor.

Results

A total of 292 cases of FEP were included in the study and 45% had a diagnosis of a schizophrenia-spectrum disorder. The age standardized incidence rate of FEP in the most deprived area was 72.4 [95% confidence interval (CI) 26.4–162.7] per 100 000 person-years compared with 21.5 (95% CI 17.6–26.0) per 100 000 person-years in the most affluent areas. This represents a 3.4-fold increase in FEP incidence in the most deprived areas. The incidence of FEP was also increased in neighbourhoods that were more socially fragmented [incidence rate ratio (IRR) = 2.40, 95% CI 1.05–5.51, p = 0.04] and there was a trend for the incidence to be increased in neighbourhoods with lower social capital (IRR = 1.43, 95% CI 0.99–2.06, p = 0.05). The median DUP was 4 months and was higher in more socially fragmented neighbourhoods.

Conclusions

The incidence of psychotic disorders is related to neighbourhood factors and it may be useful to consider neighbourhood factors when allocating resources for early intervention services.

Keywords

Duration of untreated psychosisincidencepsychosisschizophreniasocial deprivation
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 7 , May 2016 , pp. 1367 - 1378
Copyright
Copyright © Cambridge University Press 2016 

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References

Allardyce, J, Boydell, J (2006). Review: the wider social environment and schizophrenia. Schizophrenia Bulletin 32, 592–598.CrossRefGoogle ScholarPubMed
Allardyce, J, Gilmour, H, Atkinson, J, Rapson, T, Bishop, J, McCreadie, RG (2005). Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses. British Journal of Psychiatry 187, 401–406.CrossRefGoogle ScholarPubMed
Anderson, KK, Fuhrer, R, Abrahamowicz, M, Malla, AK (2012). The incidence of first-episode schizophrenia-spectrum psychosis in adolescents and young adults in Montreal: an estimate from an administrative claims database. Canadian Journal of Psychiatry 57, 626–633.CrossRefGoogle Scholar
Anderson, KK, Fuhrer, R, Malla, AK (2010). The pathways to mental health care of first-episode psychosis patients: a systematic review. Psychological Medicine 40, 1585–1597.CrossRefGoogle ScholarPubMed
Beiser, M, Erickson, D, Fleming, JA, Iacono, WG (1993). Establishing the onset of psychotic illness. American Journal of Psychiatry 150, 1349–1354.Google ScholarPubMed
Betts, KS, Williams, GM, Najman, JM, Scott, J, Alati, R (2014). Maternal prenatal infection, early susceptibility to illness and adult psychotic experiences: a birth cohort study. Schizophrenia Research 156, 161–167.CrossRefGoogle ScholarPubMed
Bhavsar, V, Boydell, J, Murray, R, Power, P (2014). Identifying aspects of neighbourhood deprivation associated with increased incidence of schizophrenia. Schizophrenia Research 156, 115–121.CrossRefGoogle ScholarPubMed
Boydell, J, Van, Os J, McKenzie, K, Murray, RM (2004). The association of inequality with the incidence of schizophrenia – an ecological study. Social Psychiatry and Psychiatric Epidemiology 39, 597–599.CrossRefGoogle ScholarPubMed
Brown, DR, Gary, LE, Greene, AD, Milburn, NG (1992). Patterns of social affiliation as predictors of depressive symptoms among urban blacks. Journal of Health and Social Behaviour 33, 242–253.CrossRefGoogle ScholarPubMed
Congdon, P (1996). Suicide and parasuicide in London: a small-area study. Urban Studies 33, 137–158.CrossRefGoogle Scholar
Croudace, TJ, Kayne, R, Jones, PB, Harrison, GL (2000). Non-linear relationship between an index of social deprivation, psychiatric admission prevalence and the incidence of psychosis. Psychological Medicine 30, 177–185.CrossRefGoogle Scholar
De Silva, MJ, McKenzie, K, Harpham, T, Huttly, SR (2005). Social capital and mental illness: a systematic review. Journal of Epidemiology and Community Health 59, 619–627.CrossRefGoogle ScholarPubMed
Di Forti, M, Morgan, C, Dazzan, P, Pariante, C, Mondelli, V, Marques, TR, Handley, R, Luzi, S, Russo, M, Paparelli, A, Butt, A, Stilo, SA, Wiffen, B, Powell, J, Murray, RM (2009). High-potency cannabis and the risk of psychosis. British Journal of Psychiatry 195, 488–491.CrossRefGoogle ScholarPubMed
First, M, Spitzer, R, Gibbon, M, Williams, J (2002). Structured Clinical Interview for the DSM-IV Axis I Disorders, Research Version, Patient Edition (SCI-I/P). Biometric Research, New York State Psychiatric Institute: New York.Google Scholar
Haase, T, Pratschke, J (2012). The Pobal HP Deprivation Index (https://www.pobal.ie).Accessed December 2015.Google Scholar
Hahn, LA, Galletly, CA, Foley, DL, MacKinnon, A, Watts, GF, Castle, DJ, Waterreus, A, Morgan, VA (2014). Inadequate fruit and vegetable intake in people with psychosis. Australian and New Zealand Journal of Psychiatry 48, 1025–1035.CrossRefGoogle ScholarPubMed
Jackson, H, McGorry, P (2009). The Recognition and Management of Early Psychosis. A Preventive Approach. Cambridge University Press: Cambridge, UK.CrossRefGoogle Scholar
Kelly, BD, O'Callaghan, E, Waddington, JL, Feeney, L, Browne, S, Scully, PJ, Clarke, M, Quinn, JF, McTigue, O, Morgan, MG, Kinsella, A, Larkin, C (2010). Schizophrenia and the city: a review of literature and prospective study of psychosis and urbanicity in Ireland. Schizophrenia Research 116, 75–89.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Boydell, J, Ploubidis, GB, Morgan, C, Dazzan, P, McKenzie, K, Murray, RM, Jones, PB (2008). Testing the association between the incidence of schizophrenia and social capital in an urban area. Psychological Medicine 38, 1083–1094.CrossRefGoogle Scholar
Kirkbride, JB, Errazuriz, A, Croudace, TJ, Morgan, C, Jackson, D, Boydell, J, Murray, RM, Jones, PB (2012). Incidence of schizophrenia and other psychoses in England, 1950–2009: a systematic review and meta-analyses. PLOS ONE 7, e31660.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Fearon, P, Morgan, C, Dazzan, P, Morgan, K, Murray, RM, Jones, PB (2007 a). Neighbourhood variation in the incidence of psychotic disorders in Southeast London. Social Psychiatry and Psychiatric Epidemiology 42, 438–445.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Jackson, D, Perez, J, Fowler, D, Winton, F, Coid, JW, Murray, RM, Jones, PB (2013). A population-level prediction tool for the incidence of first-episode psychosis: translational epidemiology based on cross-sectional data. BMJ Open 3, e001998.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Jones, PB (2014). Parity of esteem begins at home: translating empirical psychiatric research into effective public mental health. Psychological Medicine 44, 1569–1576.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Lunn, DJ, Morgan, C, Lappin, JM, Dazzan, P, Morgan, K, Fearon, P, Murray, RM, Jones, PB (2010). Examining evidence for neighbourhood variation in the duration of untreated psychosis. Health Place 16, 219–225.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Morgan, C, Fearon, P, Dazzan, P, Murray, RM, Jones, PB (2007 b). Neighbourhood-level effects on psychoses: re-examining the role of context. Psychological Medicine 37, 1413–1425.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Stochl, J, Zimbron, J, Crane, CM, Metastasio, A, Aguilar, E, Webster, R, Theegala, S, Kabacs, N, Jones, PB, Perez, J (2015). Social and spatial heterogeneity in psychosis proneness in a multilevel case–prodrome–control study. Acta Psychiatrica Scandinavica 132, 283–292.CrossRefGoogle Scholar
Lloyd-Evans, B, Crosby, M, Stockton, S, Pilling, S, Hobbs, L, Hinton, M, Johnson, S (2011). Initiatives to shorten duration of untreated psychosis: systematic review. British Journal of Psychiatry 198, 256–263.CrossRefGoogle ScholarPubMed
Marshall, M, Lewis, S, Lockwood, A, Drake, R, Jones, P, Croudace, T (2005). Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Archives of General Psychiatry 62, 975–983.CrossRefGoogle ScholarPubMed
McGrath, J, Saha, S, Welham, J, El Saadi, O, MacCauley, C, Chant, D (2004). A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Medicine 2, 13.CrossRefGoogle ScholarPubMed
McKenzie, K, Whitley, R, Weich, S (2002). Social capital and mental health. British Journal of Psychiatry 181, 280–283.CrossRefGoogle ScholarPubMed
Mortensen, PB (2000). Urban–rural differences in the risk for schizophrenia. International Journal of Mental Health 29, 101–110.CrossRefGoogle Scholar
O'Donoghue, B, Lyne, J, Renwick, L, Madigan, K, Kinsella, A, Clarke, M, Turner, N, O'Callaghan, E (2012). A descriptive study of ‘non-cases’ and referral rates to an early intervention for psychosis service. Early Intervention in Psychiatry 6, 276–282.CrossRefGoogle Scholar
O'Donoghue, B, Nelson, B, Yuen, HP, Lane, A, Wood, S, Thompson, A, Lin, A, McGorry, P, Yung, AR (2015). Social environmental risk factors for transition to psychosis in an ultra-high risk population. Schizophrenia Research 161, 150–155.CrossRefGoogle Scholar
Omer, S, Kirkbride, JB, Pringle, DG, Russell, V, O'Callaghan, E, Waddington, JL (2014). Neighbourhood-level socio-environmental factors and incidence of first episode psychosis by place at onset in rural Ireland: the Cavan–Monaghan First Episode Psychosis Study [CAMFEPS]. Schizophrenia Research 152, 152–157.CrossRefGoogle Scholar
Sariaslan, A, Larsson, H, D'Onofrio, B, Langstrom, N, Fazel, S, Lichtenstein, P (2015). Does population density and neighborhood deprivation predict schizophrenia? A nationwide Swedish family-based study of 2.4 million individuals. Schizophrenia Bulletin 41, 494–502.CrossRefGoogle ScholarPubMed
Van Os, J, Driessen, G, Gunther, N, Delespaul, P (2000). Neighbourhood variation in incidence of schizophrenia. Evidence for person–environment interaction. British Journal of Psychiatry 176, 243–248.CrossRefGoogle ScholarPubMed
Werner, S, Malaspina, D, Rabinowitz, J (2007). Socioeconomic status at birth is associated with risk of schizophrenia: population-based multilevel study. Schizophrenia Bulletin 33, 1373–1378.CrossRefGoogle ScholarPubMed
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