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Link to original content: https://doi.org/10.1007/s00127-007-0193-0
Neighbourhood variation in the incidence of psychotic disorders in Southeast London | Social Psychiatry and Psychiatric Epidemiology Skip to main content
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Neighbourhood variation in the incidence of psychotic disorders in Southeast London

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Abstract

Background

Urbanicity is a risk factor for schizophrenia, but it is unclear whether this risk is homogenous across urban areas.

Aims

To determine whether the incidence of psychotic disorders varied within an urban area, beyond variation attributable to individual-level characteristics.

Methods

All incident cases of ICD-10 psychoses from a large, 2-year, epidemiological study of first-episode psychoses in Southeast London were identified. Incidence rates for 33 wards were standardised for age, sex and ethnicity. Bayesian models produced accurate relative risk estimates that were then mapped.

Results

295 cases were identified during 565,000 person-years of follow-up. We observed significant heterogeneity in relative risks for broad and non-affective psychoses (schizophrenia), but not for affective psychoses. Highest risks were observed in contiguous wards.

Conclusions

Neighbourhood variation in the incidence of non-affective psychoses could not be explained by individual-level risk, implicating neighbourhood-level socioenvironmental factors in their aetiology. The findings are consistent with classical sociological models of mental disorders.

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References

  1. 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. Br J Psychiatry 187:401–406

    Article  PubMed  Google Scholar 

  2. Besag J, York J, Mollie A (1991) Bayesian image restoration, with application in spatial statistics with discussion. Ann Inst Stat Math 43:1–59

    Article  Google Scholar 

  3. Boydell J, van Os J, McKenzie K, et al. (2001) Incidence of schizophrenia in ethnic minorities in London: ecological study into interactions with environment. Br Med J 323:1336–1338

    Article  CAS  Google Scholar 

  4. Cannon M, Clarke MC (2005) Risk for schizophrenia – broadening the concepts, pushing back the boundaries. Schizophr Res 79:5–13

    Article  PubMed  Google Scholar 

  5. Crow TJ (2000) Schizophrenia as the price that homo sapiens pays for language: a resolution of the central paradox in the origin of the species. Brain Res Rev 31:118–129

    Article  PubMed  CAS  Google Scholar 

  6. Faris REL, Dunham HW (1939) Mental disorders in urban areas. University of Chicago Press, Chicago

    Google Scholar 

  7. Harrison G, Brewin J, Cantwell R, et al. (1996) The increased risk of psychosis in African-Caribbean migrants to the UK: a replication. Schizophr Res 18:102

    Article  Google Scholar 

  8. Harrison G, Gunnell D, Glazebrook C, Page K, Kwiecinski R (2001) Association between schizophrenia and social inequality at birth: case-control study. Br J Psychiatry 179:346–350

    Article  PubMed  CAS  Google Scholar 

  9. Haukka J, Suvisaari J, Varilo T, Lonnqvist J (2001) Regional variation in the incidence of schizophrenia in Finland: a study of birth cohorts born from 1950 to 1969. Psychol Med 31:1045–1053

    Article  PubMed  CAS  Google Scholar 

  10. Jablensky A, Sartorius N, Ernberg G, et al. (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 20:1–97

    Article  PubMed  CAS  Google Scholar 

  11. Kirkbride JB, Fearon P, Morgan C, et al. (2006) Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings From the 3-center ÆSOP study. Arc Gen Psychiatry 63:250–258

    Article  Google Scholar 

  12. Kirkwood BR, Sterne JAC (2003) Essential medical statistics. Blackwell, Malden, MA

    Google Scholar 

  13. Lawson AB, Browne W, Vidal Rodeiro CL (2003) Disease mapping with WinBUGS and MLwiN. Wiley & Sons, Chichester

    Google Scholar 

  14. Lawson AB, Clark A (2002) Spatial mixture relative risk models applied to disease mapping. Stat Med 21:359–370

    Article  PubMed  Google Scholar 

  15. Lewis G, David A, Andreasson S, Allebeck P (1992) Schizophrenia and city life. Lancet 340:137–140

    Article  PubMed  CAS  Google Scholar 

  16. MRC (2004) winBUGS. MRC Biostatistics Unit, Cambridge

    Google Scholar 

  17. Martuzzi M, Hills M (1995) Estimating the degree of heterogeneity between event rates using likelihood. Am J Epidemiol 141:369–374

    Article  PubMed  CAS  Google Scholar 

  18. McGovern D, Cope RV (1987) First psychiatric admission rates of first and second generation Afro Caribbeans. Soc Psychiatr 22:139–149

    Article  CAS  Google Scholar 

  19. Mollie A (1996) Bayesian mapping of disease. In: Gilks WR, Richardson S, Spiegelhalter DJ (eds) Markov chain Monte Carlo in practice. Chapman and Hall, London, pp 359–379

    Google Scholar 

  20. Mortensen PB, Pedersen CB, Melbye M, Mors O, Ewald H (2003) Individual and familial risk factors for bipolar affective disorders in Denmark. Arch Gen Psychiatry 60:1209–1215

    Article  PubMed  Google Scholar 

  21. Mortensen PB, Pedersen CB, Westergaard T, et al. (1999) Effects of family history and place and season of birth on the risk of schizophrenia. New Engl J Med 340:603–608

    Article  PubMed  CAS  Google Scholar 

  22. van Os J, Driessen G, Gunther N, Delespaul P (2000) Neighbourhood variation in incidence of schizophrenia. Evidence for person–environment interaction. Br J Psychiatry 176:243–248

    Article  PubMed  Google Scholar 

  23. Pedersen CB, Mortensen PB (2001) Evidence of a dose–response relationship between urbanicity during upbringing and schizophrenia risk. Arch Gen Psychiatry 58:1039–1046

    Article  PubMed  CAS  Google Scholar 

  24. Pedersen CB, Mortensen PB (2006) Urbanicity during upbringing and bipolar affective disorders in Denmark. Bipolar Disord 8:242–247

    Article  PubMed  Google Scholar 

  25. Pereira R (2002) The census coverage survey - the key element of a one number Census. Office for National Statistics, Titchfield

    Google Scholar 

  26. Richardson S, Thomson A, Best N, Elliott P (2004) Interpreting posterior relative risk estimates in disease-mapping studies. Environ Health Perspect 112:1016–1025

    PubMed  Google Scholar 

  27. Scully PJ, Owens JM, Kinsella A, Waddington JL (2004) Schizophrenia, schizoaffective and bipolar disorder within an epidemiologically complete, homogeneous population in rural Ireland: small area variation in rate. Schizophr Res 67:143–155

    Article  PubMed  Google Scholar 

  28. Silver E, Mulvey EP, Swanson JW (2002) Neighborhood structural characteristics and mental disorder: Faris and Dunham revisited. Soc Sci Med 55:1457–1470

    Article  PubMed  Google Scholar 

  29. Spiegelhalter DJ, Best N, Carlin BP, van der Linde A (2002) Bayesian measures of model complexity and fit. J R Stat Soc Ser B Stat Methodol 64:583–640

    Article  Google Scholar 

  30. StataCorp (2005) Stata. StataCorp, College Station, Texas

    Google Scholar 

  31. Sundquist K, Frank G, Sundquist J (2004) Urbanisation and incidence of psychosis and depression: follow-up study of 4.4 million women and men in Sweden. Br J Psychiatry 184:293–298

    Article  PubMed  Google Scholar 

  32. Torrey EF, Mortensen PB, Pedersen CB, Wohlfahrt J, Melbye M (2001) Risk factors and confounders in the geographical clustering of schizophrenia. Schizophr Res 49:295–299

    Article  PubMed  CAS  Google Scholar 

  33. Tsuang MT, Tohen M, Zahner GEP (1995) Textbook in psychiatric epidemiology. John Wiley & Sons, New York

    Google Scholar 

  34. Wakefield J, Best N, Waller L (2001) Bayesian approaches to disease mapping. In: Elliott P, Wakefield J, Best N, Briggs D (eds) Spatial epidemiology: methods and applications. Oxford University Press, Oxford

  35. Wakefield JC, Kelsall JE, Morris SE (2001) Clustering, cluster detection and spatial variation in risk. In: Elliott P, Wakefield JC, Best N, Briggs D (eds) Spatial epidemiology: methods and applications. Oxford University Press, Oxford

  36. Weich S, Holt G, Twigg L, Jones K, Lewis G (2003) Geographic variation in the prevalence of common mental disorders in Britain: a multilevel investigation. Am J Epidemiol 157:730–737

    Article  PubMed  Google Scholar 

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Author information

Author notes

  1. Kevin Morgan

    Present address: Dept. of Psychology, University of Westminster, London, UK

Authors and Affiliations

  1. Dept. of Psychiatry, University of Cambridge, Box 189, Cambridge, CB2 2QQ, UK

    James B. Kirkbride & Peter B. Jones

  2. Division of Psychological Medicine, Institute of Psychiatry, King’s College, London, UK

    Paul Fearon, Craig Morgan, Paola Dazzan, Kevin Morgan & Robin M. Murray

Authors
  1. James B. Kirkbride
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  2. Paul Fearon
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  3. Craig Morgan
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  4. Paola Dazzan
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  5. Kevin Morgan
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  6. Robin M. Murray
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  7. Peter B. Jones
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Corresponding author

Correspondence to James B. Kirkbride.

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Kirkbride, J.B., Fearon, P., Morgan, C. et al. Neighbourhood variation in the incidence of psychotic disorders in Southeast London. Soc Psychiat Epidemiol 42, 438–445 (2007). https://doi.org/10.1007/s00127-007-0193-0

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