Persons with schizophrenia migrate towards urban areas due to the development of their disorder or its prodromata

Pedersen, Carsten Bøcker

doi:10.1016/j.schres.2015.08.028

Cited by 28 publications

(27 citation statements)

References 38 publications

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“…The association between urbanicity and TRS could also to some extend be explained by selective migration towards more urban areas due to the development of the disorder or its prodomata (Pedersen, 2015;Freeman, 1994).…”

Section: Other Potential Explanationsmentioning

confidence: 99%

“…This finding was invariant to the definition used for urban exposure (population size or density); whether urbanicity was determined at birth, upbringing, schizophrenia diagnosis, or interview; and whether based on cohort or cross-sectional study designs (March et al, 2008;Pedersen, 2006Pedersen, , 2015Pedersen and Mortensen, 2001a;Torrey et al, 1997).…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Inverse association between urbanicity and treatment resistance in schizophrenia

Wimberley

Pedersen

MacCabe

et al. 2016

Schizophrenia Research

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Section: Other Potential Explanationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Inverse association between urbanicity and treatment resistance in schizophrenia

Wimberley

Pedersen

MacCabe

et al. 2016

Schizophrenia Research

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“… 1 The association between urbanicity and psychosis has been frequently replicated, 2–10 shows a degree of specificity to non-affective psychoses, 4 , 7 , 11 , 12 and is not explained by a range of potential confounding factors 2 , 13–15 including migration of individuals with schizophrenia into cities. 16 These converging lines of evidence suggest that the association between urbanicity and psychosis has genuine aetiological underpinnings, 16–19 though the mechanisms driving the association are currently unknown. Urbanicity is therefore a key area for psychosis research, considering that over two-thirds of the world’s population are predicted to live in cities by 2050.…”

Section: Introductionmentioning

confidence: 99%

Why Are Children in Urban Neighborhoods at Increased Risk for Psychotic Symptoms? Findings From a UK Longitudinal Cohort Study

Newbury

Arseneault

Caspi

et al. 2016

SCHBUL

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Background:Urban upbringing is associated with a 2-fold adulthood psychosis risk, and this association replicates for childhood psychotic symptoms. No study has investigated whether specific features of urban neighborhoods increase children’s risk for psychotic symptoms, despite these early psychotic phenomena elevating risk for schizophrenia and other psychiatric disorders in adulthood.Methods:Analyses were conducted on over 2000 children from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of UK-born twins. Neighborhood-level characteristics were assessed for each family via: a geodemographic discriminator indexing neighborhood-level deprivation, postal surveys of over 5000 residents living alongside the children, and in-home interviews with the children’s mothers. Children were interviewed about psychotic symptoms at age 12. Analyses were adjusted for important family-level confounders including socioeconomic status (SES), psychiatric history, and maternal psychosis.Results:Urban residency at age-5 (OR = 1.80, 95% CI = 1.16–2.77) and age-12 (OR = 1.76, 95% CI = 1.15–2.69) were both significantly associated with childhood psychotic symptoms, but not with age-12 anxiety, depression, or antisocial behavior. The association was not attributable to family SES, family psychiatric history, or maternal psychosis, each implicated in childhood mental health. Low social cohesion, together with crime victimization in the neighborhood explained nearly a quarter of the association between urbanicity and childhood psychotic symptoms after considering family-level confounders.Conclusions:Low social cohesion and crime victimization in the neighborhood partly explain why children in cities have an elevated risk of developing psychotic symptoms. Greater understanding of the mechanisms leading from neighborhood-level exposures to psychotic symptoms could help target interventions for emerging childhood psychotic symptoms.

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“…Persons born and raised in urban areas have an approximately two-fold increased risk of schizophrenia compared to those born and raised in rural areas 3,4 . Researchers have rigorously examined potentially causal elements of urban upbringing, such as accessibility to health care 3,5 , selective migration of individuals 6 , airpollution 7 , infections 8 , and socioeconomic inequality 9 . None of these candidate elements explain a substantial amount of the urbanicity-related increase in risk 3,[6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…Researchers have rigorously examined potentially causal elements of urban upbringing, such as accessibility to health care 3,5 , selective migration of individuals 6 , airpollution 7 , infections 8 , and socioeconomic inequality 9 . None of these candidate elements explain a substantial amount of the urbanicity-related increase in risk 3,[6][7][8][9] . The conditional relationship between genetic liabilities and environmental factors are even harder to detect despite some cohort studies suggesting an interaction between urban upbringing and family history of schizophrenia [10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Spatial gene-by-environment mapping for schizophrenia reveals locale of upbringing effects beyond urban-rural differences

McGrath

Appadurai

et al. 2018

Preprint

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Identification of mechanisms underlying the incidence of psychiatric disorders has been hampered by the difficulty in discovering highly-predictive environmental risk factors. For example, prior efforts have failed to establish environmental effects predicting geospatial clustering of schizophrenia incidence beyond urban-rural differences. Here, we employ a novel statistical framework for decomposing the geospatial risk for schizophrenia based on locale of upbringing (place of residence, ages 0-7 years) and its synergistic effects with genetic liabilities (polygenic risk for schizophrenia). We use this statistical framework to analyze unprecedented geolocation and genotyping data in a case-cohort study of n=24,028 subjects, drawn from the 1.47 million Danish persons born between 1981 and 2005. Using this framework we estimate the effects of upbringing locale (E) and gene-by-locale interactions (GxE). After controlling for potential confounding variables, upbringing at high-risk locales increases the risk for schizophrenia on average by 122%, while GxE modulates genetic risk for schizophrenia on average by 78%. Within the boundaries of Copenhagen (the largest and most densely populated city of Denmark) specific locales vary substantially in their E and GxE effects, with hazard ratios ranging from 0.26 to 9.26 for E and from 0.20 to 5.95 for GxE. This study provides insight into the degree of geospatial clustering of schizophrenia risk, and our novel analytic procedure provides a framework for decomposing variation in geospatial risk into G, E, and GxE components.

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Persons with schizophrenia migrate towards urban areas due to the development of their disorder or its prodromata

Cited by 28 publications

References 38 publications

Inverse association between urbanicity and treatment resistance in schizophrenia

Inverse association between urbanicity and treatment resistance in schizophrenia

Why Are Children in Urban Neighborhoods at Increased Risk for Psychotic Symptoms? Findings From a UK Longitudinal Cohort Study

Spatial gene-by-environment mapping for schizophrenia reveals locale of upbringing effects beyond urban-rural differences

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