Stress and emotional arousal in urban environments: A biosocial study with persons having experienced a first-episode of psychosis and persons at risk

Bane or boon regarding urbanicity and psychotic spectrum disorders: a scoping review of current evidence

“…Xie et al [18 ▪ ], however, found that urban birth in particular was associated with an increased risk of FES after controlling for intelligence quotient (IQ). For individuals at high risk for psychosis, there were no significant associations found between urbanicity and neuroimaging correlates [27 ▪ ], but features of the urban environment were still a source of significant stressors for those with FEP and at-risk mental state [40 ▪▪ ].…”

“…Hectic and busy features of the urban environment such as construction sites were also perceived to restrict the ability of people with schizophrenia to move freely, causing a sense of anxiety and lack of control [16 ▪▪ ]. Pedestrians, cars, bikes, and scooters also contributed to varying sources of stress within urban environments [40 ▪▪ ].…”

“…Apart from objective features of the urban environment, one's individual perception of them had been found to contribute to, or mitigate stress, which in turn attenuated the risk of psychosis [16 ▪▪ ,40 ▪▪ ]. Features of the urban environment that were perceived as hectic (e.g., construction sites [16 ▪▪ ], heavy traffic [40 ▪▪ ]) gave rise to anxiety, a sense of lack of control, and paranoid feelings in patients with psychosis [16 ▪▪ ]. These places were perceived as stressful because of the need for greater attention focus and a fear of making the wrong move [40 ▪▪ ].…”

“…Features of the urban environment that were perceived as hectic (e.g., construction sites [16 ▪▪ ], heavy traffic [40 ▪▪ ]) gave rise to anxiety, a sense of lack of control, and paranoid feelings in patients with psychosis [16 ▪▪ ]. These places were perceived as stressful because of the need for greater attention focus and a fear of making the wrong move [40 ▪▪ ]. The detached nature of urban environments, with features such as anonymous buildings, were also reported to give rise to a sense of alienation, which could trigger paranoid delusions in those susceptible to psychosis [16 ▪▪ ].…”

“…Four studies focused on patients with first-episode psychosis (FEP) or schizophrenia (FES) [18 ▪ ,25 ▪ ,26 ▪ ,29 ▪ ], one study on patients with chronic high risk of psychosis [27 ▪ ], and one study focused on both FEP and at-risk mental state individuals [40 ▪▪ ]. Five studies were conducted on individuals with psychotic-like experiences (PE) [11 ▪ ,12 ▪ ,23 ▪ ,30 ▪ ,36 ▪ ].…”