Psychology Chapter on Social Epidemiology

Social Epidemiology of Psychosis

• Social epidemiology studies the social distribution and determinants of health.
• Highest rates of psychosis are observed in inner-city areas, characterized by social disorganization and isolation.
• Major cities globally (e.g., Chicago, Ireland, London) show higher rates.

Migration and Psychosis Risk

• Income is a confounding factor in studies of migration and psychosis.
• People with a history of migration have a higher risk for psychosis.
• The context of migration (e.g., Australia, Canada) differs, with significantly easier immigration processes.
• The risk ratio for schizophrenia and immigrant status is 2.9.
• Potential confounders include gender, childhood trauma, and cannabis use.

Ethnicity and Psychosis Risk

• Income acts as a mediator in the relationship between ethnicity and psychosis.
• Conditioning mediators bias the overall causal effect.
• Additional mediators include education, linguistic differences, and discrimination.
• Psychosocial disempowerment (often exacerbated by minority status) is a key factor.
• Unmeasured confounding affecting both the mediator and the outcome is possible, even after controlling for mediators.

EU-GEI Case Study

• The study examined 1,130 first-episode psychosis (FEP) cases and 1,479 controls across five European countries (Brazil, UK, Netherlands, Spain, Italy).
• Factors studied included social distance (education, parental socioeconomic status, social isolation) and cultural/linguistic characteristics (using language trees and fluency).
• Age, sex, childhood trauma, and cannabis use were controlled for.
• The study also controlled for social distance.

Urbanicity and Psychosis

• Higher rates of schizophrenia are seen in urban centres like London.
• Possible reverse causality; non-affective psychotic disorders might increase urban residence (e.g., people seeking treatment).
• To avoid this, psychosis symptoms should be assessed at a young age.
• People experiencing psychotic symptoms might move to cities for treatment.

Explore the intricate relationships between social factors and psychosis in this quiz on social epidemiology. Delve into how migration, ethnicity, and socio-economic status influence psychotic disorders, with insights from major cities around the world. Test your understanding of these crucial determinants of mental health.