Psychosis Risk: Social and Ethnic Factors

Social Epidemiology of Psychosis

• Focuses on the social distribution and determinants of health, specifically psychosis.
• High rates are found in inner-city areas, characterized by social disorganization and isolation.
• Major urban centers, such as Chicago, Ireland, and London, show elevated rates.

Migration and Psychosis Risk

• Income is a confounding factor.
• Individuals with a migrant history have a higher risk of psychosis.
• The migration context differs significantly between countries like Australia and Canada, where immigration is more accessible.
• The risk ratio for schizophrenia and immigrant status is 2.9.
• Factors like gender, childhood trauma, and cannabis use are potential confounders needing adjustment.

Ethnicity and Psychosis Risk

• Income acts as a mediator in the relationship between ethnicity and psychosis.
• Mediators, such as education, linguistic distance, and discrimination, influence the impact of ethnicity.
• Psychosocial disempowerment due to minority status may contribute.
• Unobserved confounding, impacting both the mediator and outcome, could occur even with mediator adjustment.

EU-GEI Case Study

• Investigated 1130 first-episode psychosis (FEP) cases and 1479 controls from Brazil, UK, Netherlands, Spain, and Italy.
• Factors assessed included social distance (education, parental socioeconomic status, social isolation) and cultural/linguistic aspects (language trees and fluency).
• Data were adjusted for age, sex, childhood trauma, cannabis use, and social distance.

Urbanicity and Psychosis

• Higher rates of schizophrenia are observed in urban centers like London.
• Reverse causality is a potential concern, where non-affective psychotic disorders might push individuals towards urban areas for treatment, potentially skewing results.
• Measuring symptoms at an early age helps mitigate reverse causality.
• Individuals experiencing psychotic symptoms might relocate to urban areas for treatment.

This quiz explores the social epidemiology of psychosis, focusing on the impact of migration, income, and ethnicity on mental health. It discusses key findings from urban areas and the role of psychosocial factors in determining risk levels. Test your understanding of the intricate relationships between these variables.