Psychosis Risk: Social and Ethnic Factors

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Questions and Answers

What is a significant finding regarding the social epidemiology of psychosis?

  • Higher rates occur in socially organized communities.
  • Higher rates are found in rural areas.
  • Rates are uniform across all types of communities.
  • Major cities exhibit the highest rates of psychosis. (correct)

What role does income play in the context of migration and psychosis risk?

  • Income acts as a main determinant without confounding effects.
  • Income mediates the effects of childhood trauma on psychosis.
  • Income is unrelated to psychosis risk in migrants.
  • Income serves as a confounder for psychosis risk among migrants. (correct)

Which of the following factors is NOT considered a confounder in the study of immigrant status and psychosis risk?

  • Gender
  • Ethnic background (correct)
  • Childhood trauma
  • Cannabis use

In the context of social epidemiology, which of the following is a psychosocial disempowerment factor linked to minority status?

<p>Linguistic distance from the dominant language (D)</p> Signup and view all the answers

What is the relationship between urbanicity and schizophrenia according to the findings?

<p>Schizophrenia leads people to migrate to urban areas for treatment. (B)</p> Signup and view all the answers

What is the risk ratio for schizophrenia related to immigrant status?

<p>2.9 (C)</p> Signup and view all the answers

Which factor is NOT identified as a mediator in the research on ethnicity and psychosis?

<p>Income inequality (B)</p> Signup and view all the answers

Which city is mentioned as having higher rates of schizophrenia due to urbanicity?

<p>London (D)</p> Signup and view all the answers

What does psychosocial disempowerment indicate in the context of ethnicity and psychosis risk?

<p>A decrease in educational opportunities (B)</p> Signup and view all the answers

What adjustment factors were included in the EU-GEI case study related to social distance?

<p>Age, sex, childhood trauma, cannabis use, and social distance (D)</p> Signup and view all the answers

What characteristic is commonly observed in areas with the highest rates of psychosis?

<p>Social disorganization (B)</p> Signup and view all the answers

How does migration impact the risk of psychosis according to the findings?

<p>Migrant history is associated with higher psychosis risk (D)</p> Signup and view all the answers

Which factor is considered a conditioning mediator in the context of ethnicity and psychosis?

<p>Education (A)</p> Signup and view all the answers

What reverse causality issue is suggested in the study of urbanicity and non-affective psychotic disorders?

<p>Psychotic symptoms can motivate relocation to urban centers for treatment (B)</p> Signup and view all the answers

Which group exhibited a social distance in the EU-GEI case study that could influence psychosis risk?

<p>Participants isolated from educational resources (D)</p> Signup and view all the answers

What social characteristic is associated with higher rates of psychosis in urban areas?

<p>Increased social disorganization (A)</p> Signup and view all the answers

Which factor is identified as a mediator affecting the relationship between ethnicity and psychosis risk?

<p>Discrimination (C)</p> Signup and view all the answers

In the context of migration, which of the following is a confounding factor that may influence psychosis risk?

<p>Gender (D)</p> Signup and view all the answers

What is one potential consequence of reverse causality observed in studies of urbanicity and psychotic disorders?

<p>Those with psychotic symptoms seeking treatments in urban centers (D)</p> Signup and view all the answers

What factor significantly contributes to the risk of psychosis in migrant populations?

<p>Income levels (A)</p> Signup and view all the answers

What factors are considered mediators contributing to the psychosocial disempowerment of minority populations in relation to psychosis risk?

<p>Education and discrimination (A), Parental socioeconomic status (B)</p> Signup and view all the answers

Which urban characteristic is indicated to potentially reverse the causality related to non-affective psychotic disorders?

<p>Increased population density (A)</p> Signup and view all the answers

What is a significant confounder affecting the relationship between immigrant history and the risk of psychosis?

<p>Gender and childhood trauma (B)</p> Signup and view all the answers

In the context of migration, which characteristic significantly influences psychosis risk among immigrant populations?

<p>Historical discrimination experiences (C)</p> Signup and view all the answers

How does the concept of income serve in the study of ethnicity and psychosis risk?

<p>As a confounder and mediator (D)</p> Signup and view all the answers

Flashcards

Social Epidemiology

A branch of epidemiology that investigates the social distribution and social determinants of health.

Social Determinants of Psychosis

Factors like social isolation, disorganization, and urbanicity that contribute to higher psychosis rates in some communities.

Migration and Psychosis Risk

Migrant populations may have a higher risk of psychotic disorders, possibly due to conditions such as differing cultural contexts, income, and other factors.

Ethnicity and Psychosis Risk

Ethnicity, often intertwined with income, education, linguistic barriers, and discrimination, can be a contributing factor in psychosis risk.

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Urbanicity and Psychosis

Higher rates of psychosis may occur in urban centers, but the relationship is complex and could include reverse causality.

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Social Disorganization

A condition in communities where social structures break down, leading to a lack of social control, increased crime, and potentially higher rates of psychosis.

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Migration and Psychosis

Individuals with a migrant history may have a higher risk of developing psychosis. This could be due to differences in cultural context, income, and other factors.

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Ethnicity and Psychosis: Income

While ethnicity itself may not directly increase psychosis risk, lower income levels associated with some ethnicities can increase the risk.

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Psychosocial Disempowerment

When someone lacks power or control over their social environment, usually due to belonging to a minority group. This can contribute to increased risk of psychosis.

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Unobserved Confounding

A hidden variable that influences both the risk factor you study (mediator) and the outcome (psychosis) in a way you don't see.

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What does 'inner city tracts' mean?

'Inner city tracts' refers to densely populated areas within cities, often characterized by higher rates of poverty and social challenges, which have been linked to increased psychosis rates.

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What is a confounder?

A confounder is a variable that influences both the risk factor being studied (e.g., migration) and the outcome (e.g., psychosis), muddying the relationship between the two.

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What is 'linguistic distance'?

'Linguistic distance' refers to how different a person's native language is from the dominant language of the society they live in, which can create social barriers and impact well-being.

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How does income act as a mediator in ethnicity & psychosis?

Income acts as a mediator because lower income levels, often associated with certain ethnicities, increase the risk of psychosis, potentially due to stress, discrimination, and lack of resources.

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Reverse Causality

Reverse causality occurs when the outcome (psychosis) potentially influences the risk factor (urbanicity), rather than the other way around. For example, people with psychosis might move to urban areas for better access to treatment.

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Social Epidemiology of Psychosis

The study of how social factors contribute to the distribution of psychosis in populations.

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Confounding Variable

A variable that influences both the risk factor and the outcome of interest, making it difficult to determine the true relationship between them.

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Income as a Confounder

Income can confuse the relationship between migration and psychosis risk. This means income itself could affect both migration and psychosis risk, making it hard to see if migration directly influences psychosis.

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Study Notes

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.

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