期刊
SCHIZOPHRENIA BULLETIN
卷 39, 期 6, 页码 1288-1295出版社
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sbs112
关键词
schizophrenia; social disadvantage; unemployment; separation; loss; environment
类别
资金
- Medical Research Council [G0500817]
- Wellcome Trust [WT087417]
- European Union (European Community's Seventh Framework Program) [HEALTH-F2-2009-241909]
- Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award
- Maudsley NHS Foundation Trust (SLaM)
- Institute of Psychiatry at King's College London
- Academy of Medical Sciences (AMS) [AMS-SGCL5-Mondelli] Funding Source: researchfish
- Medical Research Foundation [C0439] Funding Source: researchfish
- National Institute for Health Research [CL-2012-17-004, CL-2008-17-005] Funding Source: researchfish
- MRC [G108/603] Funding Source: UKRI
Background: An association between social disadvantage and established psychosis is well documented in the literature, but there remains a lack of data on the social circumstances of patients before they became ill. We investigated whether social disadvantage at, and prior to, first contact with psychiatric services, is associated with psychosis. Method: We collected information on social disadvantage in childhood and adulthood from 278 cases presenting with their first episode of psychosis to the South London and Maudsley National Health Service Foundation Trust and from 226 controls recruited from the local population. Three markers of childhood social disadvantage and 3 markers of disadvantage in adulthood were analyzed. Results: Long term separation from, and death of, a parent before the age of 17 years were both strongly associated with a 2- to 3-fold-increased odds of psychosis. Cases were also significantly more likely to report 2 or more markers of adult social disadvantage than healthy controls (OR = 9.03) at the time of the first presentation with psychosis, independent of a number of confounders. When we repeated these analyses for long-standing adult social disadvantage, we found that the strength of the association decreased but still remained significant for 1 year (OR = 5.67) and 5 years (OR = 2.57) prior to the first contact. Conclusions: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood.
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