Friday, May 26, 2017

Psychotic Experiences Found to Be Higher Among Adolescent City Dwellers


Adolescents raised in urban neighborhoods may be significantly more likely to have psychotic experiences than their rural counterparts, according to a study published this week in Schizophrenia Bulletin. The association remained significant after adjusting for other factors, including family socioeconomic status, family psychiatric history, and adolescent cannabis use.

“These findings highlight the importance of early, preventative strategies for reducing psychosis risk and suggest that adolescents living in threatening neighborhoods within cities should be made a priority,” said senior author Helen Fisher, Ph.D., of King’s College London in a press release

Fisher, together with colleagues at King’s College London and Duke University, found that neighborhood social conditions and personal victimization by violent crime were strong contributing factors to adolescent psychotic expressions. Adolescents who had grown up in the most adverse neighborhoods and had been victim to a violent crime had nearly five times the chances of experiencing psychotic phenomena compared with those without such history, according to the study.

As part of the Environmental Risk (E-Risk) Longitudinal Twin Study, the researchers asked 2,063 18-year-olds in England and Wales about whether they had had any psychotic experiences since the age of 12. Participants were deemed to have these experiences if they reported during an interview at least one out of 13 potential psychotic experiences, such as believing they were being followed, hearing voices others could not hear, or thinking their food was poisoned. Just over 30% of the study’s total participants said they had at least one psychotic experience.

Researchers measured neighborhood social factors, such as trust and support between neighbors, and signs of threats such as assaults and vandalism through postal code surveys of neighbors living alongside participants. Personal victimization by violent crime was assessed through interviews with the participants themselves.

Of adolescents who had lived in the most socially adverse neighborhoods (neighborhoods that were simultaneously characterized by lower levels of social cohesion and higher levels of neighborhood disorder), 24% reported to have been personally victimized, compared with 15% who lived in better neighborhoods. Adolescents who had been victimized by violent crime had over three times greater odds of having psychotic experiences, the study found. 

Early intervention offers the best hope for improving outcomes in psychosis, the authors concluded. “It is crucial to understand how the wider structural and social environment may influence psychotic experiences among young people in order to design and effectively target preventive interventions,” they wrote. 

For related information, see the Psychiatric News article “Hallucinations Can Be Marker For Variety of Psychiatric Disorders in Youth.”

(Image: iStock/LeoPatrizi)