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The association between social deprivation and the rate of identification of individuals at Ultra-High Risk for psychosis and transition to psychosis

Bibliographic Data

ID19273974
AuthorsDanielle Moore (0000-0002-5861-8706, Orygen, Parkville, VIC, Australia), SCOTT EATON (0000-0002-7089-8659, Orygen, Parkville, VIC, Australia), Andrea Polari (0000-0002-0680-3192, Orygen, Parkville, VIC, Australia), Patrick D Mcgorry (0000-0002-3789-6168, The University of Melbourne), Patrick McGorry (Orygen, Parkville, VIC, Australia), Barnaby Nelson (0000-0002-6263-2332, Orygen, Parkville, VIC, Australia), Brian O’Donoghue (0000-0001-6240-6952, Orygen, Parkville, VIC, Australia, corresponding author)
Year2023
Volume69
Issue2
Pages294-303
Publication date2023-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Social Psychiatry (JOURNAL)
Journal identifiersISSN: 0020-7640 • E-ISSN: 1741-2854
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/00207640221087608
PMID35470718
OpenAlexW4224950755
LanguageEN
References cited43

Background: There is a higher incidence of psychotic disorders in neighbourhoods of greater social deprivation. However, it is not known whether this represents a causal relationship, as the stage at which social deprivation exerts its influence on the development of psychotic disorders is yet to be elucidated. We aimed to investigate the association between neighbourhood-level social deprivation and the rate of identification of individuals at Ultra-High Risk for psychosis (UHR), as well as the risk of transition to psychosis in UHR individuals. Methods: The cohort included all young people aged 15 to 24 identified as UHR attending an Early Intervention clinic in northwestern Melbourne over a 5-year period (2012–2016). Australian census data were used to obtain the at-risk population and social deprivation information according to the postcode of residence. Levels of social deprivation were arranged into quartiles. Poisson regression was used to calculate rate ratios and Cox regression analysis determined hazard ratios. Results: Of the 461 young people identified as UHR, 11.1% ( n = 49) lived in the most affluent neighbourhoods (Quartile 1) compared to 36.7% ( n = 162) in the most deprived neighbourhoods (Quartile 4). There was a 35% higher rate of identification of young people who were UHR from the most deprived neighbourhoods (aIRR = 1.35, 95% CI [0.98, 1.86]). Over a median follow-up of approximately 10 months (308 days (IQR: 188–557), 17.5% ( n = 77) were known to have transitioned to a full-threshold psychotic disorder. Residing in a neighbourhood of above average deprivation had a hazard ratio of 2.05 (95% CI [0.88, 4.80]) for risk of transition, when controlling for age, sex and substance use. Conclusions: These findings provide more support that EI services should be funded as per the expected incidence of psychotic disorders

Cohort · Confidence interval · Hazard ratio · Neighbourhood (mathematics) · Poisson regression · Population · Proportional hazards model · Psychiatry · Psychosis · Quartile · Social deprivation · Demography · Health disparities and outcomes · Internal Medicine · Medicine · Mental Health Treatment and Access · Psychology · Schizophrenia research and treatment · Gerontology

  • Mapping the Onset of Psychosis

    Open Access•Alison R Yung, Hok Pan Yuen et al.•Australian & New Zealand Journal…•2005

  • Is there evidence that social class at birth increases risk of psychosis? A systematic review

    Open Access•Wingfai Kwok•International Journal of Social…•2014

Citation velocityhistorical
Highly citedNo

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