Social Disadvantage: Cause or Consequence of Impending Psychosis?

TY - JOUR

T1 - Social Disadvantage

T2 - Cause or Consequence of Impending Psychosis?

AU - Stilo, Simona A

AU - Di Forti, Marta

AU - Mondelli, Valeria

AU - Falcone, Maria Aurora

AU - Russo, Manuela

AU - O'Connor, Jennifer

AU - Palmer, Emma

AU - Paparelli, Alessandra

AU - Kolliakou, Anna

AU - Sirianni, Miriam

AU - Taylor, Heather

AU - Handley, Rowena

AU - Dazzan, Paola

AU - Pariante, Carmine

AU - Reis Marques, Tiago

AU - Zoccali, Rocco

AU - David, Anthony

AU - Murray, Robin M

AU - Morgan, Craig

PY - 2013/11

Y1 - 2013/11

N2 - 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.Conclusions1: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood.

AB - 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.Conclusions1: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood.

KW - Acknowledged-BRC

KW - Acknowledged-BRC-13/14

U2 - 10.1093/schbul/sbs112

DO - 10.1093/schbul/sbs112

M3 - Article

C2 - 23091267

SN - 0586-7614

VL - 39

SP - 1288

EP - 1295

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

IS - 6

ER -