Variation of subclinical psychosis as a function of population density across different European settings: Findings from the multi-national EU-GEI study.

IF 5.3 2区医学 Q1 PSYCHIATRY Acta Psychiatrica Scandinavica Pub Date : 2024-11-01 DOI:10.1111/acps.13767

Giuseppe D'Andrea, Diego Quattrone, Giada Tripoli, Edoardo Spinazzola, Charlotte Gayer-Anderson, Hannah E Jongsma, Lucia Sideli, Simona A Stilo, Caterina La Cascia, Laura Ferraro, Daniele La Barbera, Andrea Tortelli, Eva Velthorst, Lieuwe de Haan, Pierre-Michel Llorca, Jose Luis Santos, Manuel Arrojo, Julio Bobes, Julio Sanjuán, Miguel Bernardo, Celso Arango, James B Kirkbride, Peter B Jones, Bart P Rutten, Franck Schürhoff, Andrei Szöke, Jim van Os, Evangelos Vassos, Jean-Paul Selten, Craig Morgan, Marta Di Forti, Ilaria Tarricone, Robin M Murray

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Abstract

Background: Urbanicity is a well-established risk factor for psychosis. Our recent multi-national study found an association between urbanicity and clinical psychosis in Northern Europe but not in Southern Europe. In this study, we hypothesized that the effect of current urbanicity on variation of schizotypy would be greater in North-western Europe countries than in Southern Europe ones.

Methods: We recruited 1080 individuals representative of the populations aged 18-64 of 14 different sites within 5 countries, classified as either North-western Europe (England, France, and The Netherlands) with Southern Europe (Spain and Italy). Our main outcome was schizotypy, assessed through the Structured Interview for Schizotypy-Revised. Our main exposure was current urbanicity, operationalized as local population density. A priori confounders were age, sex, ethnic minority status, childhood maltreatment, and social capital. Schizotypy variation was assessed using multi-level regression analysis. To test the differential effect of urbanicity between North-western and Southern European, we added an interaction term between population density and region of recruitment.

Results: Population density was associated with schizotypy (β = 0.248,95%CI = 0.122-0.375;p < 0.001). The addition of the interaction term improved the model fit (likelihood test ratio:χ² = 6.85; p = 0.009). The effect of urbanicity on schizotypy was substantially stronger in North-western Europe (β = 0.620,95%CI = 0.362-0.877;p < 0.001) compared with Southern Europe (β = 0.190,95%CI = 0.083-0.297;p = 0.001).

Conclusions: The association between urbanicity and both subclinical schizotypy and clinical psychosis, rather than being universal, is context-specific. Considering that urbanization is a rapid and global process, further research is needed to disentangle the specific factors underlying this relationship.

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亚临床精神病的变化与欧洲不同地区的人口密度有关：多国欧盟-全球精神病研究所（EU-GEI）的研究结果。

背景：城市化是一个公认的精神病风险因素。我们最近的一项跨国研究发现，北欧的城市化与临床精神病之间存在关联，而南欧则没有。在本研究中，我们假设当前城市化对精神分裂症变异的影响在西北欧国家比在南欧国家更大：我们在 5 个国家的 14 个不同地点招募了 1080 名 18-64 岁人口的代表，这些国家被划分为西北欧（英格兰、法国和荷兰）和南欧（西班牙和意大利）。我们的主要研究结果是精神分裂症，通过精神分裂症结构式访谈（Structured Interview for Schizotypy-Revised）进行评估。我们的主要暴露因素是当前的城市化程度，即当地的人口密度。先验混杂因素包括年龄、性别、少数民族身份、童年虐待和社会资本。采用多层次回归分析对分裂型变异进行了评估。为了检验城市化在西北欧和南欧之间的不同影响，我们在人口密度和招募地区之间添加了一个交互项：结果：人口密度与精神分裂症相关（β = 0.248，95%CI = 0.122-0.375；P 2 = 6.85；P = 0.009）。城市化对精神分裂症的影响在欧洲西北部更为明显（β = 0.620,95%CI = 0.362-0.877;p 结论：城市化与精神分裂症之间的联系在欧洲西北部更为明显：城市化与亚临床精神分裂症和临床精神病之间的关系不是普遍存在的，而是有特定背景的。考虑到城市化是一个快速而全球性的过程，我们需要进一步研究来厘清这种关系背后的具体因素。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.