J van Os1, G Driessen, N Gunther, P Delespaul. 1. Department of Psychiatry and Neuropsychology, Maastricht University, European Graduate School of Neuroscience, The Netherlands.
Abstract
BACKGROUND: Neighbourhood characteristics may influence the risk of psychosis, independently of their individual-level equivalents. AIMS: To examine these issues in a multi-level model of schizophrenia incidence. METHOD: Cases of schizophrenia, incident between 1986 and 1997, were identified from the Maastricht Mental Health Case Register. A multi-level analysis was conducted to examine the independent effects of individual-level and neighbourhood-level variables in 35 neighbourhoods. RESULTS: Independent of individual-level single and divorced marital status, an effect of the proportion of single persons and proportion of divorced persons in a neighbourhood was apparent (per 1% increase respectively: RR = 1.02; 95% CI 1.00-1.03; and RR = 1.12, 95% CI 1.04-1.21). Single marital status interacted with the neighbourhood proportion of single persons, the effect being stronger in neighbourhoods with fewer single-person households. CONCLUSIONS: The neighbourhood environment modifies the individual risk for schizophrenia. Premorbid vulnerability resulting in single marital status may be more likely to progress to overt disease in an environment with a higher perceived level of social isolation.
BACKGROUND: Neighbourhood characteristics may influence the risk of psychosis, independently of their individual-level equivalents. AIMS: To examine these issues in a multi-level model of schizophrenia incidence. METHOD: Cases of schizophrenia, incident between 1986 and 1997, were identified from the Maastricht Mental Health Case Register. A multi-level analysis was conducted to examine the independent effects of individual-level and neighbourhood-level variables in 35 neighbourhoods. RESULTS: Independent of individual-level single and divorced marital status, an effect of the proportion of single persons and proportion of divorced persons in a neighbourhood was apparent (per 1% increase respectively: RR = 1.02; 95% CI 1.00-1.03; and RR = 1.12, 95% CI 1.04-1.21). Single marital status interacted with the neighbourhood proportion of single persons, the effect being stronger in neighbourhoods with fewer single-person households. CONCLUSIONS: The neighbourhood environment modifies the individual risk for schizophrenia. Premorbid vulnerability resulting in single marital status may be more likely to progress to overt disease in an environment with a higher perceived level of social isolation.
Authors: Nil Kaymaz; Lydia Krabbendam; Ron de Graaf; Willem Nolen; Margreet Ten Have; Jim van Os Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2006-07-03 Impact factor: 4.328
Authors: A C Kalff; M Kroes; J S Vles; J G Hendriksen; F J Feron; J Steyaert; T M van Zeben; J Jolles; J van Os Journal: J Epidemiol Community Health Date: 2001-04 Impact factor: 3.710
Authors: J B Kirkbride; D J Lunn; C Morgan; J M Lappin; P Dazzan; K Morgan; P Fearon; R M Murray; P B Jones Journal: Health Place Date: 2009-10-07 Impact factor: 4.078