Benson S Ku1, Jean Addington2, Carrie E Bearden3, Kristin S Cadenhead4, Tyrone D Cannon5, Michael T Compton6, Barbara A Cornblatt7, Matcheri Keshavan8, Daniel H Mathalon9, Diana O Perkins10, William S Stone8, Ming T Tsuang4, Elaine F Walker11, Scott W Woods5, Benjamin G Druss12. 1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States. Electronic address: bsku@emory.edu. 2. Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. 3. Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, United States. 4. Department of Psychiatry, University of California, San Diego, CA, United States. 5. Department of Psychiatry, Yale University, New Haven, CT, United States. 6. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, United States. 7. Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States. 8. Harvard Medical School, Departments of Psychiatry at Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Boston, MA, United States. 9. Department of Psychiatry, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States. 10. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States. 11. Department of Psychology, Emory University, Atlanta, GA, United States. 12. Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Abstract
OBJECTIVE: Accumulating evidence supports an association between residential instability and increased risk for psychosis, but the association between residential instability and conversion to psychosis among adolescents at clinical high risk (CHR) is unclear. In this study, we determined whether individual-level and area-level residential instability and their interaction are associated with conversion to psychosis within two years. METHODS: Data were collected as part of the North American Prodrome Longitudinal Study Phase 2. Individual-level residential instability, defined as having ever moved during lifetime, was derived from the Life Events Scale. Area-level residential instability, defined as the percentage of people who were not living in the same house five years ago, was derived from the U.S. Decennial Censuses. RESULTS: This study included 285 adolescents at CHR (including 36 subjects who later converted to full psychosis). We found that individual-level residential instability was associated with conversion (adjusted OR = 2.769; 95% CI = 1.037-7.393). The interaction between individual-level and area-level residential instability was significant (p = 0.030). In a subgroup of CHR participants who have never moved (n = 91), area-level residential instability during childhood was associated with conversion (adjusted OR = 1.231; 95% CI = 1.029-1.473). Conversely, in a subgroup of CHR participants who resided in residentially stable areas during childhood (n = 142), the association between individual-level residential instability and conversion remained significant (adjusted OR = 15.171; 95% CI = 1.753-131.305). CONCLUSIONS: These findings suggest that individual-level and area-level residential instability may be associated with conversion to psychosis.
OBJECTIVE: Accumulating evidence supports an association between residential instability and increased risk for psychosis, but the association between residential instability and conversion to psychosis among adolescents at clinical high risk (CHR) is unclear. In this study, we determined whether individual-level and area-level residential instability and their interaction are associated with conversion to psychosis within two years. METHODS: Data were collected as part of the North American Prodrome Longitudinal Study Phase 2. Individual-level residential instability, defined as having ever moved during lifetime, was derived from the Life Events Scale. Area-level residential instability, defined as the percentage of people who were not living in the same house five years ago, was derived from the U.S. Decennial Censuses. RESULTS: This study included 285 adolescents at CHR (including 36 subjects who later converted to full psychosis). We found that individual-level residential instability was associated with conversion (adjusted OR = 2.769; 95% CI = 1.037-7.393). The interaction between individual-level and area-level residential instability was significant (p = 0.030). In a subgroup of CHR participants who have never moved (n = 91), area-level residential instability during childhood was associated with conversion (adjusted OR = 1.231; 95% CI = 1.029-1.473). Conversely, in a subgroup of CHR participants who resided in residentially stable areas during childhood (n = 142), the association between individual-level residential instability and conversion remained significant (adjusted OR = 15.171; 95% CI = 1.753-131.305). CONCLUSIONS: These findings suggest that individual-level and area-level residential instability may be associated with conversion to psychosis.
Authors: Benson S Ku; Jean Addington; Carrie E Bearden; Kristin S Cadenhead; Tyrone D Cannon; Michael T Compton; Barbara A Cornblatt; Benjamin G Druss; Matcheri Keshavan; Daniel H Mathalon; Diana O Perkins; William S Stone; Ming T Tsuang; Scott W Woods; Elaine F Walker Journal: Schizophr Res Date: 2022-01-20 Impact factor: 4.939