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Neighbourhood characteristics and the incidence of first-episode psychosis and duration of untreated psychosis

Published online by Cambridge University Press:  05 February 2016

B. O'Donoghue ,
J. P. Lyne ,
L. Renwick ,
A. Lane ,
K. Madigan ,
A. Staines ,
E. O'Callaghan  and
M. Clarke
B. O'Donoghue*
Affiliation:
The Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
J. P. Lyne
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland North Dublin Mental Health Services, Beaumont Road, Dublin, Republic of Ireland
L. Renwick
Affiliation:
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
A. Lane
Affiliation:
Department of Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland
K. Madigan
Affiliation:
DETECT, Early Intervention for Psychosis Service, Blackrock, Dublin, Republic of Ireland
A. Staines
Affiliation:
School of Nursing and Human Services, Dublin City University, Dublin, Republic of Ireland
E. O'Callaghan*
Affiliation:
Department of Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland DETECT, Early Intervention for Psychosis Service, Blackrock, Dublin, Republic of Ireland
M. Clarke
Affiliation:
Department of Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland DETECT, Early Intervention for Psychosis Service, Blackrock, Dublin, Republic of Ireland
*
*Address for correspondence: B. O'Donoghue, MRCPsych Ph.D., University of Melbourne, Melbourne, VIC, Australia. (Email: [email protected])
†Deceased.
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Abstract

Background

The incidence of psychotic disorders varies between geographical areas and it has been hypothesized that neighbourhood-level factors may influence this variation. It is also plausible that the duration of untreated psychosis (DUP) is associated with neighbourhood characteristics. The aims of this study were to determine whether the incidence of first-episode psychosis (FEP) and the DUP are associated with the level of social deprivation, fragmentation, social capital and population density.

Method

All individuals with a FEP from a geographical defined catchment area over a 5-year period were included. Age-standardized incidence rates were calculated for each neighbourhood factor.

Results

A total of 292 cases of FEP were included in the study and 45% had a diagnosis of a schizophrenia-spectrum disorder. The age standardized incidence rate of FEP in the most deprived area was 72.4 [95% confidence interval (CI) 26.4–162.7] per 100 000 person-years compared with 21.5 (95% CI 17.6–26.0) per 100 000 person-years in the most affluent areas. This represents a 3.4-fold increase in FEP incidence in the most deprived areas. The incidence of FEP was also increased in neighbourhoods that were more socially fragmented [incidence rate ratio (IRR) = 2.40, 95% CI 1.05–5.51, p = 0.04] and there was a trend for the incidence to be increased in neighbourhoods with lower social capital (IRR = 1.43, 95% CI 0.99–2.06, p = 0.05). The median DUP was 4 months and was higher in more socially fragmented neighbourhoods.

Conclusions

The incidence of psychotic disorders is related to neighbourhood factors and it may be useful to consider neighbourhood factors when allocating resources for early intervention services.

Keywords

Duration of untreated psychosisincidencepsychosisschizophreniasocial deprivation
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 7 , May 2016 , pp. 1367 - 1378
Copyright
Copyright © Cambridge University Press 2016 

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