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Social Disadvantage: Cause or Consequence of Impending Psychosis?

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Title: Social Disadvantage: Cause or Consequence of Impending Psychosis?
Author(s): Stilo, SA
Di Forti, M
Mondelli, V
Falcone, AM
Russo, M
O'Connor, J
Palmer, E
Paparelli, A
Kolliakou, A
Sirianni, M
Taylor, H
Handley, R
Dazzan, P
Pariante, C
Marques, TR
Zoccali, R
David, A
Murray, RM
Morgan, C
Item Type: Journal Article
Abstract: 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. CONCLUSIONS: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood.
Publication Date: 22-Oct-2012
Date of Acceptance: 22-Oct-2012
URI: http://hdl.handle.net/10044/1/40545
DOI: http://dx.doi.org/10.1093/schbul/sbs112
ISSN: 1745-1701
Publisher: Oxford University Press
Start Page: 1288
End Page: 1295
Journal / Book Title: Schizophrenia Bulletin
Volume: 39
Issue: 6
Copyright Statement: This is an Open Access article distributed under the terms of the Creative CommonsAttributionNon-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: environment
loss
schizophrenia
separation
social disadvantage
unemploy ment
Adolescent
Adult
Aged
Anxiety, Separation
Case-Control Studies
Female
Humans
Life Change Events
London
Male
Middle Aged
Parental Death
Psychotic Disorders
Risk
Socioeconomic Factors
Time Factors
Unemployment
Young Adult
Humans
Risk
Case-Control Studies
Life Change Events
Anxiety, Separation
Psychotic Disorders
Time Factors
Socioeconomic Factors
Adolescent
Adult
Aged
Middle Aged
Unemployment
London
Female
Male
Young Adult
Parental Death
Psychiatry
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Publication Status: Published
Appears in Collections:Clinical Sciences
Imaging Sciences
Faculty of Medicine



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