Assessment of the Role of IQ in Associations Between Population Density and Deprivation and Nonaffective Psychosis

Dykxhoorn, Jennifer; Karlsson, Håkan; Khandaker, Golam M.; Dalman, Christina; Kirkbride, James

doi:10.1001/jamapsychiatry.2020.0103

Cited by 23 publications

(33 citation statements)

References 48 publications

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“…The indirect pathway of GPS-intelligence-psychotic-like experiences aligns with the recent findings of the ABCD study reporting the associations between educational attainment GPSs and psychotic-like experiences 16 . Our study is a step forward in that the magnitude of the genetic effect was compared with those of key environmental factors 53 . Additionally, genetic data from the large epidemiological samples and a wide spectrum of the environmental and socioeconomic status allowed for unbiased testing of the relationships among the multimodal variables.…”

Section: Discussionmentioning

confidence: 99%

Gene-Environment Pathways to Cognitive Intelligence and Psychotic-Like Experiences in Children

Park

Lee

Cho³

et al. 2021

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Identifying the social and biological mechanisms of cognitive and psychological development of children is essential for optimizing preventive and educational efforts. However, the causal pathways by which genetic and environmental factors affect cognitive and psychiatric outcomes remain unknown, especially in early childhood. We examined the causal relationships among genes, the environment, intelligence, and psychotic-like experiences in 7,632 multiethnic (5,905 with European ancestry) children aged 9-10 years old from the Adolescent Brain Cognitive Development (ABCD) Study. Using up-to-date computational causal analysis and rigorous path modeling, we found a significant causal influence of residential, family, and school environments and genome-wide polygenic scores of cognitive capacities on preadolescents' psychotic-like experiences mediated by intelligence. Mitigation of good parenting behavior and positive school environments on psychotic-like experiences dominated the pernicious effects of genetic and residential adversities. Our findings support that intelligence may be a biological resilience factor for psychosis. To the best of our knowledge, this is the first study to identify casual trajectories of neurocognitive development in early childhood and the first to provide empirical evidence that positive parenting behavior and school environment can impose a considerable degree of causal impact on children's cognitive and psychiatric outcomes. We suggest the implementation of socioeconomic policies to improve family and school environments and promote local economic development to enhance children's cognitive ability and mental health.

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Section: Discussionmentioning

confidence: 99%

Gene-Environment Pathways to Cognitive Intelligence and Psychotic-Like Experiences in Children

Park

Lee

Cho³

et al. 2021

Preprint

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“…Knowledge that neighborhood-level factors -here, specifically deprivation -could influence the age-atfirst-diagnosis of psychosis could help inform the allocation of resources to support timely access to early intervention programs for people in their first episode of psychosis. Given our research has also shown that a disproportionate burden of new cases will present in more deprived areas, 32,50 mental health policymakers should prioritize resourcing appropriate psychosis services in these areas. Our data suggest this should include provision of early detection and outreach strategies in more deprived communities to minimize delays to care, and maximize positive functional, symptomatic, and social outcomes for people in their first episode of psychosis.…”

Section: Discussionmentioning

confidence: 99%

“…Our exposures were neighborhood deprivation and population density at birth. Following similar studies in Sweden, 31,32 we defined neighborhoods according to the "Small Area for Market Statistics" (SAMS) classification system, which contains annual information on residential area characteristics. There are about 9,200 SAMS areas in Sweden, and their median population size in 2011 was 726 people (interquartile range (IQR), 312-1,378).…”

Section: Exposuresmentioning

confidence: 99%

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Neighborhood-level predictors of age-at-first-diagnosis of psychotic disorders: a Swedish register-based cohort study

Spyridonidis¹,

Dykxhoorn²,

Hollander³

et al. 2022

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The relationship between neighborhood-level factors and the incidence of psychotic disorders is well established. However, it is unclear whether neighborhood characteristics are also associated with age-at-first-diagnosis of these disorders. We used linked Swedish register data to identify a cohort of persons first diagnosed with an ICD-10 non-affective or affective psychotic disorder (F20-33) between 1997 and 2016. Using multilevel mixed-effect linear modelling, we investigated whether neighborhood deprivation and population density at birth were associated with age-at-first diagnosis of a psychotic disorder. Our final cohort included 13,440 individuals, with a median age-at-first-diagnosis of 21.8 years for women (interquartile range [IQR]: 19.0-25.5) and 22.9 years for men (IQR: 20.1-26.1; p<.0001). In an unadjusted model, we found no evidence of an association between neighborhood deprivation and age-at-first-diagnosis of psychotic disorder (p=.07). However, after multivariable adjustment, age-at-first-diagnosis increased by .13 years (95% CI: .05 to .21; p=.002) for a one standard deviation increase in neighborhood deprivation. This was equivalent to a later diagnosis of 47 days (95% CI: 18 to 77). We found no evidence of a different relationship for non-affective versus affective psychoses (LRT χ2(1) = .14; p=.71). Population density was not associated with age-at-first-diagnosis in unadjusted (p=.81) or adjusted (p=.85) models. Later age-at-first-diagnosis for individuals born in more deprived neighborhoods suggests structural barriers to accessing equitable psychiatric care.

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“…However rates of opioid use vary across England, with more deprived regions experiencing greater prevalence compared to less deprived areas(2). Since social deprivation is also strongly associated with risk of several psychiatric disorders, including psychotic disorders (3,4), this raises the possibility of syndemic effects, where the co-occurrence of substance use disorders and mental health disorders in the same population (i.e. a syndemic) or same individuals (co-morbidity or dual diagnoses) share common causes.…”

Section: Introductionmentioning

confidence: 99%

Investigating social deprivation and comorbid mental health diagnosis as predictors of treatment access among patients with an opioid use disorder using substance use services: a prospective cohort study

Adams

Yang

O’Donnell

et al. 2022

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Aims We investigated whether social deprivation and comorbid mental health diagnoses were predictors of subsequent engagement with substance use services or crisis and inpatient services amongst people with an opioid related disorder diagnosed in secondary mental health care. Design Prospective cohort study, using anonymised electronic health records from a substance use and secondary mental health care provider. Setting Camden and Islington, London, UK. Participants We followed 1,888 individuals with either an opioid use disorder diagnosis or prescription for methadone or buprenorphine for one-year after initial substance use service engagement between September 2015 and May 2020. Measurements Our primary outcomes were rates of subsequent engagement with substance use and crisis/inpatient services. Our secondary outcome was time to first contact with a crisis/inpatient service. Exposures were social deprivation quartile and comorbid mental health diagnoses. We assessed associations using Poisson regression and Cox proportional survival analyses. Results Rates of subsequent engagement with substance use services were not associated with social deprivation but were increased for those with a single comorbid mental health diagnosis (incidence rate ratio [IRR]: 1.69; 95%CI: 1.24 to 2.31). Rates of contact with crisis/inpatient services were lower in those in the most versus least deprived quartile (IRR: 0.44; 95%CI: 0.31 to 0.61) but elevated for those with single (IRR: 3.41; 95%CI: 2.58 to 4.49) or multiple comorbid mental health diagnoses (IRR: 5.01; 95%CI 4.02 to 6.24). For our secondary outcome, deprivation did not predict time to first contact, but single (Hazard Ratio [HR]: 4.15; 95%CI 2.71 to 6.35) and multiple (HR: 4.49; 95%CI 3.15 to 6.39) comorbid mental health diagnoses led to earlier contact with crisis/inpatient services. Conclusion Our findings illustrate greater substance and secondary mental health care service use amongst opioid users with diagnosed comorbid mental health conditions.

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Assessment of the Role of IQ in Associations Between Population Density and Deprivation and Nonaffective Psychosis

Cited by 23 publications

References 48 publications

Gene-Environment Pathways to Cognitive Intelligence and Psychotic-Like Experiences in Children

Gene-Environment Pathways to Cognitive Intelligence and Psychotic-Like Experiences in Children

Neighborhood-level predictors of age-at-first-diagnosis of psychotic disorders: a Swedish register-based cohort study

Investigating social deprivation and comorbid mental health diagnosis as predictors of treatment access among patients with an opioid use disorder using substance use services: a prospective cohort study

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