Effect of social class at birth on risk and presentation of schizophrenia: case-control study

Mulvany, Fiona; O’Callaghan, Eadbhard; Takei, Noriyoshi; Byrne, Majella; Fearon, Paul; Larkin, Conall

doi:10.1136/bmj.323.7326.1398

Cited by 62 publications

(54 citation statements)

References 25 publications

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“…This is in agreement with an inverse parental SEP gradient for suicide 11 , 13 , 14 as well as for schizophrenia in several 16 , 19 , 29 , 38 , 39 but not all 40 studies. This particular pattern could have several interpretations.…”

Section: Discussionsupporting

confidence: 88%

“…One possibility is that a mismatch between parental aspirations and expectations and own ability could have adverse effects on mental health 11 . It has also been suggested that schizophrenia could be diagnosed earlier for patients with parents in high social positions 38 . We should recognize that distinguishing between direct (‘drift’) and indirect selection for schizophrenia could be extremely difficult because the disease often is preceded by adverse social events long before diagnosis 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

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Influence of early life factors on social inequalities in psychiatric outcomes among young adult Norwegian men

Kristensen

Gravseth

Bjérkedal

2010

European Journal of Public Health

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Background: Social inequalities in health can to a substantial degree be explained by social causation. However, indirect selection by early life factors has been suggested. The main aim of this study was to estimate how much adult social gradients in selected psychiatric outcomes depended on parental and individual characteristics in early life. Methods: The population comprised all males born in Norway 1967–71 (n = 170 678). We compiled data on several social and biological variables from birth onwards from different national registers. Health outcomes were collected from the Cause of Death Register (suicide) and the Labour and Welfare Administration (psychiatric disability, psychiatric sickness absence). Indicator of socio-economic position was education level at the age of 28 years. Men were followed up between 4 and 9 years from the age of 29 years. Results: Crude rates per 100 000 person-years were 21.8 (suicide), 145.7 (disability) and 1164.7 (sickness absence). Social inequalities were strong and consistent for all outcomes. Parental and individual characteristics accounted for a substantial part of the social inequalities in neurosis or personality disorder disability (44.1%) and a moderate role for inequalities in psychiatric sickness absence (25.6%), schizophrenia disability (20.7%) and suicide (17.4%). General ability at the age of 18 years had strongest influence on the social health gradients. Suicide and schizophrenia disability were associated with a combination of high parental and low own education level. Conclusion: This study indicates that indirect selection explains a substantial part of social inequalities in certain psychiatric outcomes and that early life prevention is important to reduce health gradients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Influence of early life factors on social inequalities in psychiatric outcomes among young adult Norwegian men

Kristensen

Gravseth

Bjérkedal

2010

European Journal of Public Health

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“…Mulvany et al (2001) concluded that low social class at birth was not associated with increased risk of schizophrenia, but views remain divided on the association between social inequality and psychoses and no definite conclusion has been reached. Brown et al (2000) studied the relationship between social class of origin and cardinal symptoms of schizophrenic disorders over the course of early illness.…”

Section: Psychosesmentioning

confidence: 99%

Poverty, social inequality and mental health

Murali¹,

Oyebode²

2004

Adv. psychiatr. treat

344

195

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The World Health Organization has described poverty as the greatest cause of suffering on earth. This article considers the direct and indirect effects of relative poverty on the development of emotional, behavioural and psychiatric problems, in the context of the growing inequality between rich and poor. The problems of children in particular are reviewed. Targets to reduce inequality have been set both nationally and internationally.

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“…A Danish case control study of almost 8,000 first admissions for schizophrenia found that risk of schizophrenia was associated with unemployment, low educational attainment, lower wealth status, low income, being single with no children, urban birth, parental unemployment and paternal lower income, but not with parental wealth . They found an association with higher education in parents and cited other studies that had found a link with higher social class (Goldberg & Morrison, 1963;Jones & Done, 1997;Makikyro et al, 1997;Malama et al, 1988;Mulvany et al, 2001) or educational attainment (Wiersma, Giel, De Jong, & Slooff, 1983), concluding that there was insufficient evidence linking low parental socioeconomic status (and therefore, early social disadvantage) to schizophrenia and that the lowered socioeconomic status apparent on admission was explained by social drift.…”

Section: Socioeconomic Statusmentioning

confidence: 91%

Beyond the first episode: Candidate factors for a risk prediction model of schizophrenia

Murphy

2010

International Review of Psychiatry

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Many early psychosis services are financially compromised and cannot offer a full tenure of care to all patients. To maintain viability of services it is important that those with schizophrenia are identified early to maximize long-term outcomes, as are those with better prognoses who can be discharged early. The duration of untreated psychosis remains the mainstay in determining those who will benefit from extended care, yet its ability to inform on prognosis is modest in both the short and medium term. There are a number of known or putative genetic and environmental risk factors that have the potential to improve prognostication, though a multivariate risk prediction model combining them with clinical characteristics has yet to be developed. Candidate risk factors for such a model are presented, with an emphasis on environmental risk factors. More work is needed to corroborate many putative factors and to determine which of the established factors are salient and which are merely proxy measures. Future research should help clarify how gene-environment and environment-environment interactions occur and whether risk factors are dose-dependent, or if they act additively or synergistically, or are redundant in the presence (or absence) of other factors.

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Effect of social class at birth on risk and presentation of schizophrenia: case-control study

Abstract: Objectives To examine if low parental social class increases children's risk of subsequently developing schizophrenia or modifies the presentation.

Cited by 62 publications

References 25 publications

Influence of early life factors on social inequalities in psychiatric outcomes among young adult Norwegian men

Influence of early life factors on social inequalities in psychiatric outcomes among young adult Norwegian men

Poverty, social inequality and mental health

Beyond the first episode: Candidate factors for a risk prediction model of schizophrenia

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