The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis

Crossley, Nicolás; Alliende, Luz María; Czepielewski, Letícia Sanguinetti; Aceituno, David; Castañeda, Carmen; Díaz, Camila; Iruretagoyena, Bárbara; Mena, Carlos; Mena, Cristián; Ramírez-Mahaluf, Juan Pablo; Tepper, Ángeles; Vasquez, Javiera; Fonseca, Laís; Machado, Viviane; Hernández, Camilo E.; Vargas-Upegui, Cristian; Gómez-Cruz, Gladys; Kobayashi-Romero, Luis Fabián; Moncada-Habib, Tomás; Arango, Celso; Barch, Deanna M.; Carter, Cameron; Correll, Christoph U.; McGuire, Philip; Evans‐Lacko, Sara; Undurraga, Eduardo A.; Bressan, Rodrigo Affonseca; Gama, Clarissa Severino; López‐Jaramillo, Carlos; Fuente‐Sandoval, Camilo de la; González-Valderrama, Alfonso; Undurraga, Juan; Gadelha, Ary

doi:10.1016/s2215-0366(22)00121-3

Cited by 29 publications

(15 citation statements)

References 30 publications

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“…Mental diagnoses account for 25% of years lived with disability worldwide 2 . The risk of being diagnosed with a mental disorder is higher among those with lower educational attainment (EA) [3][4][5] . If the relationship between education and mental .…”

Section: Introductionmentioning

confidence: 99%

“…Psychiatric diagnoses are estimated to account for 25% of years lived with disability worldwide 2 . The risk of being diagnosed with a mental disorder is higher among those with lower educational attainment (EA) [3][4][5] . If the relationship between education and mental diagnoses is indeed causal, educational policies primarily aimed at improving educational outcomes could also lead to improved mental health.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the causal relationship between educational attainment and mental health

Demange

Boomsma

Bergen

et al. 2023

Preprint

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We investigate the causal relationship between educational attainment (EA) and mental health using two research designs. First, we compare the relationship between EA and seventeen psychiatric diagnoses within sibship in Dutch national registry data (N = 1.7 million), controlling for unmeasured familial factors. Second, we use two-sample Mendelian Randomization, which uses genetic variants related to EA or psychiatric diagnosis as instrumental variables, to test whether there is a causal relation in either direction. Our results suggest that lower levels of EA causally increase the risk of MDD, ADHD, alcohol dependence, GAD and PTSD diagnoses. We also find evidence of a causal effect in the opposite direction for ADHD. Additionally, we find inconsistent results for schizophrenia, anorexia nervosa, OCD, and bipolar disorder, highlighting the importance of using multiple research designs to understand the complex relationship between EA and mental health.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating the causal relationship between educational attainment and mental health

Demange

Boomsma

Bergen

et al. 2023

Preprint

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“…Regarding the difference in educational attainment between the schizophrenia group and controls, other studies have shown that patients with schizophrenia have lower educational attainment than those without [51,52]. Attempts to create a pool of schizophrenia patients with the same level of education as controls is referred to in the literature as the "matching fallacy", as it can lead to the selection of atypical groups, such as patients with high education or, conversely, controls with low education [53,54].…”

Section: Length Of the Csmentioning

confidence: 99%

Morphology of Anterior Cingulate Cortex and Its Relation to Schizophrenia

Lahutsina

Španiel

Mrzílková

et al. 2022

JCM

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Cortical folding of the anterior cingulate cortex (ACC), particularly the cingulate (CS) and the paracingulate (PCS) sulci, represents a neurodevelopmental marker. Deviations in in utero development in schizophrenia can be traced using CS and PCS morphometry. In the present study, we measured the length of CS, PCS, and their segments on T1 MRI scans in 93 patients with first- episode schizophrenia and 42 healthy controls. Besides the length, the frequency and the left-right asymmetry of CS/PCS were compared in patients and controls. Distribution of the CS and PCS morphotypes in patients was different from controls. Parcellated sulcal pattern CS3a in the left hemisphere was longer in patients (53.8 ± 25.7 mm vs. 32.7 ± 19.4 mm in controls, p < 0.05), while in CS3c it was reversed—longer in controls (52.5 ± 22.5 mm as opposed to 36.2 ± 12.9 mm, n.s. in patients). Non parcellated PCS in the right hemisphere were longer in patients compared to controls (19.4 ± 10.2 mm vs. 12.1 ± 12.4 mm, p < 0.001). Therefore, concurrent presence of PCS1 and CS1 in the left hemisphere and to some extent in the right hemisphere may be suggestive of a higher probability of schizophrenia.

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“…1 However, the social and economic consequences of psychotic disorders can be just as troubling as the symptoms themselves. People with psychotic disorders (and in many cases, their family members) have a high risk of experiencing violence, 6 extreme poverty, 7 homelessness, 8 incarceration, 9 unemployment and reduced educational attainment, 10 among other adverse outcomes. 11 In many low-and middle-income countries (LMICs), including in sub-Saharan Africa, 6,12 80-90% of people with psychotic disorders do not receive treatment.…”

Section: Introductionmentioning

confidence: 99%

SUCCEED Africa: Protocol for a multi-method pilot study of a community-based intervention for people with psychosis in West and Southeast Africa

Greenley,

Tamambang,

Koroma

et al. 2023

Preprint

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Background: Recent reviews have highlighted the need for participatory research to design and evaluate inclusive, community-based interventions that address the diverse needs of people with lived experience of psychosis, within and beyond the health sector. The SUCCEED Africa consortium aims to co-produce a six-year programme of research following a Theory of Change-driven approach. This protocol describes the pilot study in which SUCCEED’s community-based intervention, research tools and processes will be tested on a small scale in four countries (Malawi, Nigeria, Sierra Leone, Zimbabwe) in preparation for larger-scale evaluation research. Methods: The pilot uses a before-and-after study design investigating change in subjective quality of life (WHOQOL-BREF) in adults diagnosed with a primary psychotic disorder or another mental disorder with psychotic symptoms who are offered the SUCCEED intervention over a four-month period. Nested within this study are: a baseline assessment of the feasibility, acceptability and face validity of WHOQOL-BREF as a measurement tool and validity of proxy versus self-completion; and a multi-method process evaluation examining key process indicators and implementation, service and client-level outcomes. Methods include: baseline cognitive interviews; semi-structed observation and routine monitoring and evaluation of service delivery; endline interviews and focus group discussions; and a comparison of provider competencies at endline (using an adapted version of the ENACT tool). At each of the four pilot sites, participants will include: ten people with lived experience of psychosis, recruited from either health services or community settings using purposive sampling to maximise variation; up to ten adult family members (one per participant with lived experience) involved in their care; the peer support worker, community support worker and supervisor responsible for the intervention; and the data collector responsible for administering WHOQOL-BREF. Recruitment will take place in July and August 2023. Discussion: To the best of our knowledge, this will be the first study of a community-based intervention incorporating lay-delivered case management, formal peer support and livelihoods activities for people with lived experience of psychosis in sub-Saharan Africa. Findings will be relevant not only to SUCCEED but also to others interested in promoting rights-based approaches to community mental health in low-resource settings. Trial Registration: US National Library of Medicine (ClinicalTrials.gov), Protocol reference ID 28346. Initially registered retrospectively July 20/2023: In review.

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The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis

Cited by 29 publications

References 30 publications

Evaluating the causal relationship between educational attainment and mental health

Evaluating the causal relationship between educational attainment and mental health

Morphology of Anterior Cingulate Cortex and Its Relation to Schizophrenia

SUCCEED Africa: Protocol for a multi-method pilot study of a community-based intervention for people with psychosis in West and Southeast Africa

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