The Relationship Between Risk of Hospitalization for Schizophrenia, SES, and Cognitive Functioning

Abstract

Although most studies find low socioeconomic status (SES) to be associated with prevalence of schizophrenia, incidence studies do not generally support this, and some even report an inverse association. The objective of the current historical prospective study was to examine the relationship between SES, cognitive functioning, and risk of hospitalization for schizophrenia in a population-based sample of Israeli adolescents. Subjects were 811 487 adolescents, assessed by the Israeli military draft board for socio-demographic factors and cognitive functioning. Data on later hospitalization for schizophrenia were obtained from a population-based hospitalization registry. Findings indicated that when simply examining SES and schizophrenia, lower SES was associated with greater risk of hospitalization for schizophrenia (Hazard Ratio [HR] = 1.193, 95% CI = 1.091-1.303). When dividing the cohort into low, average, and high cognitive functioning, SES did not influence the risk for schizophrenia among individuals with high and average cognitive functioning, whereas among individuals with low cognitive functioning, high SES was found to slightly increase the risk for schizophrenia (HR = 1.21, 95% CI = 1.03-1.42). One possible explanation for this finding might be that among individuals from low socioeconomic backgrounds, low IQ may reflect decreased opportunities related to SES, whereas among individuals from high SES backgrounds, low IQ might reflect risk for later psychopathology.

Employment and income among first-time cases diagnosed with non-affective psychosis in Stockholm, Sweden: a follow-up study 2004/2005–2010

“…Presumably, our findings of poor employment and income conditions the year prior to diagnosis may partly be explained by the knowledge that a significant number of patients with schizophrenia have prodromal symptoms or untreated psychoses several years before diagnosis [28,29]. There is increasing evidence that social adversity during childhood is a risk factor for the later development of psychotic disorders [10][11][12][13][14]30]. Thus, poor social conditions at baseline may reflect this phenomenon.…”

“…Lower individual socioeconomic status is found to be associated with higher prevalence of schizophrenia [8,9], and also various measures of childhood social factors (e.g., parental socioeconomic status and social adversity) have influence [10][11][12][13][14]. Previous research has found that family life and employment of those with psychosis and schizophrenia are negatively impacted [15,16].…”

Cognitive Function and the Risk for Diabetes Among Young Men

“…Counts with percentages were used for binary variables. GIS was analyzed as a continuous as well as a categorical variable comprised of four groups of scores, 1-3, 4-5, 6-7, and 8-9, as reported previously (13,(17)(18)(19)(20)(21). Linear regression models were used to delineate the relationship between differences of 1 unit in GIS at age 17 years and the risk for incident diabetes.…”

Processing speed and executive functions predict real-world everyday living skills in adolescents with early-onset schizophrenia

“…Although it may be a controversial issue, groups were not matched by IQ, academic grade or SES. As EOS is associated with compromised general cognitive intellectual ability [36] and schizophrenia is associated with low socioeconomic status, especially in patients with low cognitive abilities [60], matching the groups in these areas could actually remove the effect of the disease, leading to biased comparisons between overachieving patients and underachieving controls [20,38]. Despite this, we have controlled for IQ and SES differences through further analysis of covariance.…”