van Os J, Driessen G, Gunther N, Delespaul P
Department of Psychiatry and Neuropsychology, Maastricht University, European Graduate School of Neuroscience, The Netherlands.
Br J Psychiatry. 2000 Mar;176:243-8. doi: 10.1192/bjp.176.3.243.
Neighbourhood characteristics may influence the risk of psychosis, independently of their individual-level equivalents.
To examine these issues in a multi-level model of schizophrenia incidence.
Cases of schizophrenia, incident between 1986 and 1997, were identified from the Maastricht Mental Health Case Register. A multi-level analysis was conducted to examine the independent effects of individual-level and neighbourhood-level variables in 35 neighbourhoods.
Independent of individual-level single and divorced marital status, an effect of the proportion of single persons and proportion of divorced persons in a neighbourhood was apparent (per 1% increase respectively: RR = 1.02; 95% CI 1.00-1.03; and RR = 1.12, 95% CI 1.04-1.21). Single marital status interacted with the neighbourhood proportion of single persons, the effect being stronger in neighbourhoods with fewer single-person households.
The neighbourhood environment modifies the individual risk for schizophrenia. Premorbid vulnerability resulting in single marital status may be more likely to progress to overt disease in an environment with a higher perceived level of social isolation.
社区特征可能会影响精神病风险，独立于个体层面的等效因素。
在精神分裂症发病率的多层次模型中研究这些问题。
从马斯特里赫特心理健康病例登记册中识别出1986年至1997年间发病的精神分裂症病例。进行多层次分析以检验个体层面和社区层面变量在35个社区中的独立影响。
独立于个体层面的单身和离婚婚姻状况，社区中单身人口比例和离婚人口比例的影响明显（每增加1%，相对风险分别为：RR = 1.02；95%置信区间1.00 - 1.03；RR = 1.12，95%置信区间1.04 - 1.21）。单身婚姻状况与社区单身人口比例存在交互作用，在单身家庭较少的社区中这种影响更强。
社区环境会改变个体患精神分裂症的风险。导致单身婚姻状况的病前易感性在社会隔离感较高的环境中可能更易发展为显性疾病。
