Kirkbride James B, Fearon Paul, Morgan Craig, Dazzan Paola, Morgan Kevin, Murray Robin M, Jones Peter B
Dept. of Psychiatry, University of Cambridge, Box 189, Cambridge CB2 2QQ, UK.
Soc Psychiatry Psychiatr Epidemiol. 2007 Jun;42(6):438-45. doi: 10.1007/s00127-007-0193-0. Epub 2007 Apr 30.
Urbanicity is a risk factor for schizophrenia, but it is unclear whether this risk is homogenous across urban areas.
To determine whether the incidence of psychotic disorders varied within an urban area, beyond variation attributable to individual-level characteristics.
All incident cases of ICD-10 psychoses from a large, 2-year, epidemiological study of first-episode psychoses in Southeast London were identified. Incidence rates for 33 wards were standardised for age, sex and ethnicity. Bayesian models produced accurate relative risk estimates that were then mapped.
295 cases were identified during 565,000 person-years of follow-up. We observed significant heterogeneity in relative risks for broad and non-affective psychoses (schizophrenia), but not for affective psychoses. Highest risks were observed in contiguous wards.
Neighbourhood variation in the incidence of non-affective psychoses could not be explained by individual-level risk, implicating neighbourhood-level socioenvironmental factors in their aetiology. The findings are consistent with classical sociological models of mental disorders.
城市化是精神分裂症的一个风险因素，但尚不清楚这种风险在城市地区是否具有同质性。
确定在城市区域内，除个体水平特征差异外，精神障碍的发病率是否存在变化。
从伦敦东南部一项为期两年的首次发作精神病大型流行病学研究中，识别出所有国际疾病分类第十版（ICD - 10）精神病的新发病例。对33个病房的发病率按年龄、性别和种族进行了标准化。贝叶斯模型产生了准确的相对风险估计值，然后进行了绘图。
在565,000人年的随访期间共识别出295例病例。我们观察到广泛的非情感性精神病（精神分裂症）的相对风险存在显著异质性，但情感性精神病不存在。在相邻病房观察到最高风险。
非情感性精神病发病率的社区差异不能用个体水平风险来解释，这表明社区水平的社会环境因素在其病因学中起作用。这些发现与经典的精神障碍社会学模型一致。
