Ku Benson, Yuan Qingyue, Christensen Grace M, Dimitrov Lina, Risk Benjamin, Huels Anke
medRxiv. 2024 Aug 29:2024.08.21.24312315. doi: 10.1101/2024.08.21.24312315.
Recent research has demonstrated that domains of social determinants of health (SDOH) (e.g., air pollution and social context) are associated with psychosis. However, SDOHs have often been studied in isolation.
To identify distinct exposure profiles, estimate their associations with persistent distressing psychotic-like experiences (PLE), and evaluate whether involvement with physical activities partially explains this association.
This population-based study used data from the Adolescent Brain and Cognitive Development (ABCD) Study. Participants were recruited from 22 US sites between September 2016 and January 2022. Data from baseline and three follow-ups were included.
Area-level geocoded variables spanning various domains of SDOH, including socioeconomic status (SES), education, crime, built environment, social context, and crime, were clustered using a self-organizing map method to identify exposure profiles.
Persistent distressing PLE was derived from the Prodromal Questionnaire-Brief Child Version across four years. Generalized linear mixed modeling tested the association between exposure profiles and persistent distressing PLE as well as physical activities (i.e., team and individual sports), adjusting for individual-level covariates including age, sex, race/ethnicity, highest level of parent education, family-relatedness, and study sites.
Among 8,145 participants (baseline mean [SD] age, 9.92 [0.63] years; 3,868 (47.5%) females; 5,566 (68.3%) White, 956 (11.7%) Black, 159 (2.0%) Asian, and 1,480 (18.4%) Hispanic participants), five exposure profiles were identified. Compared to the reference Profile 1 (suburban affluent areas, 2521 children, 30.9%), Profile 3 (rural areas with low walkability and high ozone; 1459 children, 17.9%; adjusted OR: 1.34, 95% CI: 1.09-1.64) and Profile 4 (urban areas with high SES deprivation, high crime, and high pollution; 715 children, 8.8%; adjusted OR: 1.40, 95% CI: 1.08-1.81), were associated with persistent distressing PLE. Team sports mediated 6.14% of the association for Profile 3.
This study found that neighborhoods characterized by rural areas with low walkability and urban areas with high socioeconomic deprivation, air pollutants, and crime were associated with persistent distressing PLE. Further research is needed to explore the pathways through which different environmental factors may impact the development of psychosis.
近期研究表明，健康的社会决定因素（SDOH）领域（如空气污染和社会环境）与精神病有关。然而，SDOH通常是孤立进行研究的。
识别不同的暴露模式，估计它们与持续性痛苦的精神病样体验（PLE）之间的关联，并评估参与体育活动是否能部分解释这种关联。
设计、背景和参与者：这项基于人群的研究使用了青少年大脑与认知发展（ABCD）研究的数据。参与者于2016年9月至2022年1月期间从美国22个地点招募。纳入了基线和三次随访的数据。
使用自组织映射方法对涵盖SDOH各个领域的区域级地理编码变量进行聚类，这些变量包括社会经济地位（SES）、教育、犯罪、建成环境、社会环境和犯罪，以识别暴露模式。
持续性痛苦的PLE来自四年期间的《前驱症状问卷 - 儿童简版》。广义线性混合模型测试了暴露模式与持续性痛苦的PLE以及体育活动（即团队和个人运动）之间的关联，并对包括年龄、性别、种族/族裔、父母最高教育水平、家庭关系和研究地点在内的个体水平协变量进行了调整。
在8145名参与者中（基线平均[标准差]年龄为9.92[0.63]岁；3868名（47.5%）为女性；5566名（68.3%）为白人，956名（11.7%）为黑人，159名（2.0%）为亚洲人，1480名（18.4%）为西班牙裔参与者），识别出五种暴露模式。与参考模式1（郊区富裕地区，2521名儿童，30.9%）相比，模式3（步行便利性低且臭氧含量高的农村地区；1459名儿童，17.9%；调整后的比值比：1.34，95%置信区间：1.09 - 1.64）和模式4（社会经济剥夺程度高、犯罪率高且污染严重的城市地区；715名儿童，8.8%；调整后的比值比：1.40，95%置信区间：1.08 - 1.81）与持续性痛苦的PLE相关。团队运动介导了模式3关联的6.14%。
本研究发现，以步行便利性低的农村地区以及社会经济剥夺程度高、空气污染物多且犯罪率高的城市地区为特征的社区与持续性痛苦的PLE相关。需要进一步研究以探索不同环境因素可能影响精神病发展的途径。
