Impact of urban birth and upbringing on expression of psychosis in a Chinese undergraduate population

分裂型 精神病 精神科 精神分裂症(面向对象编程) 心理学 人口 兄弟姐妹 精神病性 临床心理学 自杀意念 医学 毒物控制 伤害预防 发展心理学 人格 环境卫生 五大性格特征 社会心理学 外向与内向
作者
Jeremy Coid,Yamin Zhang,Huan Sun,Hua Yu,Wei Wei,Xiaojing Li,Qing Lv,Wanjie Tang,Qiang Wang,Wei Deng,Wanjun Guo,Liansheng Zhao,Xiaoyan Ma,Yajing Meng,Mingli Li,Huiyao Wang,Ting Chen,Tao Li
出处
期刊:BMC Psychiatry [BioMed Central]
卷期号:21 (1) 被引量:5
标识
DOI:10.1186/s12888-021-03475-w
摘要

Urban birth and upbringing show consistent associations with psychotic illness but the key urban exposures remain unknown. Associations with psychotic-like experiences (PEs) are inconsistent. These could be confounded by common mental disorders associated with PEs. Furthermore, associations between PEs and urban exposures may not extrapolate to psychotic disorders such as schizophrenia.Annual cross-sectional surveys among first year Chinese undergraduates 2014-2019 (n = 47,004). Self-reported, hierarchical categorisation of psychosis: from psychoticism, paranoid ideation, schizotypal symptoms, nuclear syndrome using SCL-90-R, to clinical diagnosis of schizophrenia. Depressive symptoms using PHQ 9. Dissociative symptoms and posttraumatic stress disorder (PTSD) measured using PCL-C. Etiological factors of family history and childhood disadvantage. We studied effects of urban birth, urban living and critical times of exposure in childhood on psychosis phenotypes.Associations with urbanicity were found only after adjustments for depression. Urban birth was associated with paranoia (AOR 1.34, 1.18-1.53), schizotypal symptoms (AOR 1.59, 1.29-1.96), and schizophrenia (AOR 2.07, 1.10-3.87). The same phenotypes showed associations with urban residence > 10 years. Only schizophrenia showed an association with urban exposure birth-3 years (AOR 7.01, 1.90-25.86). Child maltreatment was associated with both psychosis and depression. Urbanicity measured across the total sample did not show any associations with demography, family history of psychosis, or child maltreatment. Sensitivity analysis additionally adjusting for dissociative symptoms and PTSD showed the same pattern of findings.Urban birth and urban living showed a hierarchical pattern of increasing associations from paranoid ideation to schizotypal disorder to schizophrenia, confirming that associations for psychotic experiences could be extrapolated to schizophrenia, but only after adjusting for confounding from depression, dissociative symptoms and PTSD. Several etiological factors were the same for psychosis and depression. Future studies of PEs should adjust for confounding from common mental disorders and dissociative symptoms. Effects of urbanicity on psychosis were not explained by demography, family history of mental disorder, or child maltreatment.
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