Abstract
A growing body of evidence suggests that indicators of social disadvantage are associated with an increased risk of psychosis. However, only a few studies have specifically looked at cumulative effects and long-term associations. The aims of this study are: To compare the prevalence of specific indicators of social disadvantage at, and prior to, first contact with psychiatric services in patients suffering their first episode of psychosis and in a control sample. To explore long-term associations, cumulative effects, and direction of effects. We collected information on social disadvantage from 332 patients and from 301 controls recruited from the local population in South London. Three indicators of social disadvantage in childhood and six indicators of social disadvantage in adulthood were analysed. Across all the domains considered, cases were more likely to report social disadvantage than were controls. Compared with controls, cases were approximately two times more likely to have had a parent die and approximately three times more likely to have experienced a long-term separation from one parent before the age of 17 years. Cases were also more likely than controls to report two or more indicators of adult social disadvantage, not only at first contact with psychiatric services [odds ratio (OR) 9.5], but also at onset of psychosis (OR 8.5), 1 year pre-onset (OR 4.5), and 5 years pre-onset (OR 2.9). Greater numbers of indicators of current and long-term exposure are associated with progressively greater odds of psychosis. There is some evidence that social disadvantage tends to cluster and accumulate.
Highlights
Evidence for the effects of social factors on psychosis is accumulating (Corcoran et al 2003; Morgan et al 2010; Howes & Murray, 2014)
In our previous study, the Genetic and Psychosis (GAP) study, social disadvantage was associated with greater risk of psychosis at first contact with psychiatric services[odds ratio (OR) 9.03, 95% confidence interval (CI) 5.60–14.58] and 1 year prior to admission and 5 years prior to admission (Stilo et al 2013)
The aims of this article are: (1) To compare the prevalence of specific indicators of social disadvantage in childhood, 5 years pre-onset of psychosis, 1 year pre-onset, at onset, and at first presentation to psychiatric services, in patients suffering their first episode of psychosis, and in a control sample
Summary
Evidence for the effects of social factors on psychosis is accumulating (Corcoran et al 2003; Morgan et al 2010; Howes & Murray, 2014). There is emerging evidence that specific indicators of social disadvantage are related to psychosis. Many studies have looked at the association between single indicators of social disadvantage. A growing body of evidence suggests that indicators of social disadvantage are associated with an increased risk of psychosis. Only a few studies have looked at cumulative effects and long-term associations. The aims of this study are: To compare the prevalence of specific indicators of social disadvantage at, and prior to, first contact with psychiatric services in patients suffering their first episode of psychosis and in a control sample. To explore long-term associations, cumulative effects, and direction of effects
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