Abstract

BackgroundIndividuals are defined as being at ultra-high risk (UHR) for psychosis based on a combination of attenuated psychotic symptoms, help-seeking behaviour, genetic risk, and social/occupational deterioration. Limited evidence is available on whether UHR detection differs by neighbourhood, and potential explanations. AimsTo examine neighbourhood distribution of detected UHR using cases from the OASIS service in South East London, investigating neighbourhood deprivation as an explanatory variable. MethodsGeographic data were collected on patients who met UHR criteria over a fourteen-year period, at the neighbourhood (lower super output area, LSOA) level. Rates were calculated based on cases and age-specific population estimates. Poisson regression assessed associations between UHR rate and neighbourhood deprivation, and with particular deprivation domains, adjusting for referrals for UHR assessment, population density, and proportions of non-White people, and young single people. ResultsRate of UHR detection was statistically related to neighbourhood deprivation, but referral rate was not: compared to the least deprived neighbourhoods, the most deprived neighbourhoods had a greater than two-fold increase in incidence rate of detected UHR (adjusted incidence rate ratio (IRR): 2.11, 95% confidence interval (CI): 1.21,3.67). In contrast, a small, imprecise association was observed for referral for assessment for UHR (adjusted IRR: 1.26 (95%CI: 0.84,1.89)). Evidence was also found for associations of UHR detection rate with domains of deprivation pertaining to health and barriers to services. ConclusionsThe distribution of UHR detection rates by neighbourhood is not random and may be explained in part by differences in the social environment between neighbourhoods.

Highlights

  • The ultra-high risk state (UHR) (Fusar-Poli et al, 2013b) for psychosis defines a group of people who are putatively at elevated risk for the development of psychotic disorders (Fusar-Poli et al, 2013a)

  • The estimate for the total person-years of observation for the study period was 2,347,022 person-years, giving an overall UHR detection rate of 14.3 cases per hundred thousand person-years (95%confidence interval (CI): 12.8,15.9), and an overall referral rate of 26 referrals per hundred thousand person-years

  • P-values are reported from Wald tests, and are italicised where they fall below the pre-defined alpha-level (0.05)

Read more

Summary

Introduction

The ultra-high risk state (UHR) (Fusar-Poli et al, 2013b) for psychosis defines a group of people who are putatively at elevated risk for the development of psychotic disorders (Fusar-Poli et al, 2013a). At risk mental state services (Broome et al, 2005; Phillips et al, 2002) aim to intervene in this group with a view to preventing psychosis, thereby reducing the incidence and ensuing burden of these disorders at a population level. Accessing these services requires help-seeking behaviour, which may not be commonplace in people with psychotic symptoms (Falkenberg et al, 2015; Fridgen et al, 2013; Green et al, 2011). Conclusions: The distribution of UHR detection rates by neighbourhood is not random and may be explained in part by differences in the social environment between neighbourhoods

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call