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  Urbanicity, social adversity and psychosis

Heinz, A., Deserno, L., & Reininghaus, U. (2013). Urbanicity, social adversity and psychosis. World Psychiatry, 12(3), 187-197. doi:10.1002/wps.20056.

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 Creators:
Heinz, Andreas1, Author
Deserno, Lorenz1, 2, Author              
Reininghaus, Ulrich3, Author
Affiliations:
1Department of Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany, ou_persistent22              
2Max Planck Fellow Group Cognitive and Affective Control of Behavioural Adaptation, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_1753350              
3Section of Social Psychiatry, Health Service and Population Research Department, Institute of Psychiatry, London, UK, ou_persistent22              

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Free keywords: Urbanicity; social adversity; psychosis; schizophrenia; social fragmentation; isolation; discrimination; stress
 Abstract: In recent years, there has been increasing interest in research on geographical variation in the incidence of schizophrenia and other psychoses. In this paper, we review the evidence on variation in incidence of schizophrenia and other psychoses in terms of place, as well as the individual‐ and area‐level factors that account for this variation. We further review findings on potential mechanisms that link adverse urban environment and psychosis. There is evidence from earlier and more recent studies that urbanicity is associated with an increased incidence of schizophrenia and non‐affective psychosis. In addition, considerable variation in incidence across neighbourhoods has been observed for these disorders. Findings suggest it is unlikely that social drift alone can fully account for geographical variation in incidence. Evidence further suggests that the impact of adverse social contexts – indexed by area‐level exposures such as population density, social fragmentation and deprivation – on risk of psychosis is explained (confounding) or modified (interaction) by environmental exposures at the individual level (i.e., cannabis use, social adversity, exclusion and discrimination). On a neurobiological level, several studies suggest a close link between social adversity, isolation and stress on the one hand, and monoamine dysfunction on the other, which resembles findings in schizophrenia patients. However, studies directly assessing correlations between urban stress or discrimination and neurobiological alterations in schizophrenia are lacking to date.

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Language(s): eng - English
 Dates: 2013-10-032013-10
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1002/wps.20056
PMC: PMC3799240
PMID: 24096775
 Degree: -

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Title: World Psychiatry
Source Genre: Journal
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Pages: - Volume / Issue: 12 (3) Sequence Number: - Start / End Page: 187 - 197 Identifier: -