14 DAY TRIAL // A report within the September issue of Archives of General Psychiatry, suggests that the high social fragmentation present in cities, might be the cause of a connection between psychotic disorders and life in urban areas.
In order to see if individual, school or area features have anything to do with psychosis and can give hints on the association with urbanicity, 203,829 individuals living in Sweden, were studied, with data at the individual, school, municipality and county levels.
Stanley Zammit, PhD, of Cardiff University, Cardiff, Wales, and his colleagues, found that “the risk of nonaffective psychosis was higher in cities and towns than in rural areas.”
0.16 percent of the people in the study, were admitted with a diagnosis of schizophrenia, 0.36 percent with non-affective psychoses, 0.17 percent with affective psychoses and 0.47 percent with other psychoses.
The researchers also found that most discrepancies in the risk of non-affective psychosis had an explanation at an individual level - “an association between urbanicity and nonaffective psychosis was explained by higher-level characteristics, primarily school-level social fragmentation.”
They “observed cross-level markers of ethnicity, social fragmentation and deprivation on risk of developing any psychotic disorder, all with qualitative patterns of interaction.”
As background of the article, they say that “there is a substantial worldwide variation in incidence rates of schizophrenia [and] the clearest geographic pattern within this distribution of rates is that urban areas have a higher incidence of schizophrenia than rural areas.”
Apparently, being raised in a more urbanized area gives you a higher risk of developing a non-affective psychotic disorder, and this is mainly due to the living area, and not to the characteristics of the individual.
This high risk of psychosis in urban individuals was explained mainly by social fragmentation, and the authors note that their “findings highlight the concern that physical integration alone is not sufficient but that some of the positive characteristics traditionally conferred by segregation, such as a localized sense of safety, cohesion and community spirit, must also be maintained to enhance the mental health of individuals within the population.”