Social Factors in Psychosis Flashcards
What did the 10 country study of the WHO find about schizophrenia incidence rates and what was the issue with the study?
They found the incidence rate was uniform across locations.
The study was largely underpowered
Broad schizophrenia rates showed a diverse incidence rate.
What did a meta-analysis by John McGarth in Queensland Australia find and how?
In 100 studies, when the top 10 and bottom 10 were discounted there was still 5 fold difference in incidence rates.
Men, urban areas and migrant populations all had a notable increase in rate.
Most replicable is urban areas and migrant pops.
What did a study from Denmark by Pedersen and Mortensen find regarding population levels and schizophrenia?
That where you lived as a child had a direct effect on your risk of schizophrenia. The higher the population the higher risk. From least to most populated carried a risk of 2 fold.
This includes when you move into or out of these areas within 5 years.
What did Kirkbride et al find in his study of 3 British cities?
By looking at London, Nottingham and Bristol they found incidence rates followed the density of populations.
What did Kirkbride’s meta-analysis find regarding migrant populations?
Incidence rates were related to migrant populations, but even more so for those from developing nations, and even more for black populations.
How has ethnicity been found to relate to incidence rates?
Black Caribbean and African migrants have increased incidence rates. Regardless of first or second generation, therefore it may be minority.
Eastern European or Asian’s do not share this.
What is the evidence that psychosis exists on a continuum and why is it important?
10% of the population shows some level of psychosis, many of them share the same risk factors.
What did the Chicago study of Faris and Dunham find?
That hospitalisation rates of Schizophrenia were higher in areas of Social fragmentation:
Areas of high:
Social mobility
Rental or Single occupancy
Migrant groups
Crime
But: Is this causation or social drift.
How was the Chicago study built on?
Allardyce in Scotland, showed how Social Fragmentation related directly to Psychotic Disorders, even when adjusted for deprivation.
How does ethnic density contribute to Schizophrenia incidence and can Social drift explain it?
The lower the density the higher the risk of developing schizophrenia.
Social drift is unable to explain this as the minorities are found in the higher socio-economic classes.
Are there any indicators in childhood adversity that contribute to Schizophrenia?
Yes, a Sweedish study found that unemployment, welfare, single parent household, rented living and low income status all increased it. Some evidence this was accumulative.
However these factors increase risk to all Disorders.
What did a Meta-analysis on Childhood adversity and risk to psychosis find?
That childhood adversity carried a risk of 2 to 3 fold. This was independent of the type of study that was used.
What are some issues regarding the study of childhood adversity?
Often done on Psychotic episodes rather than psychotic disorders due to the rarity.
Longitudinal studies with large samples are needed which are not feasible.
Problems occur with:
Co morbitity Sample size First episode Recall Control match Exposure details of adversity
What did Arseneualt et al find with regard to severity and specificity of childhood trauma?
Using twin studies and followed up at 12 years,
Specific trauma had more effect than others. Potentially those with ill intent.
Also, the compounding of effect when multiple traumas involved.
What did the study in Australia by Cutajar find regarding sexual abuse and psychotic disorders?
All sexual abuse increases likelihood of psychotic disorders and Schizophrenia.
Severity increased the likelihood of both, but more so Schizophrenia.
