Small area variations in non-affective first-episode psychosis: the role of socioeconomic and environmental factors
Consultable a partir de
2024-07-31
Fecha
2023Autor
Versión
Acceso embargado / Sarbidea bahitua dago
Tipo
Artículo / Artikulua
Versión
Versión aceptada / Onetsi den bertsioa
Identificador del proyecto
Impacto
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10.1007/s00406-023-01665-z
Resumen
Background: There is strong evidence supporting the association between environmental factors and increased risk of non-affective psychotic disorders. However, the use of sound statistical methods to account for spatial variations associated with environmental risk factors, such as urbanicity, migration, or deprivation, is scarce in the literature. Methods: We studied the geographical distributio ...
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Background: There is strong evidence supporting the association between environmental factors and increased risk of non-affective psychotic disorders. However, the use of sound statistical methods to account for spatial variations associated with environmental risk factors, such as urbanicity, migration, or deprivation, is scarce in the literature. Methods: We studied the geographical distribution of non-affective first-episode psychosis (NA-FEP) in a northern region of Spain (Navarra) during a 54-month period considering area-level socioeconomic indicators as putative explanatory variables. We used several Bayesian hierarchical Poisson models to smooth the standardized incidence ratios (SIR). We included neighborhood-level variables in the spatial models as covariates. Results: We identified 430 NA-FEP cases over a 54-month period for a population at risk of 365,213 inhabitants per year. NA-FEP incidence risks showed spatial patterning and a significant ecological association with the migrant population, unemployment, and consumption of anxiolytics and antidepressants. The high-risk areas corresponded mostly to peripheral urban regions; very few basic health sectors of rural areas emerged as high-risk areas in the spatial models with covariates. Discussion: Increased rates of unemployment, the migrant population, and consumption of anxiolytics and antidepressants showed significant associations linked to the spatial-geographic incidence of NA-FEP. These results may allow targeting geographical areas to provide preventive interventions that potentially address modifiable environmental risk factors for NA-FEP. Further investigation is needed to understand the mechanisms underlying the associations between environmental risk factors and the incidence of NA-FEP. [--]
Materias
Environmental risk factors,
Epidemiology,
First-episode psychosis,
Incidence
Editor
Springer
Publicado en
European Archives of Psychiatry and Clinical Neuroscience (2023)
Departamento
Universidad Pública de Navarra. Departamento de Estadística, Informática y Matemáticas /
Nafarroako Unibertsitate Publikoa. Estatistika, Informatika eta Matematika Saila /
Universidad Pública de Navarra/Nafarroako Unibertsitate Publikoa. Institute for Advanced Materials and Mathematics - INAMAT2
Versión del editor
Entidades Financiadoras
This study was funded by a grant from the Carlos III Health Institute of the Ministry of Science and Innovation of the Government of Spain (PI19/01698). It was also funded by project PID2020-113125RB-I00/MCIN/AEI/10.13039/501100011033.