Further evidence of a cumulative effect of social disadvantage on risk of psychosis.
Further evidence of a cumulative effect of social disadvantage on risk of psychosis.
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DOI：
10.1017/s0033291716002993
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发表时间：
2017-04
影响因子：
6.9
通讯作者：
Morgan C
中科院分区：
文献类型：
--
作者：
Stilo SA;Gayer-Anderson C;Beards S;Hubbard K;Onyejiaka A;Keraite A;Borges S;Mondelli V;Dazzan P;Pariante C;Di Forti M;Murray RM;Morgan C
越来越多的证据表明，社会劣势与精神病风险增加有关。然而，只有少数研究专门研究了累积效应和长期关联。本研究的目的是：比较首次精神病发作患者与对照样本中首次接触精神科服务时和之前社会劣势具体指标的患病率。探讨长期关联、累积效应和效应方向。我们收集了来自伦敦南部当地人口的332名患者和301名对照者的社会劣势信息。分析了儿童时期社会劣势的3个指标和成年期社会劣势的6个指标。在所有考虑的领域中，病例比对照组更有可能报告社会劣势。与对照组相比，病例中父母一方死亡的可能性大约是对照组的两倍，在17岁之前与父母一方长期分离的可能性大约是对照组的三倍。与对照组相比，病例更有可能报告两项或两项以上的成人社会劣势指标，不仅在首次接触精神科服务时[比值比（or） 9.5]，而且在精神病发病时（or 8.5），发病前1年（or 4.5）和发病前5年（or 2.9）。当前和长期暴露的指标越多，患精神病的几率就越高。有证据表明，社会劣势倾向于聚集和积累。
A growing body of evidence suggests that indicators of social disadvantage are associated with an increased risk of psychosis. However, only a few studies have specifically looked at cumulative effects and long-term associations. The aims of this study are: To compare the prevalence of specific indicators of social disadvantage at, and prior to, first contact with psychiatric services in patients suffering their first episode of psychosis and in a control sample. To explore long-term associations, cumulative effects, and direction of effects. We collected information on social disadvantage from 332 patients and from 301 controls recruited from the local population in South London. Three indicators of social disadvantage in childhood and six indicators of social disadvantage in adulthood were analysed. Across all the domains considered, cases were more likely to report social disadvantage than were controls. Compared with controls, cases were approximately two times more likely to have had a parent die and approximately three times more likely to have experienced a long-term separation from one parent before the age of 17 years. Cases were also more likely than controls to report two or more indicators of adult social disadvantage, not only at first contact with psychiatric services [odds ratio (OR) 9.5], but also at onset of psychosis (OR 8.5), 1 year pre-onset (OR 4.5), and 5 years pre-onset (OR 2.9). Greater numbers of indicators of current and long-term exposure are associated with progressively greater odds of psychosis. There is some evidence that social disadvantage tends to cluster and accumulate.