Small area variations in non-affective first-episode psychosis: the role of socioeconomic and environmental factors.

Autor: Gutiérrez G; Department of Psychiatry, Navarra University Hospital, Pamplona, Spain.; Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain., Goicoa T; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.; Statistics, Computer Science and Mathematics, Public University of Navarra, Pamplona, Spain.; Institute for Advanced Material and Mathematics, INAMAT2, Public University of Navarra, Pamplona, Spain., Ugarte MD; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.; Statistics, Computer Science and Mathematics, Public University of Navarra, Pamplona, Spain.; Institute for Advanced Material and Mathematics, INAMAT2, Public University of Navarra, Pamplona, Spain., Aranguren L; Department of Psychiatry, Navarra University Hospital, Pamplona, Spain.; Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain., Corrales A; Department of Psychiatry, Navarra University Hospital, Pamplona, Spain.; Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain., Gil-Berrozpe G; Department of Psychiatry, Navarra University Hospital, Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain., Librero J; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.; Navarrabiomed, Navarra University Hospital, Public University of Navarra, Pamplona, Spain., Sánchez-Torres AM; Department of Psychiatry, Navarra University Hospital, Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain., Peralta V; Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain., García de Jalon E; Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain., Cuesta MJ; Department of Psychiatry, Navarra University Hospital, Pamplona, Spain. mcuestaz@navarra.es.; Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain. mcuestaz@navarra.es., Martínez M, Otero M, Azcarate L, Pereda N, Monclús F, Moreno L, Fernández A, Ariz MC, Sabaté A, Aquerreta A, Aguirre I, Lizarbe T, Begué MJ
Jazyk: angličtina
Zdroj: European archives of psychiatry and clinical neuroscience [Eur Arch Psychiatry Clin Neurosci] 2024 Sep; Vol. 274 (6), pp. 1497-1506. Date of Electronic Publication: 2023 Aug 23.
DOI: 10.1007/s00406-023-01665-z
Abstrakt: 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.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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