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Evidence that the wider social environment moderates the association between familial liability and psychosis spectrum outcome

Published online by Cambridge University Press:  16 April 2012

T. Binbay ,
M. Drukker ,
K. Alptekin ,
H. Elbi ,
F. Aksu Tanık ,
F. Özkınay ,
H. Onay ,
N. Zağlı  and
J. van Os
T. Binbay
Affiliation:
Department of Psychiatry, Atatürk State Hospital, Sinop, Turkey Maastricht University Medical Center, School of Mental Health and Neuroscience, Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Vijverdal, Maastricht, The Netherlands
M. Drukker
Affiliation:
Maastricht University Medical Center, School of Mental Health and Neuroscience, Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Vijverdal, Maastricht, The Netherlands
K. Alptekin
Affiliation:
Department of Psychiatry, School of Medicine, Dokuz Eylül University, Izmir, Turkey
H. Elbi
Affiliation:
Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
F. Aksu Tanık
Affiliation:
Department of Public Health, School of Medicine, Ege University, Izmir, Turkey
F. Özkınay
Affiliation:
Department of Medical Genetics, School of Medicine, Ege University, Izmir, Turkey
H. Onay
Affiliation:
Department of Medical Genetics, School of Medicine, Ege University, Izmir, Turkey
N. Zağlı
Affiliation:
Veritas Psychiatry and Neuroscience, Istanbul, Turkey
J. van Os*
Affiliation:
Maastricht University Medical Center, School of Mental Health and Neuroscience, Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Vijverdal, Maastricht, The Netherlands Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College, De Crespigny Park, Denmark Hill, London, UK
*
*Address for correspondence: J. van Os, Ph.D., Department of Psychiatry and Psychology, Maastricht University Medical Center, PO Box 616 (DRT12), 6200MD Maastricht, The Netherlands. (Email: [email protected])
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Abstract

Background

Familial liability to both severe and common mental disorder predicts psychotic disorder and psychotic symptoms, and may be used as a proxy in models examining interaction between genetic risk and the environment at individual and contextual levels.

Method

In a representative general population sample (n=4011) in Izmir, Turkey, the full spectrum of expression of psychosis representing (0) no symptoms, (1) subclinical psychotic experiences, (2) low-impact psychotic symptoms, (3) high-impact psychotic symptoms and (4) full-blown clinical psychotic disorder was assessed in relation to mental health problems in the family (proxy for familial liability) and the wider social environment. Quality of the wider social environment was assessed in an independent sample using contextual measures of informal social control, social disorganization, unemployment and low income, aggregated to the neighbourhood level.

Results

The association between familial liability to severe mental illness and expression of psychosis spectrum was stronger in more deprived neighbourhoods [e.g. this association increased from β=0.33 (p=0.01) in low-unemployment neighbourhoods to β=0.92 (p<0.001) in high-unemployment neighbourhoods] and in neighbourhoods high in social control, while neighbourhood variables did not modify the association between familial liability to common mental disorder and the psychosis outcome. Neighbourhood variables mediated urbanicity effects.

Conclusions

Contextual effects may be important in moderating the expression of psychosis liability in populations, representing a specific pathway independent of the link between common mental disorder and psychosis.

Keywords

Familial liabilitymodifiersneighbourhoodpsychosissocial capital
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 12 , December 2012 , pp. 2499 - 2510
Copyright
Copyright © Cambridge University Press 2012

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References

Allardyce, J, Boydell, J (2006). Review: the wider social environment and schizophrenia. Schizophrenia Bulletin 32, 592–598.CrossRefGoogle ScholarPubMed
Alptekin, K, Ulas, H, Akdede, BB, Tumuklu, M, Akvardar, Y (2009). Prevalence and risk factors of psychotic symptoms: in the city of Izmir, Turkey. Social Psychiatry and Psychiatric Epidemiology 44, 905–910.CrossRefGoogle ScholarPubMed
Andrews, G, Peters, L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 80–88.CrossRefGoogle ScholarPubMed
Binbay, T, Drukker, M, Elbi, H, Aksu, F, Özkınay, F, Önay, H, Zağlı, N, Van Os, J, Alptekin, K (2011 a). Testing the psychosis continuum: differential impact of genetic and non-genetic risk factors and comorbid psychopathology across the entire spectrum of psychosis. Schizophrenia Bulletin. Published online: 27 April 2011. doi:10.1093/schbul/sbr003.Google Scholar
Binbay, T, Elbi, H, Alptekin, K, Aksu, F, Drukker, M, Önay, H, Özkınay, F, Zağlı, N, Van Os, J (2011 b). Izmir Mental Health Survey for Gene–Environment Interaction in Psychoses (TürkSch): objectives and methodology. Türk Psikiyatri Dergisi 22, 65–76.Google ScholarPubMed
Buckner, JC (1988). The development of an instrument to measure neighbourhood cohesion. American Journal of Community Psychology 16, 771–791.CrossRefGoogle Scholar
Buka, SL, Brennan, RT, Rich-Edwards, JW, Raudenbush, SW, Earls, F (2003). Neighborhood support and the birth weight of urban infants. American Journal of Epidemiology 157, 1–8.CrossRefGoogle ScholarPubMed
De Silva, MJ, McKenzie, K, Harpham, T, Huttly, SR (2005). Social capital and mental illness: a systematic review. Journal of Epidemiology and Community Health 59, 619–627.CrossRefGoogle ScholarPubMed
Deveci, A, Taskin, O, Dinc, G, Yilmaz, H, Demet, MM, Erbay-Dundar, P, Kaya, E, Ozmen, E (2007). Prevalence of pseudoneurologic conversion disorder in an urban community in Manisa, Turkey. Social Psychiatry and Psychiatric Epidemiology 42, 857–864.CrossRefGoogle Scholar
Drukker, M, Buka, SL, Kaplan, CD, McKenzie, K, Van Os, J (2005). Social capital and children's general health in different sociocultural settings. Social Science and Medicine 61, 185–198.CrossRefGoogle ScholarPubMed
Drukker, M, Driessen, G, Krabbendam, L, Van Os, J (2004). The wider social environment and mental health service use. Acta Psychiatrica Scandinavica 110, 119–129.CrossRefGoogle ScholarPubMed
Drukker, M, Gunther, N, Van Os, J (2007). Disentangling associations between poverty at various levels of aggregation and mental health. Epidemiologia e Psichiatria Sociale 16, 3–9.CrossRefGoogle ScholarPubMed
Drukker, M, Kaplan, CD, Feron, FJM, Van Os, J (2003). Children's health-related quality of life, neighbourhood socio-economic deprivation and social capital; a contextual analysis. Social Science and Medicine 57, 825–841.CrossRefGoogle ScholarPubMed
Drukker, M, Krabbendam, L, Driessen, G, Van Os, J (2006). Social disadvantage and schizophrenia: a combined neighbourhood and individual-level analysis. Social Psychiatry and Psychiatric Epidemiology 41, 595–604.CrossRefGoogle ScholarPubMed
Gottesman, II, Wolfgram, DL (1991). Schizophrenia Genesis, the Origins of Madness. Freeman & Co.: New York.Google Scholar
Hanssen, M, Bak, M, Bijl, R, Vollebergh, W, van Os, J (2005). The incidence and outcome of subclinical psychotic experiences in the general population. British Journal of Clinical Psychology 44, 181–191.CrossRefGoogle ScholarPubMed
Jencks, C, Mayer, SE (1990). The social consequences of growing up in a poor neighborhood. In Inner-City Poverty in the United States (ed. Lynn, L. E. Jr. and McGeary, M. G. H.), pp. 111–186. Brookings: Washington, DC.Google Scholar
Kasarda, JD (1993). Urban Underclass Database: An Overview and Machine-Readable File Documentation. Social Science Research Council: New York.Google Scholar
Kirkbride, JB, Boydell, J, Ploubidis, GB, Morgan, C, Dazzan, P, McKenzie, K, Murray, RM, Jones, PB (2008). Testing the association between the incidence of schizophrenia and social capital in an urban area. Psychological Medicine 38, 1083–1094.CrossRefGoogle Scholar
Kish, L (1949). A procedure for objective respondent selection within the household. Journal of the American Statistical Association 44, 380–387.CrossRefGoogle Scholar
Krabbendam, L, van Os, J (2005). Schizophrenia and urbanicity: a major environmental influence – conditional on genetic risk. Schizophrenia Bulletin 31, 795–799.CrossRefGoogle Scholar
Lederbogen, F, Kirsch, P, Haddad, L, Streit, F, Tost, H, Schuch, P, Wust, S, Pruessner, JC, Rietschel, M, Deuschle, M, Meyer-Lindenberg, A (2011). City living and urban upbringing affect neural social stress processing in humans. Nature 474, 498–501.CrossRefGoogle Scholar
Lee, BK, Glass, TA, James, BD, Bandeen-Roche, K, Schwartz, BS (2011). Neighborhood psychosocial environment, apolipoprotein E genotype, and cognitive function in older adults. Archives of General Psychiatry 68, 314–321.CrossRefGoogle ScholarPubMed
Leventhal, T, Brooks Gunn, J (2000). The neighborhoods they live in: the effects of neighborhood residence on child and adolescent outcomes. Psychological Bulletin 126, 309–337.CrossRefGoogle ScholarPubMed
Marcelis, M, Navarro-Mateu, F, Murray, R, Selten, JP, Van Os, J (1998). Urbanization and psychosis: a study of 1942–1978 birth cohorts in The Netherlands. Psychological Medicine 28, 871–879.CrossRefGoogle ScholarPubMed
March, D, Hatch, SL, Morgan, C, Kirkbride, JB, Bresnahan, M, Fearon, P, Susser, E (2008). Psychosis and place. Epidemiologic Reviews 30, 84–100.CrossRefGoogle ScholarPubMed
McCulloch, A (2003). An examination of social capital and social disorganisation in neighbourhoods in the British household panel study. Social Science and Medicine 56, 1425–1438.CrossRefGoogle ScholarPubMed
McGue, M, Gottesman, II (1991). The genetic epidemiology of schizophrenia and the design of linkage studies. European Archives of Psychiatry and Clinical Neuroscience 240, 174–181.CrossRefGoogle ScholarPubMed
McKenzie, K, Whitley, R, Weich, S (2002). Social capital and mental health. British Journal of Psychiatry 181, 280–283.CrossRefGoogle ScholarPubMed
Meier, MH, Slutske, WS, Arndt, S, Cadoret, RJ (2008). Impulsive and callous traits are more strongly associated with delinquent behavior in higher risk neighborhoods among boys and girls. Journal of Abnormal Psychology 117, 377–385.CrossRefGoogle ScholarPubMed
Metropolitan Municipality of Izmir (2007). Urban Information System. Büyükşehir Belediyesi: Izmir.Google Scholar
Mortensen, PB, Pedersen, MG, Pedersen, CB (2010). Psychiatric family history and schizophrenia risk in Denmark: which mental disorders are relevant? Psychological Medicine 40, 201–210.CrossRefGoogle ScholarPubMed
National Institute of Mental Health Genetics Initiative (1992). Family Interview for Genetic Studies (FIGS). National Institute of Mental Health: Rockville, MD.Google Scholar
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 1053–1058.CrossRefGoogle ScholarPubMed
Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, Farmer, A, Jablenski, A, Pickens, R, Regier, DA, Sartorius, N, Towle, LH (1988). The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry 45, 1069–1077.CrossRefGoogle ScholarPubMed
Ross, CE, Reynolds, JR, Geis, KJ (2000). The contingent meaning of neighborhood stability for residents' psychological well-being. American Sociological Review 65, 581–597.Google Scholar
Rothman, KJ, Greenland, S (1998). Modern Epidemiology. Lippincott-Raven: Philadelphia.Google Scholar
Samele, C, van Os, J, McKenzie, K, Wright, A, Gilvarry, C, Manley, C, Tattan, T, Murray, R (2001). Does socioeconomic status predict course and outcome in patients with psychosis? Social Psychiatry and Psychiatric Epidemiology 36, 573–581.CrossRefGoogle ScholarPubMed
Sampson, RJ (1997). Collective regulation of adolescent misbehavior: validation results from eighty Chicago neighborhoods. Journal of Adolescent Research 12, 227–244.CrossRefGoogle Scholar
Sampson, RJ, Morenoff, JD, Earls, F (1999). Beyond social capital: spatial dynamics of collective efficacy for children. American Sociological Review 64, 633–660.CrossRefGoogle Scholar
Sönmez, IÖ (2007). Concentrated urban poverty: the case of Izmir inner area, Turkey. European Planning Studies 15, 319–338.CrossRefGoogle Scholar
Subramanian, SV, Lochner, KA, Kawachi, I (2003). Neighborhood differences in social capital: a compositional artifact or a contextual construct? Health and Place 9, 33–44.CrossRefGoogle ScholarPubMed
Ünverdi, H (2005). 1980 sonrası değişim, yeni dinamikler ve kimlik temelli yapılanmalar: İzmir gecekonduları örneği (Changes after 1980s, new dynamics and identity based structures: the case of İzmir's gecekondus). Sosyoloji Dergisi 14, 69–100.Google Scholar
Van Os, J, Driessen, G, Gunther, N, Delespaul, P (2000 a). Neighbourhood variation in incidence of schizophrenia: evidence for person–environment interaction. British Journal of Psychiatry 176, 243–248.CrossRefGoogle ScholarPubMed
Van Os, J, Hanssen, M, Bijl, RV, Ravelli, A (2000 b). Strauss (1969) revisited: a psychosis continuum in the general population? Schizophrenia Research 45, 11–20.CrossRefGoogle ScholarPubMed
Van Os, J, Kenis, G, Rutten, BP (2010). The environment and schizophrenia. Nature 468, 203–212.CrossRefGoogle ScholarPubMed
Van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychological Medicine 39, 179–195.CrossRefGoogle ScholarPubMed
Van Os, J, Rutten, BP, Poulton, R (2008). Gene–environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophrenia Bulletin 34, 1066–1082.CrossRefGoogle ScholarPubMed
Whitley, R, McKenzie, K (2005). Social capital and psychiatry: review of the literature. Harvard Review of Psychiatry 13, 71–84.CrossRefGoogle ScholarPubMed
Wilson, WJ (1987). The Truly Disadvantaged: The Inner City, The Underclass, and Public Policy. University of Chicago Press: Chicago, IL.Google Scholar
Zammit, S, Lewis, G, Rasbash, J, Dalman, C, Gustafsson, JE, Allebeck, P (2010). Individuals, schools, and neighborhood: a multilevel longitudinal study of variation in incidence of psychotic disorders. Archives of General Psychiatry 67, 914–922.CrossRefGoogle ScholarPubMed
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