Troubled Neighborhoods Seem to Raise Risk of Psychotic Disorder Diagnoses

People who live in more “disorganized” and troubled neighborhoods — especially high-crime ones — are more likely to get diagnoses of psychotic disorders, according to a study in Psychological Medicine.

Netherlands and New York-based researchers examined the numbers of people identified by health care providers as having a newly diagnosed psychotic disorder over a 7-year period in The Hague. They then correlated this data to information known about the people’s home neighborhoods, concerning characteristics such as socio-economic level, residential mobility, ethnic diversity, proportion of single person households, voter turnout, population density and crime level. They also tried to control for certain individual risk factors for psychotic disorders.

“(N)eighborhood social characteristics were statistically significantly associated with the incidence of psychotic disorders,” the researchers stated. “Socio-economic level and residential mobility of the neighborhood had the strongest relationship with incidence rates, but high ethnic diversity, crime level, population density and low voter turnout also separately predicted higher incidence… The cumulative degree of neighborhood social disorganization was strongly and linearly associated with the incidence of psychotic disorders.”

“Sociological and epidemiological literature over the past century suggests that mental and physical health of individuals is strongly determined by the social context in which they live,” the researchers stated. “Our results add to the evidence that neighborhood social characteristics contribute to the risk for psychotic disorders and that this association is not entirely confounded by individual risk factors.”

One possible explanation for their findings, they commented, “is that living in a disorganized, deprived neighborhood context with low mutual trust and reciprocity fosters experiences of exclusion, perceived hostility and paranoid thoughts, that may take on psychotic intensity in individuals with vulnerability to psychosis.”

“It should be noted, however, that the mechanism by which neighborhood disorganization would lead to psychotic disorder might well be other than social,” they added. “Living in disorganized neighborhoods most likely means higher exposure to toxins, infectious agents and air pollution. These factors have been implicated in the etiology of psychotic disorders, but have hardly been investigated in relation to spatial variation in rates of psychotic disorders.”

Veling, W., E. Susser, J.-P. Selten, and H. W. Hoek. “Social Disorganization of Neighborhoods and Incidence of Psychotic Disorders: A 7-Year First-Contact Incidence Study.” Psychological Medicine 45, no. 09 (July 2015): 1789–98. doi:10.1017/S0033291714002682. (Abstract)