In a report conducted by UK-based researchers, Jesus Perez and colleagues, the authors compiled literature from prior studies in order to understand the social epidemiology of psychosis to detect “high risk” individuals and make recommendations for improving services amongst this group. Their findings indicate that rates of psychosis tend to be higher in ethnic minority groups and in individuals from lower socioeconomic backgrounds.
Despite the fact that psychotic conditions can be a major concern for individuals, their families, and their providers, work towards understanding the full picture of the condition, as well as developing interventions targeting it, has moved slowly. The benefits of newer pharmacological therapies for psychosis remain uncertain and the deleterious effects of older antipsychotics have been previously established.
Even the more evidence-based and effective psychotherapies are not widely available for those who need them. Among other innovative interventions surging in Europe, the National Health Service (NHS) has led the way in home treatment services for individuals with psychotic conditions, and they continue to work on early intervention services, which includes understanding the determinants of psychosis.
Researchers compiled data from population and cohort-based studies, as well as clinical surveillance of electronic records in specific regions of England. Through their extensive compiled results and recommendations the researchers aimed to provide education, investigate determinants of psychosis, and utilize their predictions to guide policy.
The study found higher rates of psychosis than the incidence rates reported by the UK Department of Health. Psychosis rates, they found, were higher in men and they tend to decline with age. Rates were also higher in black and other ethnic minority groups, in both rural and urban settings. In addition, rates were higher in individuals facing so-named socioenvironmental adversities, and in neighborhoods with multiple deprivations.
“The sociodemographic characteristics of incidence rates were also similar to those of more urban studies, including higher rates in black and ethnic minority groups, indicating that psychosocial and other phenomena contributing to this variation are not confined to urban populations.”
A recent study published last month in the American Journal of Psychiatry found similar results, also in England. The authors reported that the highest rates of psychosis “were restricted to urban and deprived communities, suggesting that a threshold of socioenvironmental adversity may be necessary to increase incidence.” Their results specifically indicated that rates of psychosis were higher for men and women under 20 years old, individuals from ethnic minority groups, lower socioeconomic status, and “deprived” neighborhoods. In communities with access to early intervention, the incidence of psychosis was lower.
As the researchers working on both of these studies observed, these results have implications for both getting a clearer picture of psychosis, as well as who receives treatment for it. This research, with its focus on social epidemiology, has the potential for influencing how appropriate services should be distributed.
Perez, J., Russo, D. A., Stochl, J., Shelley, G. F., Crane, C. M., Painter, M., … & Jones, P. B. (2016). Understanding causes of and developing effective interventions for schizophrenia and other psychoses. Programme Grants for Applied Research, 4.2. (Abstract)