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Spatial Variation in Psychosis Incidence in Rural Areas

For first episodes of nonaffective, affective psychotic disorders, incidence varies between neighborhoods

running on a country road

MONDAY, Dec. 4, 2017 (HealthDay News) -- In rural areas, there is spatial variation in the incidence of nonaffective and affective psychotic disorders, according to a study published online Nov. 29 in JAMA Psychiatry.

Lucy Richardson, from University College London, and colleagues examined neighborhood-level factors associated with first-episode psychosis (FEP) in a predominantly rural population-based cohort. Data were included for 631 individuals aged 16 to 35 years who met diagnostic criteria for first episodes of nonaffective psychoses and affective psychoses.

The researchers found that the crude incidence of FEP was 31.2 per 100,000 person-years. After adjustment for age, sex, race/ethnicity, and socioeconomic status, the incidence varied significantly between neighborhoods. For nonaffective psychoses, incidence was higher in neighborhoods that were more economically deprived and socially isolated (incidence rate ratios [IRRs], 1.13 and 1.11) and was lower in more racially/ethnically diverse neighborhoods (IRR, 0.94). There were correlations for higher intragroup racial/ethnic density and lower intragroup racial/ethnic fragmentation with reduced risk of affective psychosis (IRRs, 0.97 and 0.98).

"Spatial variation in the incidence of nonaffective and affective psychotic disorders exists in rural areas," the authors write. "This suggests that the social environment contributes to psychosis risk across the rural-urban gradient."

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