Study examines association between urban living and psychotic disorders

JAMA and Archives Journals ^ | September 6, 2010 | Unknown

[decimon]

The association between psychotic disorders and living in urban areas appears to be a reflection of increased social fragmentation present within cities, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

"There is a substantial worldwide variation in incidence rates of schizophrenia," the authors write as background in the article. "The clearest geographic pattern within this distribution of rates is that urban areas have a higher incidence of schizophrenia than rural areas." Characteristics of neighborhoods that have been associated with an increased risk of developing psychosis include population and ethnic density, deprivation and social fragmentation or reduced social capital and cohesion.

To examine whether individual, school or area characteristics are associated with psychosis and can explain the association with urbanicity (the quality of being urban), Stanley Zammit, Ph.D., of Cardiff University, Cardiff, Wales, and colleagues studied a total of 203,829 individuals living in Sweden, with data at the individual, school, municipality and county levels.

According to the findings, "the risk of nonaffective psychosis was higher in cities and towns than in rural areas." Of the 203,829 people in the study, 328 (0.16 percent) were ever admitted with a diagnosis of schizophrenia, 741 (0.36 percent) with other nonaffective psychoses, 355 (0.17 percent) with affective psychoses and 953 (0.47 percent) with other psychoses. Additionally, the authors found that almost all variance in the risk of nonaffective psychosis was explained at the individual-level rather than at a higher-level variation. "An association between urbanicity and nonaffective psychosis was explained by higher-level characteristics, primarily school-level social fragmentation." The authors "observed cross-level markers of ethnicity, social fragmentation and deprivation on risk of developing any psychotic disorder, all with qualitative patterns of interaction."

The authors comment that, "being raised in more urbanized areas was associated with an increased risk of developing any nonaffective psychotic disorder." Additionally, "this association was explained primarily by area characteristics rather than by characteristics of the individuals themselves. Social fragmentation was the most important area characteristic that explained the increased risk of psychosis in individuals brought up in cities." The authors also note that, "our findings highlight the concern that physical integration alone is not sufficient but that some of the positive characteristics traditionally conferred by segregation, such as a localized sense of safety, cohesion and community spirit, must also be maintained to enhance the mental health of individuals within the population."

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(Arch Gen Psychiatry. 2010;67[9]:914-922. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by the National Assembly for Wales and Swedish Research Council for Working Life and Social Research. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

[SWAMPSNIPER]

This fact was the rationale behind the electoral college system, the founders did not want the big city mentality to rule American politics.

[cripplecreek]

While being somewhat aristocratic to varying degrees themselves, our founders recognized the need for all of society to be participants. The electoral college is a shield against elitism

George Washington’s rules of etiguette is an interesting read. One of his rules that I found to be particularly striking was about greeting all men as equals. He made a point of standing to greet every man, even subordinates.

If you’re interested in that sort of thing, I found this site to be a valuable source of original documents from 500 BC to the mid 1800s. Many of the links are missing but further searching can find most of them. Among my favorites was testimoney given to Parliment by Ben Franklin reguarding the direction relations between the colonies and Great Britain were heading.

http://www.constitution.org/primarysources/primarysources.html#bc

[Lancer_N3502A]

Ping

[SunkenCiv]

I’ve begun to believe it, considering some of the whacked-out tinfoil-hat conspiracy nutjobs that infest the internet, regardless of (claimed) political orientation. Oh, and I live in the city myself. Hey, why’s everyone staring at me?

Thanks decimon. :’)