Growing up in a poor urban neighborhood more than doubles the average person’s risk of developing a psychosis-spectrum disorder by middle adulthood, according to a new study led by researchers from the University of California (UC) Davis and Concordia University in Canada.
The results of the research, which followed nearly 4,000 Québec families for more than 30 years, suggest that interventions through social policies and neighborhood improvements could prevent future debilitating illnesses as well as the societal and personal costs associated with them, said the study’s authors.
“One important message to take from this study is that the stresses and chronic day-to-day challenges of living in under-resourced or impoverished communities can undermine the well-being of individuals whether they seem to have a vulnerability or not,” said Dr. Paul D. Hastings, professor in the Department of Psychology at UC Davis and the lead author of the paper.
He explains that although heredity is a major factor in predicting schizophrenia, bipolar disorder and other disorders involving psychoses, the new findings show clear evidence that environmental factors experienced in childhood also affect future mental health.
The study is published in the journal Development and Psychopathology.
The origins of the Concordia Longitudinal Research Project date back to the 1970s, when the initial researchers sought to test existing theories on the roles of early adversity and children’s social traits on the development of psychiatric disorders.
The study followed families living in low-income urban communities in French-speaking parts of Montréal, Québec, comprising, in the end, nearly 11,000 individuals. Peer reports of behavior at school were used to assess children’s aggression, withdrawal and likability.
Beginning in the mid 2000s, researchers began analyzing the previous three decades of individual medical records as well as census data on neighborhood economic conditions. On average, the children were around 10 years old at the beginning of the study and were followed until they were 40. Meanwhile, their parents aged from their late 30s into their late 60s.
Residents of Québec receive government-funded health care, and the researchers were able to analyze numerically coded records of the subject families in order to identify psychiatric diagnoses. Since the researchers were able to identify parental diagnoses in the study, their analyses were able to predict the children’s future prevalence of psychiatric disorders above and beyond what would result from heredity, Hastings said.
The findings show that more than 6 percent of the children in the study had developed schizophrenia, bipolar disorder with psychosis, or other psychosis-spectrum disorders by middle-adulthood. Those who grew up in the most economically disadvantaged neighborhoods had the greatest likelihood of developing schizophrenia or bipolar disorder.
In addition, childhood social behaviors were strong predictors of psychotic illnesses. In particular, children who were evaluated by their peers as both highly aggressive and highly withdrawn were likely to develop psychosis-spectrum disorders if they also grew up in more impoverished neighborhoods.
The findings suggest that interventions with young children who exhibit these complex patterns of antisocial behavior could lead to better outcomes.
“Once psychosis spectrum disorders take hold they are difficult to treat. It is kind of like ALS (amyotrophic lateral sclerosis) and similar illnesses,” said Hastings.
“Disorders like schizophrenia really become chronic diseases that require constant care, management, and maintenance. Reducing them by improving neighborhood conditions for all families in economically disadvantaged communities, and working directly with the families of children showing risky profiles of behavior, could improve the quality of people’s lives and markedly reduce health care costs.”
Source: University of California- Davis