new research in JAMA Psychiatry found that living in socio-economic “deprivation” at birth and early childhood increases the likelihood of psychosis and bipolar disorder. We found that children who experienced ‘upward mobility’ had a significantly reduced risk of these disorders, making them comparable to children who had never experienced deprivation.
The researchers added:
“Socioeconomic interventions that lift people out of more disadvantaged environments early in childhood will reduce future SMI risk.”
Although researchers use the term SMI, current research reveals that it refers to psychosis (such as schizophrenia) or bipolar disorder.
The study was conducted by Yanakan Rogeswaran, Jennifer Dijksorn and James B. Kirkbride from University College London, and Kristina Dalman from the Karolinska Institute in Stockholm, Sweden.
The researchers determined the socio-economic defined areas of deprivation. Also includes population density.
The study included 26,729 people with psychosis or bipolar disorder from a longitudinal population registry called Swedish Psychiatry, matched on age and gender with a similar number of people without such a diagnosis.
Here are their findings:
“From birth to early adolescence, we found a strong gradient between living in poorer, more densely populated areas and the probability of future mental illness, consistent with social causation theory. These probabilities were , which improved in proportion to the degree of upward mobility experienced during their upbringing.”
The researchers controlled for factors such as family history of SMI. They write this as “lend.”[s] Confidence in the causal interpretation of their results”.
There’s a reason why it was so important to describe a family history of psychiatric diagnoses. Other researchers theorize that families with SMI are more “cognitively impaired,” have poorer academic outcomes, and as a result live in “disadvantaged” environments. Later, their children would also receive her SMI diagnosis. This is because it is thought to be genetic rather than environmental. (There is no research to support some of this speculation.)
However, once you rule out genetics (in this case, by family history of SMI), the main factor that causes SMI remains environmental. This was also the case in the current study. Additionally, upward mobility also reduced the risk of subsequent SMI diagnosis, another important implication that environment, rather than genetics, plays a role in the development of mental health problems.
Finally, another unsubstantiated theory is that people with SMI experience “social drift”, where they experience downward social mobility and end up in worse circumstances. However, in the new study, researchers found that only 2.7% of SMI patients were actually placed in poor conditions. Instead, people with SMI were more likely to remain in similar environments than to experience upward or downward mobility.
These findings suggest that genetics, including polygenic risk scores, can explain a small or no proportion of people who develop psychosis, as opposed to socioeconomic status, trauma, or other environmental factors. This is consistent with previous research findings. big percentage.
One important limitation, the researchers noted, is that the results were obtained from a Swedish sample, so it is unclear whether the results generalize to other countries outside the Arctic. I am.
Still, the study results suggest that future researchers and policymakers should look to see if they can lift families out of poverty and thereby reduce future diagnoses of psychosis and bipolar disorder. The researchers write that there is.
“Ambitious trials investigating whether SMI risk can be ameliorated by moving people out of more disadvantaged settings are now warranted. To our knowledge, no trial has tested such an intervention on SMI. However, the Mobility to Opportunity Trial shows evidence that moving to higher-quality neighborhoods led to reduced psychological distress among adolescents, although this may be an unintended consequence for some groups. It may also have caused harm: increased mental health risks for boys.”
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Logeswaran, Y., Dykxhoorn, J., Dalman, C., and Kirkbride, J.B. (2023). Changes in social deprivation and population density before and after diagnosis of psychotic disorders. JAMA Psychiatry. Published online on September 6, 2023. doi:10.1001/jamapsychiatry.2023.3220 (link)
