Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses

作者：Judith Allardyce, Harper Gilmour, Jacqueline M. Atkinson, Tracey Rapson, Jennifer Bishop, Robin G. McCreadie · 发表于：The British Journal of Psychiatry · 年份：2005 · DOI：10.1192/bjp.187.5.401 · 被引用次数：208 · 研究领域：Schizophrenia research and treatment、Health disparities and outcomes、Mental Health Treatment and Access

BACKGROUND: Social disorganisation, fragmentation and isolation have long been posited as influencing the rate of psychoses at area level. Measuring such societal constructs is difficult. A census-based index measuring social fragmentation has been proposed. AIMS: To investigate the association between first-admission rates for psychosis and area-based measures of social fragmentation, deprivation and urban/rural index. METHOD: We used indirect standardisation methods and logistic regression models to examine associations of social fragmentation, deprivation and urban/rural categories with first admissions for psychoses in Scotland for the 5-year period 1989-1993. RESULTS: Areas characterised by high social fragmentation had higher first-ever admission rates for psychosis independent of deprivation and urban/rural status. There was a dose-response relationship between social fragmentation category and first-ever admission rates for psychosis. There was no statistically significant interaction between social fragmentation, deprivation and urban/rural index. CONCLUSIONS: First-admission rates are strongly associated with measures of social fragmentation, independent of material deprivation and urban/rural category.