City life more likely to result in mental health problems
Sep 8 2010 by Claire Miller, Western Mail
LIVING in a city puts you at greater risk of mental health problems.
The research, by academics at Cardiff University, suggests increased social fragmentation in places like Cardiff, Newport and Swansea makes people more likely to develop schizophrenia and other psychotic disorders, than those living in rural areas such as Powys or Ceredigion.
Studies have consistently shown that the rate of nonaffective psychotic disorders – delusional disorders not related to emotions or moods – is higher in cities.
The research, led by Dr Stanley Zammit, attempted to find out what factors might be behind the statistic.
The research looked at data on 203,829 individuals born in Sweden in 1972 and 1977, of whom 881 were diagnosed with non-affective psychosis including schizophrenia. The study was carried out using data from Sweden because there is more comprehensive data on people and their life histories there. But Dr Zammit said findings were likely to be similar if applied to other countries.
“The things we looked at were, is it something to do with the people who live in cities – are they more likely to use drugs, or to be very poor, or to come from an ethnic minority? “It might be to do with the city, it might be to do with the neighbourhood, you might live in an area with a lot of deprivation or with a lot of migration,” he added.
The study found that the risk of developing the disorder was partly down to the level of social fragmentation at school level, which tends to be higher in cities. This included the proportion of children who were immigrants, who changed cities between the ages of eight and 16, or who were raised in a single-parent household.
Dr Zammit said: “When people move it ends up breaking up their social network, at least for children. In areas where there’s a lot of single-parent families, those areas seemed to experience that increased risk in the city. The high risk in the city is probably a result of areas where there’s these movements and family instability.”
People were around 32% more likely to develop non-affective psychosis if they lived in a city than in rural areas, even after controlling for individual characteristics such as gender, family history of schizophrenia, immigrant status, and single- parent families.
When the researchers controlled for school and municipality-level variables, they mostly eliminated the relationship between living in an urban area and the prevalence of psychosis, suggesting it is where one lives which has an effect.
Standing out from the crowd was also found by researchers to be a risk factor in developing non-affective psychotic disorders.
Dr Zammit said: “People of an ethnic minority group have a very high risk of getting a psychotic disorder if they live or are raised in an area where there were few people from that background, if they were surrounded by people of native Sweden. “When they’re brought up in areas of lots of people of their ethnic group, the risk fell. The risk went up for native Swedes if they lived in an area of lots of people of ethnic-minority background.
“We found exactly the same kind of relationship for –deprivation – children who came from poor backgrounds who lived in affluent areas,” he added.
The academics suggested in the article in Archives of General Psychiatry that if their research was replicated in other studies, it could have implications for social policy, such as the need to increase integration by promoting development of socially and ethnically-mixed communities