PMID- 32249120
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20210617
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 220
DP  - 2020 Jun
TI  - Area deprivation, urbanicity, severe mental illness and social drift - A 
      population-based linkage study using routinely collected primary and secondary 
      care data.
PG  - 130-140
LID - S0920-9964(20)30154-7 [pii]
LID - 10.1016/j.schres.2020.03.044 [doi]
AB  - We investigated whether associations between area deprivation, urbanicity and 
      elevated risk of severe mental illnesses (SMIs, including schizophrenia and 
      bipolar disorder) is accounted for by social drift or social causation. We 
      extracted primary and secondary care electronic health records from 2004 to 2015 
      from a population of 3.9 million. We identified prevalent and incident 
      individuals with SMIs and their level of deprivation and urbanicity using the 
      Welsh Index of Multiple Deprivation (WIMD) and urban/rural indicator. The 
      presence of social drift was determined by whether odds ratios (ORs) from 
      logistic regression is greater than the incidence rate ratios (IRRs) from Poisson 
      regression. Additionally, we performed longitudinal analysis to measure the 
      proportion of change in deprivation level and rural/urban residence 10 years 
      after an incident diagnosis of SMI and compared it to the general population 
      using standardised rate ratios (SRRs). Prevalence and incidence of SMIs were 
      significantly associated with deprivation and urbanicity (all ORs and IRRs 
      significantly >1). ORs and IRRs were similar across all conditions and cohorts 
      (ranging from 1.1 to 1.4). Results from the longitudinal analysis showed 
      individuals with SMIs are more likely to move compared to the general population. 
      However, they did not preferentially move to more deprived or urban areas. There 
      was little evidence of downward social drift over a 10-year period. These 
      findings have implications for the allocation of resources, service configuration 
      and access to services in deprived communities, as well as, for broader public 
      health interventions addressing poverty, and social and environmental contexts.
CI  - Copyright (c) 2020 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Lee, Sze Chim
AU  - Lee SC
AD  - HDRUK, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK; 
      National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK.
FAU - DelPozo-Banos, Marcos
AU  - DelPozo-Banos M
AD  - HDRUK, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK; 
      National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK.
FAU - Lloyd, Keith
AU  - Lloyd K
AD  - HDRUK, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK; 
      National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK.
FAU - Jones, Ian
AU  - Jones I
AD  - National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK; MRC Centre for Neuropsychiatric Genetics and 
      Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy 
      Road, Cathays, Cardiff CF24 4HQ, UK.
FAU - Walters, James T R
AU  - Walters JTR
AD  - National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK; MRC Centre for Neuropsychiatric Genetics and 
      Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy 
      Road, Cathays, Cardiff CF24 4HQ, UK.
FAU - Owen, Michael J
AU  - Owen MJ
AD  - National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK; MRC Centre for Neuropsychiatric Genetics and 
      Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy 
      Road, Cathays, Cardiff CF24 4HQ, UK.
FAU - O'Donovan, Michael
AU  - O'Donovan M
AD  - National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK; MRC Centre for Neuropsychiatric Genetics and 
      Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy 
      Road, Cathays, Cardiff CF24 4HQ, UK.
FAU - John, Ann
AU  - John A
AD  - HDRUK, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK; 
      National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, 
      Maindy Road, Cardiff CF24 4HQ, UK. Electronic address: a.john@swansea.ac.uk.
LA  - eng
GR  - MR/L010305/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
DEP - 20200402
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
MH  - *Bipolar Disorder/epidemiology
MH  - Humans
MH  - Poverty
MH  - Rural Population
MH  - *Schizophrenia/epidemiology
MH  - Secondary Care
OTO - NOTNLM
OT  - Bipolar disorder
OT  - Deprivation
OT  - Schizophrenia
OT  - Severe mental illness
OT  - Social drift
OT  - Urbanicity
COIS- Declaration of competing interest None.
EDAT- 2020/04/07 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/04/07 06:00
PHST- 2019/05/18 00:00 [received]
PHST- 2020/01/20 00:00 [revised]
PHST- 2020/03/21 00:00 [accepted]
PHST- 2020/04/07 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/04/07 06:00 [entrez]
AID - S0920-9964(20)30154-7 [pii]
AID - 10.1016/j.schres.2020.03.044 [doi]
PST - ppublish
SO  - Schizophr Res. 2020 Jun;220:130-140. doi: 10.1016/j.schres.2020.03.044. Epub 2020 
      Apr 2.