PMID- 37634386
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20240221
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 260
DP  - 2023 Oct
TI  - Trends in socioeconomic inequalities in incidence of severe mental illness - A 
      population-based linkage study using primary and secondary care routinely 
      collected data between 2000 and 2017.
PG  - 113-122
LID - S0920-9964(23)00283-9 [pii]
LID - 10.1016/j.schres.2023.08.014 [doi]
AB  - OBJECTIVE: In 2008, the UK entered a period of economic recession followed by 
      sustained austerity measures. We investigate changes in inequalities by area 
      deprivation and urbanicity in incidence of severe mental illness (SMI, including 
      schizophrenia-related disorders and bipolar disorder) between 2000 and 2017. 
      METHODS: We analysed 4.4 million individuals from primary and secondary care 
      routinely collected datasets (2000-2017) in Wales and estimated the incidence of 
      SMI by deprivation and urbanicity measured by the Welsh Index of Multiple 
      Deprivation (WIMD) and urban/rural indicator respectively. Using linear modelling 
      and joinpoint regression approaches, we examined time trends of the incidence and 
      incidence rate ratios (IRR) of SMI by the WIMD and urban/rural indicator adjusted 
      for available confounders. RESULTS: We observed a turning point of time trends of 
      incidence of SMI at 2008/2009 where slope changes of time trends were 
      significantly increasing. IRRs by deprivation/urbanicity remained stable or 
      significantly decreased over the study period except for those with bipolar 
      disorder sourced from secondary care settings, with increasing trend of IRRs 
      (increase in IRR by deprivation after 2010: 1.6 % per year, 95 % CI: 1.0 %-2.2 %; 
      increase in IRR by urbanicity 1.0 % per year, 95 % CI: 0.6 %-1.3 %). CONCLUSIONS: 
      There was an association between recession/austerity and an increase in the 
      incidence of SMI over time. There were variations in the effects of 
      deprivation/urbanicity on incidence of SMI associated with short- and long-term 
      socioeconomic change. These findings may support targeted interventions and 
      social protection systems to reduce incidence of SMI.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Lee, Sze Chim
AU  - Lee SC
AD  - DATAMIND at 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  - DATAMIND at 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  - DATAMIND at 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  - DATAMIND at 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; 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  - DATAMIND at 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
GR  - WT_/Wellcome Trust/United Kingdom
GR  - BHF_/British Heart Foundation/United Kingdom
GR  - CSO_/Chief Scientist Office/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230825
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
MH  - Humans
MH  - Incidence
MH  - *Routinely Collected Health Data
MH  - Secondary Care
MH  - *Mental Disorders/epidemiology/complications
MH  - Socioeconomic Factors
OTO - NOTNLM
OT  - Austerity
OT  - Deprivation
OT  - Inequality
OT  - Recession
OT  - Severe mental illness
OT  - Urbanicity
COIS- Declaration of competing interest None declared.
EDAT- 2023/08/28 00:41
MHDA- 2023/10/23 12:42
CRDT- 2023/08/27 18:06
PHST- 2021/05/04 00:00 [received]
PHST- 2023/06/30 00:00 [revised]
PHST- 2023/08/13 00:00 [accepted]
PHST- 2023/10/23 12:42 [medline]
PHST- 2023/08/28 00:41 [pubmed]
PHST- 2023/08/27 18:06 [entrez]
AID - S0920-9964(23)00283-9 [pii]
AID - 10.1016/j.schres.2023.08.014 [doi]
PST - ppublish
SO  - Schizophr Res. 2023 Oct;260:113-122. doi: 10.1016/j.schres.2023.08.014. Epub 2023 
      Aug 25.