Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-18T10:44:50.477Z Has data issue: false hasContentIssue false

Urban birth and risk of schizophrenia: a worrying example of epidemiology where the data are stronger than the hypotheses

Published online by Cambridge University Press:  18 May 2011

Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

There is robust and consistent evidence from epidemiological studies showing that urban birth is associated with an increased risk of developing schizophrenia. Evidence suggests that this exposure may be associated with a sizeable proportion of cases. To date the candidate exposures underlying the urban birth risk factor have included infectious agents, low prenatal vitamin D, toxins associated with pollution, and stress. However, in general, the hypotheses proposed to explain the urban birth risk factor have been unsatisfying. In light of the general trend towards increasing urbanization, it is feasible that the attributable fraction of schizophrenia associated with urban birth may increase. The psychiatric research community should have a sense of urgency in exploring the mechanisms linking urban birth and risk of schizophrenia.

Type
Editorials
Copyright
Copyright © Cambridge University Press 2006

References

Agerbo, E., Torrey, E.F. & Mortensen, P.B. (2001). Household crowding in early adulthood and schizophrenia are unrelated in Denmark: a nested case-control study. Schizophrenia Research 47, 243246.CrossRefGoogle Scholar
Allardyce, J., Gilmour, H., Atkinson, J., Rapson, T., Bishop, J. & McCreadie, R.G. (2005). Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses. British Journal of Psychiatry 187, 401406.CrossRefGoogle ScholarPubMed
Andrews, G., Sanderson, K., Corry, J., Issakidis, C. & Lapsley, H. (2003). Cost-effectiveness of current and optimal treatment for schizophrenia. British Journal of Psychiatry 183, 427435.CrossRefGoogle ScholarPubMed
Andrews, G., Issakidis, C, Sanderson, K., Corry, J. & Lapsley, H. (2004). Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders. British Journal of Psychiatry 184, 526533.CrossRefGoogle ScholarPubMed
Corcoran, C, Walker, E., Huot, R., Mittal, V., Tessner, K., Kestler, L. & Malaspina, D. (2003). The stress cascade and schizophrenia: etiology and onset. Schizophrenia Bulletin 29, 671692.CrossRefGoogle ScholarPubMed
Drukker, M., Buka, S.L., Kaplan, C, McKenzie, K. & van Os, J. (2005). Social capital and young adolescents perceived health in different sociocultural settings. Social Science and Medicine 61, 185198.CrossRefGoogle Scholar
Eyles, D., Brown, J., Mackay-Sim, A., McGrath, J. & Feron, F. (2003). Vitamin D3 and brain development. Neuroscience 118, 641653.CrossRefGoogle ScholarPubMed
Faris, R.E.L. & Dunham, H.W. (1939). Mental Disorders in Urban Areas. Chicago University Press: Chicago.Google Scholar
Freeman, H. (1994). Schizophrenia and city residence. British Journal of Psychiatry, Suppl. 23, 3950.CrossRefGoogle Scholar
Goldberg, E.M. & Morrison, S.L. (1963). Schizophrenia and social class. British Journal of Psychiatry 109, 785802.CrossRefGoogle ScholarPubMed
Hall, W., Degenhardt, L. & Teesson, M. (2004). Cannabis use and psychotic disorders: an update. Drug and Alcohol Review, 433–443.Google Scholar
Haukka, J., Suvisaari, J., Varilo, T. & Lonnqvist, J. (2001). Regional variation in the incidence of schizophrenia in Finland: a study of birth cohorts born from 1950 to 1969. Psychological Medicine 31, 10451053.CrossRefGoogle ScholarPubMed
Hoek, H.W., Brown, A.S. & Susser, E. (1998). The Dutch famine and schizophrenia spectrum disorders. Social Psychiatry and Psychiatric Epidemiology 33, 373379.CrossRefGoogle ScholarPubMed
Jablensky, A.V. & Kalaydjieva, L.V. (2003). Genetic epidemiology of schizophrenia: phenotypes, risk factors, and reproductive behavior. American Journal of Psychiatry 160, 425429.CrossRefGoogle ScholarPubMed
Kuller, L.H. (1999). Circular epidemiology. American Journal of Epidemiology 150, 897903.CrossRefGoogle ScholarPubMed
Lewis, G., David, A., Andreasson, S. & Allebeck, P. (1992). Schizophrenia and city life. Lancet 340, 137140.CrossRefGoogle ScholarPubMed
Marcelis, M., Navarro-Mateu, F., Murray, R., Selten, J.-P. & van Os, J. (1998). Urbanization and psychosis: a study of 1942-1978 birth cohorts in The Netherlands. Psychological Medicine 28, 871879.CrossRefGoogle ScholarPubMed
Marcelis, M., Takei, N. & van Os, J. (1999). Urbanization and risk for schizophrenia: does the effect operate before or around the time of illness onset? Psychological Medicine 29, 11971203.CrossRefGoogle ScholarPubMed
McGrath, J.J. (2003). Invited commentary: Gaining traction on the epidemiologic landscape of schizophrenia. American Journal of Epidemiology 158, 301304.CrossRefGoogle ScholarPubMed
McGrath, J.J. & Murray, R.M. (2003). Risk factors for schizophrenia: from conception to birth. In Schizophrenia (ed. Weinberger, D.R. and Hirsch, S.R.), pp. 232250. Blackwells: Oxford.CrossRefGoogle Scholar
McGrath, J., Saha, S., Welham, J., El Saadi, O., MacCauley, C. & Chant, D. (2004). A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Medicine 2,13.CrossRefGoogle Scholar
McKenzie, K., Whitley, R. & , Weich (2002). Social capital and mental health. British Journal of Psychiatry 181, 280283.CrossRefGoogle ScholarPubMed
McMichael, A.J. (2001). Human Frontiers, Environments and Disease. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Menezes, P., Scazufca, M., Casgrande, K., Schlithler, A.C., Cordeiro, D., Coutinho, L.M., Busatto, G., McGuire, P., Fearon, P. & Murray, R.M. (2006). Incidence of first contact psychosis in Sao Paulo, Brazil. Schizophrenia Research 81, 173.Google Scholar
Morgan, C, Mallett, R., Hutchinson, G., Bagalkote, H., Morgan, K., Fearon, P., Dazzan, P., Boydell, J., Harrison, G., Murray, R., Jones, P., Craig, T. & Leff, J. (2005). Pathways to care and ethnicity. I. Sample characteristics and compulsory admission: a report from the AESOP study. British Journal of Psychiatry 186, 281289.CrossRefGoogle ScholarPubMed
Mortensen, P.B., Pedersen, C.B., Westergaard, T, Wohlfahrt, J., Ewald, H., Mors, O., Andersen, P.K. & Melbye, M. (1999). Effects of family history and place and season of birth on the risk of schizophrenia. New England Journal of Medicine 340, 603608.CrossRefGoogle ScholarPubMed
Murray, C.J. & Lopez, A.D. (1996). The Global Burden of Disease. Harvard School of Public Health: Boston.Google ScholarPubMed
Nesby-O'Dell, S., Scanlon, K.S., Cogswell, M.E., Gillespie, C, Hollis, B.W., Looker, A.C., Allen, C, Doughertly, C, Gunter, E.W. & Bowman, B.A. (2002). Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. American Journal of Clinical Nutrition 76, 187192.CrossRefGoogle ScholarPubMed
Pedersen, C.B. (2006). No evidence of time trends in the urban-rural differences in schizophrenia risk among five million people born in Denmark from 1910 to 1986. Psychological Medicine 36, 211219.CrossRefGoogle ScholarPubMed
Pedersen, C.B. & Mortensen, P.B. (2001). Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk. Archives of General Psychiatry 58, 10391046.CrossRefGoogle ScholarPubMed
Pedersen, C.B. & Mortensen, P.B. (2006a). Urbanization and traffic related exposures as risk factors for schizophrenia. BMC Psychiatry 6, 2.CrossRefGoogle ScholarPubMed
Pedersen, C.E. & Mortensen, P.B. (2006b). Why factors rooted in the family may solely explain the urban-rural differences in schizophrenia risk. Epidemiologia e Psichiatria Sociale 15, 247251.CrossRefGoogle ScholarPubMed
Read, J., van Os, J., Morrison, A.P. & Ross, C. A. (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Ada Psychiatrica Scandinavica 112, 330350.CrossRefGoogle ScholarPubMed
Saha, S., Chant, D., Welham, J. & McGrath, J. (2005). A systematic review of the prevalence of schizophrenia. PLOS Medicine 2, e141.CrossRefGoogle ScholarPubMed
Semple, D.M., Mclntosh, A.M. & Lawrie, S.M. (2005). Cannabis as a risk factor for psychosis: systematic review. Journal of Psychopharmacology 19, 187194.CrossRefGoogle ScholarPubMed
Spauwen, J. & van Os, J. (2006). The psychosis proneness. Psychosis persistence model as an explanation for the association between urbanicity and psychosis. Epidemiologia e Psichiatria Sociale 15, 252257.CrossRefGoogle ScholarPubMed
Spauwen, J., Krabbendam, L., Lieb, R., Wittchen, H.-U. & van Os, J. (2004). Early maternal stress and health behaviours and offspring expression of psychosis in adolescence. Ada Psychiatrica Scandinavica 110, 356364.CrossRefGoogle ScholarPubMed
Torrey, E.F. & Yolken, R.H. (1998). At issue: is household crowding a risk factor for schizophrenia and bipolar disorder? Schizophrenia Bulletin 24, 321324.CrossRefGoogle ScholarPubMed
van Os, J., Krabbendam, L., Myin-Germeys, I. & Delespaul, P. (2005). The schizophrenia envirome. Current Opinion in Psychiatry 18, 141145.Google ScholarPubMed
Wahlbeck, K., Osmond, C, Forsen, T., Barker, D.J. & Eriksson, J.G. (2001). Associations between childhood living circumstances and schizophrenia: a population-based cohort study. Ada Psychiatrica Scandinavica 104, 356360.CrossRefGoogle ScholarPubMed
Warner, R. (1999). Schizophrenia and the environment: speculative interventions. Epidemiologia e Psichiatria Sociale 8, 1934.CrossRefGoogle ScholarPubMed