| Title: | Is psychosis a syndemic manifestation of historical and contemporary adversity? Findings from UK Biobank |
| Journal: | The British Journal of Psychiatry |
| Published: | 7 Oct 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/35048874/ |
| DOI: | https://doi.org/10.1192/bjp.2021.142 |
| URL: | ~Ehttps://www.cambridge.org/core/services/aop-cambridge-core/content/view/B5F0AC3458907851F9CA8F7F2EC92D5F/S0007125021001422a.pdf/div-class-title-is-psychosis-a-syndemic-manifestation-of-historical-and-contemporary-adversity-findings-from-uk-biobank-div.pdf~ |
Publication 7250
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Abstract
BACKGROUND: Psychosis is associated with many forms of adversity, deprivation and living in urban areas.AIMS: To investigate whether psychosis is part of a syndemic of multiple adversities.
METHOD: Drawing on UK Biobank (UKBB) data (Project ID: 57601), we sought to understand mechanisms by which childhood, recent/contemporary and place-based adversities might cluster and interact to be implicated in pathways by which psychoses evolve. We investigated the associations between adversities, potential mediating inflammatory markers and ICD-10 diagnoses (F20-F31) of psychotic disorders. We fitted logistic regression models initially including all relevant candidate variables and used backwards deletion to retain theoretically plausible and statistically significant (P < 0.05) associations with psychotic disorders. The candidate variables were entered in a partial least squares structural equation model (PLS-SEM) to test for syndemic interactions between risk factors. We tested whether the findings were sensitive to demographics, gender and ethnicity.
RESULTS: We fitted a PLS-SEM including psychosis as a syndemic outcome, and identified three latent constructs: lifetime adversity, current adversity and biomarkers. Factor loadings were above 0.30, and all structural paths were significant (P < 0.05). There were moderate associations between lifetime adversity and current adversity (standardised coefficient s.c. = 0.178) and between current adversity and biomarkers (s.c. = 0.227). All three latent constructs showed small but significant associations with psychosis (s.c. < 0.04). Lifetime adversity and current adversity were more strongly associated among ethnic minorities (combined) than White British people.
CONCLUSIONS: Our findings stress the importance of interactions between childhood and contemporary adversities in preventive and therapeutic interventions for psychotic disorders, especially among ethnic minorities.
4 Authors
- Kamaldeep Bhui
- Kristoffer Halvorsrud
- Roisin Mooney
- Georgina M. Hosang
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