Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses

Social disorganisation, fragmentation and isolation have long been posited as influencing the rate of psychoses at area level. Measuring such societal constructs is difficult. A census-based index measuring social fragmentation has been proposed. To investigate the association between first-admissio...

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Bibliographic Details
Published in:British journal of psychiatry 2005-11, Vol.187 (5), p.401-406
Main Authors: Allardyce, Judith, Gilmour, Harper, Atkinson, Jacqueline, Rapson, Tracey, Bishop, Jennifer, McCreadie, R. G.
Format: Article
Language:English
Subjects:
Age
Censuses
Cross-Sectional Studies
Gender
Health disparities
Hospitalization - statistics & numerical data
Humans
Logistic Models
Mental Disorders - epidemiology
Mental Disorders - etiology
Patient Admission - statistics & numerical data
Patient admissions
Population
Poverty - statistics & numerical data
Psychiatry
Psychosis
Regression analysis
Rural areas
Rural communities
Rural Health - statistics & numerical data
Scotland - epidemiology
Segmentation
Social disorganization
Social Environment
Social fragmentation
Social isolation
Statistical analysis
Urban areas
Urban Health - statistics & numerical data
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Summary:Social disorganisation, fragmentation and isolation have long been posited as influencing the rate of psychoses at area level. Measuring such societal constructs is difficult. A census-based index measuring social fragmentation has been proposed. To investigate the association between first-admission rates for psychosis and area-based measures of social fragmentation, deprivation and urban/rural index. We used indirect standardisation methods and logistic regression models to examine associations of social fragmentation, deprivation and urban/rural categories with first admissions for psychoses in Scotland for the 5-year period 1989-1993. Areas characterised by high social fragmentation had higher first-ever admission rates for psychosis independent of deprivation and urban/rural status. There was a dose-response relationship between social fragmentation category and first-ever admission rates for psychosis. There was no statistically significant interaction between social fragmentation, deprivation and urban/rural index. First-admission rates are strongly associated with measures of social fragmentation, independent of material deprivation and urban/rural category.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.187.5.401