Vera Brink, Humma Andleeb, Charlotte Gayer-Anderson, Celso Arango, Manuel Arrojo, Domenico Berardi, Miquel Bernardo, Julio Bobes, Cristina Marta Del-Ben, Laura Ferraro, Lieuwe de Haan, Daniele La Barbera, Caterina La Cascia, Antonio Lasalvia, Pierre-Michel Llorca, Paolo Rossi Menezes, Baptiste Pignon, Julio Sanjuán, José Luis Santos, Jean-Paul Selten, Ilaria Tarricone, Andrea Tortelli, Giada Tripoli, Eva Velthorst, Bart P F Rutten, Jim van Os, Diego Quattrone, Robin M Murray, Peter B Jones, Craig Morgan, Marta Di Forti, Hannah E Jongsma, James B Kirkbride
{"title":"社会贫困和吸食大麻在解释精神障碍发病率差异中的作用：欧盟-全球精神病学调查研究》（EU-GEI）的结果。","authors":"Vera Brink, Humma Andleeb, Charlotte Gayer-Anderson, Celso Arango, Manuel Arrojo, Domenico Berardi, Miquel Bernardo, Julio Bobes, Cristina Marta Del-Ben, Laura Ferraro, Lieuwe de Haan, Daniele La Barbera, Caterina La Cascia, Antonio Lasalvia, Pierre-Michel Llorca, Paolo Rossi Menezes, Baptiste Pignon, Julio Sanjuán, José Luis Santos, Jean-Paul Selten, Ilaria Tarricone, Andrea Tortelli, Giada Tripoli, Eva Velthorst, Bart P F Rutten, Jim van Os, Diego Quattrone, Robin M Murray, Peter B Jones, Craig Morgan, Marta Di Forti, Hannah E Jongsma, James B Kirkbride","doi":"10.1093/schbul/sbae072","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Recent findings suggest the incidence of first-episode psychotic disorders (FEP) varies according to setting-level deprivation and cannabis use, but these factors have not been investigated together. We hypothesized deprivation would be more strongly associated with variation in FEP incidence than the prevalence of daily or high-potency cannabis use between settings.</p><p><strong>Study design: </strong>We used incidence data in people aged 18-64 years from 14 settings of the EU-GEI study. We estimated the prevalence of daily and high-potency cannabis use in controls as a proxy for usage in the population at-risk; multiple imputations by chained equations and poststratification weighting handled missing data and control representativeness, respectively. We modeled FEP incidence in random intercepts negative binomial regression models to investigate associations with the prevalence of cannabis use in controls, unemployment, and owner-occupancy in each setting, controlling for population density, age, sex, and migrant/ethnic group.</p><p><strong>Study results: </strong>Lower owner-occupancy was independently associated with increased FEP (adjusted incidence rate ratio [aIRR]: 0.76, 95% CI: 0.61-0.95) and non-affective psychosis incidence (aIRR: 0.68, 95% CI: 0.55-0.83), after multivariable adjustment. Prevalence of daily cannabis use in controls was associated with the incidence of affective psychoses (aIRR: 1.53, 95% CI: 1.02-2.31). We found no association between FEP incidence and unemployment or high-potency cannabis use prevalence. Sensitivity analyses supported these findings.</p><p><strong>Conclusions: </strong>Lower setting-level owner-occupancy and increased prevalence of daily cannabis use in controls independently contributed to setting-level variance in the incidence of different psychotic disorders. Public health interventions that reduce exposure to these harmful environmental factors could lower the population-level burden of psychotic disorders.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1039-1049"},"PeriodicalIF":5.3000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349009/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Role of Social Deprivation and Cannabis Use in Explaining Variation in the Incidence of Psychotic Disorders: Findings From the EU-GEI Study.\",\"authors\":\"Vera Brink, Humma Andleeb, Charlotte Gayer-Anderson, Celso Arango, Manuel Arrojo, Domenico Berardi, Miquel Bernardo, Julio Bobes, Cristina Marta Del-Ben, Laura Ferraro, Lieuwe de Haan, Daniele La Barbera, Caterina La Cascia, Antonio Lasalvia, Pierre-Michel Llorca, Paolo Rossi Menezes, Baptiste Pignon, Julio Sanjuán, José Luis Santos, Jean-Paul Selten, Ilaria Tarricone, Andrea Tortelli, Giada Tripoli, Eva Velthorst, Bart P F Rutten, Jim van Os, Diego Quattrone, Robin M Murray, Peter B Jones, Craig Morgan, Marta Di Forti, Hannah E Jongsma, James B Kirkbride\",\"doi\":\"10.1093/schbul/sbae072\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and hypothesis: </strong>Recent findings suggest the incidence of first-episode psychotic disorders (FEP) varies according to setting-level deprivation and cannabis use, but these factors have not been investigated together. We hypothesized deprivation would be more strongly associated with variation in FEP incidence than the prevalence of daily or high-potency cannabis use between settings.</p><p><strong>Study design: </strong>We used incidence data in people aged 18-64 years from 14 settings of the EU-GEI study. We estimated the prevalence of daily and high-potency cannabis use in controls as a proxy for usage in the population at-risk; multiple imputations by chained equations and poststratification weighting handled missing data and control representativeness, respectively. We modeled FEP incidence in random intercepts negative binomial regression models to investigate associations with the prevalence of cannabis use in controls, unemployment, and owner-occupancy in each setting, controlling for population density, age, sex, and migrant/ethnic group.</p><p><strong>Study results: </strong>Lower owner-occupancy was independently associated with increased FEP (adjusted incidence rate ratio [aIRR]: 0.76, 95% CI: 0.61-0.95) and non-affective psychosis incidence (aIRR: 0.68, 95% CI: 0.55-0.83), after multivariable adjustment. Prevalence of daily cannabis use in controls was associated with the incidence of affective psychoses (aIRR: 1.53, 95% CI: 1.02-2.31). We found no association between FEP incidence and unemployment or high-potency cannabis use prevalence. Sensitivity analyses supported these findings.</p><p><strong>Conclusions: </strong>Lower setting-level owner-occupancy and increased prevalence of daily cannabis use in controls independently contributed to setting-level variance in the incidence of different psychotic disorders. Public health interventions that reduce exposure to these harmful environmental factors could lower the population-level burden of psychotic disorders.</p>\",\"PeriodicalId\":21530,\"journal\":{\"name\":\"Schizophrenia Bulletin\",\"volume\":\" \",\"pages\":\"1039-1049\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2024-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349009/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Schizophrenia Bulletin\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/schbul/sbae072\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Schizophrenia Bulletin","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/schbul/sbae072","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
The Role of Social Deprivation and Cannabis Use in Explaining Variation in the Incidence of Psychotic Disorders: Findings From the EU-GEI Study.
Background and hypothesis: Recent findings suggest the incidence of first-episode psychotic disorders (FEP) varies according to setting-level deprivation and cannabis use, but these factors have not been investigated together. We hypothesized deprivation would be more strongly associated with variation in FEP incidence than the prevalence of daily or high-potency cannabis use between settings.
Study design: We used incidence data in people aged 18-64 years from 14 settings of the EU-GEI study. We estimated the prevalence of daily and high-potency cannabis use in controls as a proxy for usage in the population at-risk; multiple imputations by chained equations and poststratification weighting handled missing data and control representativeness, respectively. We modeled FEP incidence in random intercepts negative binomial regression models to investigate associations with the prevalence of cannabis use in controls, unemployment, and owner-occupancy in each setting, controlling for population density, age, sex, and migrant/ethnic group.
Study results: Lower owner-occupancy was independently associated with increased FEP (adjusted incidence rate ratio [aIRR]: 0.76, 95% CI: 0.61-0.95) and non-affective psychosis incidence (aIRR: 0.68, 95% CI: 0.55-0.83), after multivariable adjustment. Prevalence of daily cannabis use in controls was associated with the incidence of affective psychoses (aIRR: 1.53, 95% CI: 1.02-2.31). We found no association between FEP incidence and unemployment or high-potency cannabis use prevalence. Sensitivity analyses supported these findings.
Conclusions: Lower setting-level owner-occupancy and increased prevalence of daily cannabis use in controls independently contributed to setting-level variance in the incidence of different psychotic disorders. Public health interventions that reduce exposure to these harmful environmental factors could lower the population-level burden of psychotic disorders.
期刊介绍：
Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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