THE SOCIOSPATIAL DISTRIBUTION OF PSYCHOTIC …



THE SOCIOSPATIAL DISTRIBUTION OF PSYCHOTIC SYMPTOMS AND DIMENSIONSA MULTILEVEL INVESTIGATION FROM THE AESOP STUDY17284702929890Author: FREDRIK OHERSupervisors: JAMES KIRKBRIDE (main) MATS BOGREN ANNA LINDGREN 4000020000Author: FREDRIK OHERSupervisors: JAMES KIRKBRIDE (main) MATS BOGREN ANNA LINDGREN PrefaceThis thesis is a result of research pursued at the University of Cambridge, Department of Psychiatry, during the summer of 2012. The analyses in this paper have been undertaken together with my main supervisor Dr. James Kirkbride, Sir Henry Wellcome Research Fellow at the University of Cambridge. I am grateful for all his invaluable feedback and continued support during the creation of this thesis. It has been a genuine learning experience.I am further grateful for the encouragement and valuable comments from my supervisors Dr. Mats Bogren, senior psychiatric consultant at Sk?ne University Hospital Lund, and Dr. Anna Lindgren, Associate Professor at the Department of Mathematical Statistics, Lund University. I also want to thank Professor Peter B. Jones at the University of Cambridge, whose support has been vital for my research in England, and Associate Professor Elisabet Holst at Lund University, whose support for my somewhat atypical course has never wavered. This thesis has been written for the Medical Programme (L?karprogrammet) as well as for a bachelor’s degree in Industrial Engineering and Management, both at Lund University. This procedure has been communicated clearly to the Faculty of Medicine as well as the Department of Mathematical Statistics. I believe that the reader will find that competences from and an interest in both these fields have been fundamental for the creation of this thesis. Sincerely, Fredrik Oher, Dec 2012 Content TOC \o "1-3" \h \z \u Abstract PAGEREF _Toc345940400 \h 4Popul?rvetenskaplig sammanfattning PAGEREF _Toc345940405 \h 51. Introduction PAGEREF _Toc345940406 \h 61.1. Background PAGEREF _Toc345940407 \h 61.2 Conceptualization of psychotic disorders PAGEREF _Toc345940408 \h 71.3 Etiology PAGEREF _Toc345940409 \h 81.4 Patophysiology and Possible Mechanisms PAGEREF _Toc345940410 \h 101.5 Context and Significance of Thesis PAGEREF _Toc345940411 \h 111.6 Objectives PAGEREF _Toc345940412 \h 122. Methods PAGEREF _Toc345940413 \h 142.1. Sample PAGEREF _Toc345940414 \h 142.2. Outcome data (psychotic symptom dimensions and cluster PAGEREF _Toc345940415 \h 142.3. Individual level sociodemographic & clinical data PAGEREF _Toc345940416 \h 152.4. Neighbourhood level exposures and confounders PAGEREF _Toc345940417 \h 162.5. Statistical analysis PAGEREF _Toc345940418 \h 162.5.1. Symptom dimension overview and transformation PAGEREF _Toc345940419 \h 162.5.2. Centre & Symptom dimension comparison PAGEREF _Toc345940420 \h 172.5.3. Multilevel linear regression analysis approach PAGEREF _Toc345940421 \h 172.5.4. Model Building PAGEREF _Toc345940422 \h 172.5.5 Analytical approach for symptom dimensions PAGEREF _Toc345940423 \h 182.5.6. Analytical approach for paranoia PAGEREF _Toc345940424 \h 192.6. Sensitivity analysis PAGEREF _Toc345940425 \h 193. Results PAGEREF _Toc345940426 \h 203.1 Sample characteristics PAGEREF _Toc345940427 \h 203.2 Distribution of symptom dimensions between centres PAGEREF _Toc345940428 \h 203.3. Multilevel modeling of symptom dimensions PAGEREF _Toc345940429 \h 203.4. Sensitivity analysis PAGEREF _Toc345940430 \h 213.5. Multilevel modeling of paranoia PAGEREF _Toc345940431 \h 213.6. Symptom dimension and paranoia differences by diagnostic category PAGEREF _Toc345940432 \h 214. Discussion PAGEREF _Toc345940433 \h 244.2 Methodological considerations PAGEREF _Toc345940434 \h 244.3 Meaning of findings PAGEREF _Toc345940435 \h 255. Appendix PAGEREF _Toc345940436 \h 286. References PAGEREF _Toc345940437 \h Error! Bookmark not defined.Abstract Background The impact of our social environment on our mental health is important. Many have studied how the environment influences the incidence and prevalence of different psychiatric disorders. Few have investigated how our environment influences the symptom dimensions within psychiatric conditions such as for example psychotic disorders.MethodsWith data from 469 subjects presenting with first episode psychosis in southeast London and Nottingham, five main symptom dimensions were identified: mania, reality distortion, negative symptoms, depressive symptoms and disorganization. Different statistical methods were pursued to investigate the impact of the environment on these symptom dimensions. Results The levels of reality distortion were found to be higher in London than in Nottingham (β=0.17; 95%CI: 0.07, 0.27). Further analysis indicated that this effect might have been stronger for subjects diagnosed with non-affective psychosis. Levels of depressive symptoms were also found to be higher in London (β=0.22; 95%CI: 0.06, 0.37) while levels of disorganization where found to be higher in Nottingham (β=-0.05; 95%CI: -0.09, -0.02). No differences were observed for mania or negative symptoms. ConclusionThe notion of higher rates of reality distortion in a more urban environment is consistent with the idea that environmental stimuli could influence our levels of positive psychotic symptoms. While more work is needed, the results in this thesis indicate that this effect might be valid primarily for non-affective psychotic disorders, suggesting possibly different etiological backgrounds for non-affective and affective disorders. Popul?rvetenskaplig sammanfattning Den sociala omgivningens p?verkan p? v?r mentala h?lsa ?r viktig att f?rs?ka f?rst?. Mycket forskning har ?gnats ?t att unders?ka hur omgivningen p?verkar antalet personer som insjuknar med olika typer av psykiatriska diagnoser. F? har dock unders?kt hur omgivningen p?verkar symptombilden inom psykiatriska tillst?nd som till exempel psykotiska sjukdomar. Psykos ?r ett tillst?nd som kan innefatta till exempel hallucinationer och vanf?rest?llningar, ofta i kombination med andra psykologiska symptom. Med hj?lp av data fr?n 469 personer med f?rstaepisods-psykos fr?n syd?stra London och Nottingham kunde Demjaha et al. identifiera fem huvudsakliga symptomdimensioner inom det psykotiska sjukdomsspektrumet: mani, f?rvr?ngd verklighetsuppfattning, negativa symptom, depressiva symptom samt desorganisation. Med hj?lp av olika statistiska metoder unders?kte vi sedan, f?r samma urvalsgrupp, omgivningens p?verkan p? dessa fem symptomdimensioner.Vi fann att niv?erna av f?rvr?ngd verklighetsuppfattning var h?gre i London ?n i Nottingham. En ut?kad analys antydde att denna effekt var starkare f?r de personer som diagnosticerats med en s? kallad icke-affektiv psykotisk sjukdom (s?som schizofreni) j?mf?rt med s? kallad affektiv psykotisk sjukdom (s?som depression med psykos). Det fanns ?ven tecken p? ?kad niv? av depressiva symptom i London och ?kad niv? av desorganisation i Nottingham. Inga skillnader observerades f?r mani eller negativa symptom. Det har spekulerats att stimuli fr?n omgivningen kan p?verka risken att utveckla s? kallade positiva psykotiska symptom. V?rt fynd att h?gre niv?er av f?rvr?ngd verklighetsuppfattning kunde identifieras i en mer urban milj? (London j?mf?rt med Nottingham) passar v?l med denna idé. Resultaten i detta arbete indikerar att denna effekt fr?mst verkar g?lla f?r icke-affektiva psykotiskta sjukdomstillst?nd, vilket skulle kunna tyda p? olika etiologiska bakgrunder (uppkomstorsaker) f?r icke-affektiva och affektiva sjukdomstillst?nd. 1. Introduction1.1. BackgroundPsychosis is a descriptive psychiatric term referring to an altered condition of the mind, where delusions and divergent perceptions of reality are central features. The condition is characterized by distorted interpretations of stimuli and experiences, which can influence attention, emotional state and social life. Symptoms that might occur include hallucinations, confusion and behavioral abnormalities, such as disorganized speech and grossly disorganized or catatonic behaviour ADDIN EN.CITE <EndNote><Cite><Author>Cullberg</Author><Year>2005</Year><RecNum>1</RecNum><DisplayText><style face="superscript">1</style></DisplayText><record><rec-number>1</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">1</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Cullberg, Johan </author></authors></contributors><titles><title>Psykoser - Ett integrerat perspektiv (Psychoses - An integrative perspective) </title></titles><edition>2nd</edition><dates><year>2005</year></dates><publisher>Natur och Kultur </publisher><urls></urls></record></Cite></EndNote>1. Psychosis can arise in several instances, including as a core feature of a number of mental illnesses, as a result of neurological damage, through intoxication, or as a side effect to pharmaceuticals. Psychotic disorders, i.e. syndromes where psychosis is a core feature, are generally divided into affective and non-affective disorders, such as bipolar disorder and schizophrenia, respectively. In schizophrenia and similar syndromes, psychosis generally occurs episodically ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>2</RecNum><DisplayText><style face="superscript">2</style></DisplayText><record><rec-number>2</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">2</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1057</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>2. In certain personality disorders, psychosis can also occur as an accompanying, but non-defining, feature. For individuals with schizophrenia and their families, the cost in terms of suffering and lower quality of life can be substantial. Life expectancy is 12-15 years shorter in people with schizophrenia, due to increased rate of suicides and decreased somatic health ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>3</RecNum><DisplayText><style face="superscript">3</style></DisplayText><record><rec-number>3</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">3</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1059</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>3. Costs are also considerable for society; In Sweden, it has been estimated that the cost per affected individual and year is equivalent to roughly 50,000 British Pounds (500,000 Swedish kronor). The largest part is attributed welfare support to the individual ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>4</RecNum><DisplayText><style face="superscript">4</style></DisplayText><record><rec-number>4</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">4</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1067</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>4, but medicine and hospitals costs are also considerable. In Europe, the total cost to health services and society of psychotic disorders is only eclipsed by dementia and common mental disorders,PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HdXN0YXZzc29uPC9BdXRob3I+PFllYXI+MjAxMTwvWWVh

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ADDIN EN.CITE.DATA 6, 7. Understanding the causes, course and treatment of such disorders is therefore of great importance. As a phenomenon, schizophrenia might have a long history, but the first evident accounts of the syndrome seem to have appeared as late as the beginning of the early nineteenth century. This stands in contrast to depression and mania, which reportedly already appeared in ancient texts ADDIN EN.CITE <EndNote><Cite><Author>Heinrichs</Author><Year>2003</Year><RecNum>8</RecNum><DisplayText><style face="superscript">8</style></DisplayText><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Heinrichs, R. W.</author></authors></contributors><titles><title>Historical origins of schizophrenia: two early madmen and their illness</title><secondary-title>J Hist Behav Sci</secondary-title><alt-title>Journal of the history of the behavioral sciences</alt-title></titles><pages>349-63</pages><volume>39</volume><number>4</number><edition>2003/11/06</edition><keywords><keyword>Europe</keyword><keyword>*Famous Persons</keyword><keyword>History, 18th Century</keyword><keyword>History, Medieval</keyword><keyword>Humans</keyword><keyword>*Medicine in Art</keyword><keyword>Mental Disorders/history</keyword><keyword>Schizophrenia/*history</keyword><keyword>Schizophrenic Psychology</keyword><keyword>Sculpture/*history</keyword></keywords><dates><year>2003</year><pub-dates><date>Fall</date></pub-dates></dates><isbn>0022-5061 (Print)&#xD;0022-5061 (Linking)</isbn><accession-num>14601041</accession-num><work-type>Biography&#xD;Historical Article&#xD;Research Support, Non-U.S. Gov&apos;t</work-type><urls><related-urls><url>. During the end of the nineteenth century, the German psychiatrist Emil Kraepelin suggested a distinction in the classification of mental disorders between what he termed dementia praecox and mood disorders ADDIN EN.CITE <EndNote><Cite><Author>Stotz-Ingenlath</Author><Year>2000</Year><RecNum>9</RecNum><DisplayText><style face="superscript">9</style></DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">9</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Stotz-Ingenlath, G.</author></authors></contributors><auth-address>Psychiatrische Universitatsklinik der Ludwig-Maximilians-Universitat, Munchen. stotz@psy.med.uni muenchen.de</auth-address><titles><title>Epistemological aspects of Eugen Bleuler&apos;s conception of schizophrenia in 1911</title><secondary-title>Med Health Care Philos</secondary-title><alt-title>Medicine, health care, and philosophy</alt-title></titles><pages>153-9</pages><volume>3</volume><number>2</number><edition>2000/11/18</edition><keywords><keyword>History, 20th Century</keyword><keyword>Humans</keyword><keyword>Knowledge</keyword><keyword>Psychological Theory</keyword><keyword>Schizophrenia/etiology/*history/therapy</keyword><keyword>Schizophrenic Psychology</keyword><keyword>Switzerland</keyword></keywords><dates><year>2000</year></dates><isbn>1386-7423 (Print)&#xD;1386-7423 (Linking)</isbn><accession-num>11079343</accession-num><work-type>Biography&#xD;Historical Article</work-type><urls><related-urls><url>. Dementia praecox, meaning “early dementia”, was an attempt to describe a syndrome that appeared early in life, and resulted in reduced psychic functioning ADDIN EN.CITE <EndNote><Cite><Author>Herlofson</Author><Year>2009</Year><RecNum>5</RecNum><DisplayText><style face="superscript">6</style></DisplayText><record><rec-number>5</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">5</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Herlofson, J </author></authors></contributors><titles><title>Psykiatri, page 285</title></titles><edition>1st</edition><dates><year>2009</year></dates><publisher>Studentlitteratur </publisher><urls></urls></record></Cite></EndNote>6. Kraeplin believed that dementia praecox was a result of brain damage, an incurable process that with time would totally alter the personality of the individual ADDIN EN.CITE <EndNote><Cite><Author>Stotz-Ingenlath</Author><Year>2000</Year><RecNum>9</RecNum><DisplayText><style face="superscript">9</style></DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">9</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Stotz-Ingenlath, G.</author></authors></contributors><auth-address>Psychiatrische Universitatsklinik der Ludwig-Maximilians-Universitat, Munchen. stotz@psy.med.uni muenchen.de</auth-address><titles><title>Epistemological aspects of Eugen Bleuler&apos;s conception of schizophrenia in 1911</title><secondary-title>Med Health Care Philos</secondary-title><alt-title>Medicine, health care, and philosophy</alt-title></titles><pages>153-9</pages><volume>3</volume><number>2</number><edition>2000/11/18</edition><keywords><keyword>History, 20th Century</keyword><keyword>Humans</keyword><keyword>Knowledge</keyword><keyword>Psychological Theory</keyword><keyword>Schizophrenia/etiology/*history/therapy</keyword><keyword>Schizophrenic Psychology</keyword><keyword>Switzerland</keyword></keywords><dates><year>2000</year></dates><isbn>1386-7423 (Print)&#xD;1386-7423 (Linking)</isbn><accession-num>11079343</accession-num><work-type>Biography&#xD;Historical Article</work-type><urls><related-urls><url>. The distinction between “early dementia” and mood disorders became the foundation underpinning modern psychiatry, broadly classifying subjects with mood disorders (such as depression) or with psychotic disorders (such as schizophrenia). Today, we note that such distinctions are not always clear and that features of the two sets of disorders can occur together (see below). At the turn of the twentieth century, the Swiss psychiatrist Eugen Bleuler concluded that the syndrome described by Kraepelin was not a type of dementia, based upon the observation that some of his patients seemed improved over time rather than deteriorated. He also believed that manic or depressive symptoms could appear within this syndrome ADDIN EN.CITE <EndNote><Cite><Author>Stotz-Ingenlath</Author><Year>2000</Year><RecNum>9</RecNum><DisplayText><style face="superscript">9</style></DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">9</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Stotz-Ingenlath, G.</author></authors></contributors><auth-address>Psychiatrische Universitatsklinik der Ludwig-Maximilians-Universitat, Munchen. stotz@psy.med.uni muenchen.de</auth-address><titles><title>Epistemological aspects of Eugen Bleuler&apos;s conception of schizophrenia in 1911</title><secondary-title>Med Health Care Philos</secondary-title><alt-title>Medicine, health care, and philosophy</alt-title></titles><pages>153-9</pages><volume>3</volume><number>2</number><edition>2000/11/18</edition><keywords><keyword>History, 20th Century</keyword><keyword>Humans</keyword><keyword>Knowledge</keyword><keyword>Psychological Theory</keyword><keyword>Schizophrenia/etiology/*history/therapy</keyword><keyword>Schizophrenic Psychology</keyword><keyword>Switzerland</keyword></keywords><dates><year>2000</year></dates><isbn>1386-7423 (Print)&#xD;1386-7423 (Linking)</isbn><accession-num>11079343</accession-num><work-type>Biography&#xD;Historical Article</work-type><urls><related-urls><url>. He decided to call this condition schizophrenia, meaning roughly “splitting of the mind”, intending to describe the separation of function of thinking, memory, perception, emotion, and personality. 1.2 Conceptualization of psychotic disordersThere are two principal manuals widely used to diagnose psychiatric disorders. The first is the Diagnostic and Statistical Manual for Mental Disorders (DSM) published by the American Psychiatric Association; the other is the International Classification of Diseases [ICD], published by the World Health Organization. The manuals have been revised several times since they first came out, with new versions of each (DSM-V and ICD-11, respectively), due to be published in 2013 ADDIN EN.CITE <EndNote><Cite><Author>Association</Author><RecNum>10</RecNum><DisplayText><style face="superscript">10</style></DisplayText><record><rec-number>10</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">10</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>American Psychiatric Association </author></authors></contributors><titles><title> and 2015 ADDIN EN.CITE <EndNote><Cite><Author>Organization</Author><RecNum>11</RecNum><DisplayText><style face="superscript">11</style></DisplayText><record><rec-number>11</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">11</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>World Health Organization </author></authors></contributors><titles><title>. With regard to the diagnosis of schizophrenia, the approaches of DSM-IV and ICD-10 are quite similar. The basis is derived from the identification of specific signs, symptoms and disabilities, as well as the course of the illness. As a simplified summary, both DSM and ICD demand the identification of at least two of the following symptoms for the duration of at least one month: delusions, prominent hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. Furthermore, affective syndrome, organic etiology and drug abuse need to be cancelled out as causing factors. The major difference between the manuals lies in the duration of dysfunction. DSM demands six months of social of professional dysfunction out of which at least one month includes psychosis features while ICD only requires one month of dysfunction including psychosis features ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>14</RecNum><DisplayText><style face="superscript">12</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1061</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>12. For an overview of a selection of psychotic disorders, see Table 1. The distinction between schizophrenia and other psychotic conditions have changed with time and varied between different countries and cultures. The ICD and DSM manuals are attempts to standardize the diagnoses of these conditions. Nowadays, schizophrenia is regarded as the most common syndrome in the psychotic disorder group, but is sometimes (somewhat confusingly) used interchangeably with the term “psychosis”. Schizophrenia, however, is one particular constellation of psychotic symptoms which meet certain above-mentioned criteria with regard to severity and duration ADDIN EN.CITE <EndNote><Cite><Author>Lindstr?m</Author><RecNum>12</RecNum><DisplayText><style face="superscript">13</style></DisplayText><record><rec-number>12</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">12</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Eva Lindstr?m </author></authors></contributors><titles><title>internetmedicin.se, search word: &quot;Schizofreni &quot;</title></titles><dates></dates><urls></urls></record></Cite></EndNote>13.In the beginning of the 1980s, Tim Crow and Nancy Coover Andreason separately proposed that two distinct syndromes could be discerned within the schizophrenic symptom profilePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Dcm93PC9BdXRob3I+PFllYXI+MTk4MDwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 14, 15. The first syndrome, referred to as the Type I or positive syndrome, included symptoms such as delusions, hallucinations, and disorganized thinking. It was called positive, because these symptoms were thought of as added to the personality. The other syndrome, called Type 2, or negative, was characterized by deficits in affective, cognitive, and social functions ADDIN EN.CITE <EndNote><Cite><Author>Kay</Author><Year>1987</Year><RecNum>22</RecNum><DisplayText><style face="superscript">16</style></DisplayText><record><rec-number>22</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">22</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kay, S. R.</author><author>Fiszbein, A.</author><author>Opler, L. A.</author></authors></contributors><titles><title>The positive and negative syndrome scale (PANSS) for schizophrenia</title><secondary-title>Schizophr Bull</secondary-title><alt-title>Schizophrenia bulletin</alt-title></titles><periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></periodical><alt-periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></alt-periodical><pages>261-76</pages><volume>13</volume><number>2</number><edition>1987/01/01</edition><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Psychiatric Status Rating Scales</keyword><keyword>Psychometrics</keyword><keyword>Schizophrenia/*diagnosis</keyword><keyword>Schizophrenic Psychology</keyword></keywords><dates><year>1987</year></dates><isbn>0586-7614 (Print)&#xD;0586-7614 (Linking)</isbn><accession-num>3616518</accession-num><urls><related-urls><url> speculated that although positive and negative symptom groups could both be a part of schizophrenia, they had different etiological backgrounds, with positive symptoms thought to result from hyperdopaminergia (excess of dopamine in the brain), and negative symptoms thought to result from structural brain deficits ADDIN EN.CITE <EndNote><Cite><Author>Kay</Author><Year>1987</Year><RecNum>22</RecNum><DisplayText><style face="superscript">16</style></DisplayText><record><rec-number>22</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">22</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kay, S. R.</author><author>Fiszbein, A.</author><author>Opler, L. A.</author></authors></contributors><titles><title>The positive and negative syndrome scale (PANSS) for schizophrenia</title><secondary-title>Schizophr Bull</secondary-title><alt-title>Schizophrenia bulletin</alt-title></titles><periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></periodical><alt-periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></alt-periodical><pages>261-76</pages><volume>13</volume><number>2</number><edition>1987/01/01</edition><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Psychiatric Status Rating Scales</keyword><keyword>Psychometrics</keyword><keyword>Schizophrenia/*diagnosis</keyword><keyword>Schizophrenic Psychology</keyword></keywords><dates><year>1987</year></dates><isbn>0586-7614 (Print)&#xD;0586-7614 (Linking)</isbn><accession-num>3616518</accession-num><urls><related-urls><url>. Andreasen proposed that the positive and negative symptoms were opposite sides of a continuum, after demonstrating a negative correlation between the prevalence of the two symptom groups ADDIN EN.CITE <EndNote><Cite><Author>Kay</Author><Year>1987</Year><RecNum>22</RecNum><DisplayText><style face="superscript">16</style></DisplayText><record><rec-number>22</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">22</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kay, S. R.</author><author>Fiszbein, A.</author><author>Opler, L. A.</author></authors></contributors><titles><title>The positive and negative syndrome scale (PANSS) for schizophrenia</title><secondary-title>Schizophr Bull</secondary-title><alt-title>Schizophrenia bulletin</alt-title></titles><periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></periodical><alt-periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></alt-periodical><pages>261-76</pages><volume>13</volume><number>2</number><edition>1987/01/01</edition><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Psychiatric Status Rating Scales</keyword><keyword>Psychometrics</keyword><keyword>Schizophrenia/*diagnosis</keyword><keyword>Schizophrenic Psychology</keyword></keywords><dates><year>1987</year></dates><isbn>0586-7614 (Print)&#xD;0586-7614 (Linking)</isbn><accession-num>3616518</accession-num><urls><related-urls><url>. 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ADDIN EN.CITE.DATA 7.Ever since the days of Kraeplin and Bleuler, there has been an ongoing debate as to whether schizophrenia represents a single disease entity or not. The DSM and ICD have traditionally followed the categorical approach, attempting to create distinctions between different mental disorders. This approach has consequently received a lot of attention during the last century. More recently, however, there has been a growing opinion that grouping mental disorders into categories is, by itself, not a satisfactory practice for effective prevention and treatment ADDIN EN.CITE <EndNote><Cite><Author>van Os</Author><Year>2003</Year><RecNum>27</RecNum><DisplayText><style face="superscript">17</style></DisplayText><record><rec-number>27</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">27</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>van Os, J.</author></authors></contributors><auth-address>Department of Psychiatry and Neuropsychology, European Graduate School of Neuroscience, Maastricht University, The Netherlands. j.vanos@sp.unimaas.nl</auth-address><titles><title>Is there a continuum of psychotic experiences in the general population?</title><secondary-title>Epidemiol Psichiatr Soc</secondary-title><alt-title>Epidemiologia e psichiatria sociale</alt-title></titles><periodical><full-title>Epidemiol Psichiatr Soc</full-title><abbr-1>Epidemiologia e psichiatria sociale</abbr-1></periodical><alt-periodical><full-title>Epidemiol Psichiatr Soc</full-title><abbr-1>Epidemiologia e psichiatria sociale</abbr-1></alt-periodical><pages>242-52</pages><volume>12</volume><number>4</number><edition>2004/02/19</edition><keywords><keyword>Humans</keyword><keyword>Population Surveillance</keyword><keyword>Prevalence</keyword><keyword>Psychotic Disorders/*epidemiology/etiology/therapy</keyword></keywords><dates><year>2003</year><pub-dates><date>Oct-Dec</date></pub-dates></dates><isbn>1121-189X (Print)&#xD;1121-189X (Linking)</isbn><accession-num>14968483</accession-num><work-type>Research Support, Non-U.S. Gov&apos;t</work-type><urls><related-urls><url>. As an adjunct to the categorical approach, an alternative dimensional approach has been proposed, based upon the notion that symptoms for people with schizophrenia-like disorders vary greatly and that symptoms often fit into different, replicable dimensions (as e.g. Crow and Andreason observed). Proponents of this approach argue that identifying the presence and magnitude of these dimensions within each patient is important for effective treatment, as well as the understanding of psychotic disorders. It has further been argued that evidence of subclinical experiences of psychosis in the general population support the validity of the dimensional approach ADDIN EN.CITE <EndNote><Cite><Author>van Os</Author><Year>2003</Year><RecNum>27</RecNum><DisplayText><style face="superscript">17</style></DisplayText><record><rec-number>27</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">27</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>van Os, J.</author></authors></contributors><auth-address>Department of Psychiatry and Neuropsychology, European Graduate School of Neuroscience, Maastricht University, The Netherlands. j.vanos@sp.unimaas.nl</auth-address><titles><title>Is there a continuum of psychotic experiences in the general population?</title><secondary-title>Epidemiol Psichiatr Soc</secondary-title><alt-title>Epidemiologia e psichiatria sociale</alt-title></titles><periodical><full-title>Epidemiol Psichiatr Soc</full-title><abbr-1>Epidemiologia e psichiatria sociale</abbr-1></periodical><alt-periodical><full-title>Epidemiol Psichiatr Soc</full-title><abbr-1>Epidemiologia e psichiatria sociale</abbr-1></alt-periodical><pages>242-52</pages><volume>12</volume><number>4</number><edition>2004/02/19</edition><keywords><keyword>Humans</keyword><keyword>Population Surveillance</keyword><keyword>Prevalence</keyword><keyword>Psychotic Disorders/*epidemiology/etiology/therapy</keyword></keywords><dates><year>2003</year><pub-dates><date>Oct-Dec</date></pub-dates></dates><isbn>1121-189X (Print)&#xD;1121-189X (Linking)</isbn><accession-num>14968483</accession-num><work-type>Research Support, Non-U.S. Gov&apos;t</work-type><urls><related-urls><url> 1987 Peter Liddle was the first person to use factor analysis to create symptom dimensions. Factor analysis is a mathematical method by which variables (for example symptoms) can be grouped together with other variables showing similar variance, creating a number of factors (for example symptom dimensions). Liddle presented three dimensions: psychomotor poverty (including e.g. poverty of speech and lack of spontaneous movement), disorganization (including e.g. disturbances of the form of thought), and reality distortion (including certain types of hallucinations and delusions) ADDIN EN.CITE <EndNote><Cite><Author>Liddle</Author><Year>1987</Year><RecNum>28</RecNum><DisplayText><style face="superscript">18</style></DisplayText><record><rec-number>28</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">28</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Liddle, P. F.</author></authors></contributors><auth-address>Charing Cross and Westminster Medical School.</auth-address><titles><title>The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy</title><secondary-title>Br J Psychiatry</secondary-title><alt-title>The British journal of psychiatry : the journal of mental science</alt-title></titles><periodical><full-title>Br J Psychiatry</full-title><abbr-1>The British journal of psychiatry : the journal of mental science</abbr-1></periodical><alt-periodical><full-title>Br J Psychiatry</full-title><abbr-1>The British journal of psychiatry : the journal of mental science</abbr-1></alt-periodical><pages>145-51</pages><volume>151</volume><edition>1987/08/01</edition><keywords><keyword>Adult</keyword><keyword>Chronic Disease</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Psychiatric Status Rating Scales</keyword><keyword>Schizophrenia/classification/*diagnosis/drug therapy</keyword><keyword>*Schizophrenic Psychology</keyword><keyword>Self Care</keyword><keyword>Social Behavior</keyword><keyword>Work</keyword></keywords><dates><year>1987</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0007-1250 (Print)&#xD;0007-1250 (Linking)</isbn><accession-num>3690102</accession-num><work-type>Research Support, Non-U.S. Gov&apos;t</work-type><urls><related-urls><url>. Since then, many other attempts at different divisions have been undertaken. In a meta-analysis from 2012, researchers reviewed 39 papers that had examined the dimensional structure in patients with a broad spectrum of psychotic disorders ADDIN EN.CITE <EndNote><Cite><Author>Potuzak</Author><Year>2012</Year><RecNum>29</RecNum><DisplayText><style face="superscript">19</style></DisplayText><record><rec-number>29</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">29</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Potuzak, M.</author><author>Ravichandran, C.</author><author>Lewandowski, K. E.</author><author>Ongur, D.</author><author>Cohen, B. M.</author></authors></contributors><auth-address>McLean Hospital, Psychotic Disorders Division, Belmont, MA, 02478, USA.</auth-address><titles><title>Categorical vs dimensional classifications of psychotic disorders</title><secondary-title>Compr Psychiatry</secondary-title><alt-title>Comprehensive psychiatry</alt-title></titles><periodical><full-title>Compr Psychiatry</full-title><abbr-1>Comprehensive psychiatry</abbr-1></periodical><alt-periodical><full-title>Compr Psychiatry</full-title><abbr-1>Comprehensive psychiatry</abbr-1></alt-periodical><edition>2012/06/12</edition><dates><year>2012</year><pub-dates><date>Jun 7</date></pub-dates></dates><isbn>1532-8384 (Electronic)&#xD;0010-440X (Linking)</isbn><accession-num>22682781</accession-num><urls><related-urls><url>. They found that the majority of the studies had concluded that either four or five dimensions effectively describe the psychosis profile. The most frequently reported dimensions were the positive, negative, disorganization, and affective symptom dimensions. It is important to emphasize that dimensions does not describe particular groups of patients, but can rather be seen as a tool to describe every individual’s unique blend of symptoms. 1.3 EtiologyFor schizophrenia, genes have been emphasized as a major factor in the development of the condition ADDIN EN.CITE <EndNote><Cite><Author>Cullberg</Author><Year>2005</Year><RecNum>32</RecNum><DisplayText><style face="superscript">20</style></DisplayText><record><rec-number>32</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">32</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Cullberg, Johan </author></authors></contributors><titles><title>Psykoser - Ett integrerat perspektiv (Psychoses - An integrative perspective), page 64</title></titles><edition>2nd</edition><dates><year>2005</year></dates><publisher>Natur och Kultur</publisher><urls></urls></record></Cite></EndNote>20. Much early genetic research attempted to find a gene that by itself could more or less explain the schizophrenia phenomenon. Such a gene has not been found, and it is today generally believed that several genes act together in various combinations, contributing in different ways to the incidence of psychosis ADDIN EN.CITE <EndNote><Cite><Author>Picchioni</Author><Year>2007</Year><RecNum>34</RecNum><DisplayText><style face="superscript">21</style></DisplayText><record><rec-number>34</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">34</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Picchioni, M. M.</author><author>Murray, R. M.</author></authors></contributors><auth-address>King&apos;s College London, Institute of Psychiatry, Division of Psychological Medicine, London SE5 8AF. m.picchioni@iop.kcl.ac.uk</auth-address><titles><title>Schizophrenia</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>91-5</pages><volume>335</volume><number>7610</number><edition>2007/07/14</edition><keywords><keyword>Antipsychotic Agents/therapeutic use</keyword><keyword>Early Diagnosis</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Long-Term Care</keyword><keyword>Primary Health Care</keyword><keyword>Prognosis</keyword><keyword>Psychotherapy/methods</keyword><keyword>*Schizophrenia/diagnosis/etiology/therapy</keyword></keywords><dates><year>2007</year><pub-dates><date>Jul 14</date></pub-dates></dates><isbn>1756-1833 (Electronic)&#xD;0959-535X (Linking)</isbn><accession-num>17626963</accession-num><work-type>Review</work-type><urls><related-urls><url> . 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ADDIN EN.CITE.DATA 22. Twin studies have also shown that the risk increases to around 40 percent for monozygotic twins of affected peoplePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DYXJkbm88L0F1dGhvcj48WWVhcj4xOTk5PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 23 and that the syndrome has general heritability estimates of around 80 percent (compared to for example 30-50 percent for hypertension)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj52YW4gT3M8L0F1dGhvcj48WWVhcj4yMDA5PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 7. These factors are speculated to have an influence on, for example, twin heritability estimates, i.e. the shared upbringing is adding to the effect of the shared genetic component. Several environmental (i.e. non-genetic) risk factors for psychosis have been identified. These can conceivably be biological in origin (i.e. obstetric complications, prenatal nutrition) or social (i.e. childhood trauma, urban living) or even both (i.e. cannabis abuse). Regarding early biological events, it has been shown that obstetric complications, such as premature birth, low birth weight, and prenatal hypoxia, are associated with schizophrenia ADDIN EN.CITE <EndNote><Cite><Author>Picchioni</Author><Year>2007</Year><RecNum>34</RecNum><DisplayText><style face="superscript">21</style></DisplayText><record><rec-number>34</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">34</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Picchioni, M. M.</author><author>Murray, R. M.</author></authors></contributors><auth-address>King&apos;s College London, Institute of Psychiatry, Division of Psychological Medicine, London SE5 8AF. m.picchioni@iop.kcl.ac.uk</auth-address><titles><title>Schizophrenia</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>91-5</pages><volume>335</volume><number>7610</number><edition>2007/07/14</edition><keywords><keyword>Antipsychotic Agents/therapeutic use</keyword><keyword>Early Diagnosis</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Long-Term Care</keyword><keyword>Primary Health Care</keyword><keyword>Prognosis</keyword><keyword>Psychotherapy/methods</keyword><keyword>*Schizophrenia/diagnosis/etiology/therapy</keyword></keywords><dates><year>2007</year><pub-dates><date>Jul 14</date></pub-dates></dates><isbn>1756-1833 (Electronic)&#xD;0959-535X (Linking)</isbn><accession-num>17626963</accession-num><work-type>Review</work-type><urls><related-urls><url>. Several other factors relating to early life stages, such as the level of maternal psychic stress during pregnancy, and the size of the head of the newborn (people that later develop schizophrenia have smaller head sizes than average as a baby) seem to influence the risk of developing schizophrenia ADDIN EN.CITE <EndNote><Cite><Author>Ottosson</Author><Year>2009</Year><RecNum>50</RecNum><DisplayText><style face="superscript">24</style></DisplayText><record><rec-number>50</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">50</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Ottosson, Jan-Otto</author></authors></contributors><titles><title>Psykiatri</title></titles><edition>7th</edition><dates><year>2009</year></dates><publisher>Liber</publisher><urls></urls></record></Cite></EndNote>24. Taken together, it seems like early disturbances in neurodevelopment increases risk of schizophrenia later in life. An example of a social factor is migrant status, which has been established as a risk factor for schizophrenia and other psychotic disorders. It has been speculated that being a migrant produces stress and therefore elevated rates of schizophrenia, and also that doctors more often diagnose migrants with schizophrenia than the rest of the population, ceteris paribus ADDIN EN.CITE <EndNote><Cite><Author>Bhugra</Author><Year>2000</Year><RecNum>51</RecNum><DisplayText><style face="superscript">25</style></DisplayText><record><rec-number>51</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">51</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bhugra, D.</author></authors></contributors><auth-address>Institute of Psychiatry, De Crespigny Park, London, UK.</auth-address><titles><title>Migration and schizophrenia</title><secondary-title>Acta Psychiatr Scand Suppl</secondary-title><alt-title>Acta psychiatrica Scandinavica. Supplementum</alt-title></titles><periodical><full-title>Acta Psychiatr Scand Suppl</full-title><abbr-1>Acta psychiatrica Scandinavica. Supplementum</abbr-1></periodical><alt-periodical><full-title>Acta Psychiatr Scand Suppl</full-title><abbr-1>Acta psychiatrica Scandinavica. Supplementum</abbr-1></alt-periodical><pages>68-73</pages><number>407</number><edition>2001/03/23</edition><keywords><keyword>Cultural Characteristics</keyword><keyword>*Emigration and Immigration</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>London/epidemiology</keyword><keyword>Risk Factors</keyword><keyword>Schizophrenia/*ethnology/*genetics/physiopathology</keyword><keyword>Social Behavior</keyword><keyword>Stress, Psychological</keyword><keyword>Trinidad and Tobago/ethnology</keyword></keywords><dates><year>2000</year></dates><isbn>0065-1591 (Print)&#xD;0065-1591 (Linking)</isbn><accession-num>11261645</accession-num><work-type>Review</work-type><urls><related-urls><url>. 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ADDIN EN.CITE.DATA 26. This is known as the ethnic density effect. As a result, it has been argued that it is not being a migrant that increases the risk of developing psychosis disorders per se, but rather the degree to which one belongs to a minority group in society. Meta-analyses have demonstrated consistency in indicating an association between being in a minority position and experiencing psychosis. This association was evident across a wide range of “approaches, endpoints, settings and cultural group definitions, and after adjustment from range of confounders”PEVuZE5vdGU+PENpdGU+PEF1dGhvcj52YW4gT3M8L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 26. A risk factor that has received a lot of attention is drug use, especially cannabis use. Stimulants like cocaine and amphetamines are known to be able to induce a picture clinically similar or identical to paranoid schizophrenia ADDIN EN.CITE <EndNote><Cite><Author>Picchioni</Author><Year>2007</Year><RecNum>34</RecNum><DisplayText><style face="superscript">21</style></DisplayText><record><rec-number>34</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">34</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Picchioni, M. M.</author><author>Murray, R. M.</author></authors></contributors><auth-address>King&apos;s College London, Institute of Psychiatry, Division of Psychological Medicine, London SE5 8AF. m.picchioni@iop.kcl.ac.uk</auth-address><titles><title>Schizophrenia</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>91-5</pages><volume>335</volume><number>7610</number><edition>2007/07/14</edition><keywords><keyword>Antipsychotic Agents/therapeutic use</keyword><keyword>Early Diagnosis</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Long-Term Care</keyword><keyword>Primary Health Care</keyword><keyword>Prognosis</keyword><keyword>Psychotherapy/methods</keyword><keyword>*Schizophrenia/diagnosis/etiology/therapy</keyword></keywords><dates><year>2007</year><pub-dates><date>Jul 14</date></pub-dates></dates><isbn>1756-1833 (Electronic)&#xD;0959-535X (Linking)</isbn><accession-num>17626963</accession-num><work-type>Review</work-type><urls><related-urls><url>. Meta-analytical work is also consistent in demonstrating an association between cannabis use and psychosis ADDIN EN.CITE <EndNote><Cite><Author>Minozzi</Author><Year>2010</Year><RecNum>55</RecNum><DisplayText><style face="superscript">27</style></DisplayText><record><rec-number>55</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">55</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Minozzi, S.</author><author>Davoli, M.</author><author>Bargagli, A. M.</author><author>Amato, L.</author><author>Vecchi, S.</author><author>Perucci, C. A.</author></authors></contributors><auth-address>Department of Epidemiology, Local Health Unit Roma E, Roma, Italy.</auth-address><titles><title>An overview of systematic reviews on cannabis and psychosis: discussing apparently conflicting results</title><secondary-title>Drug Alcohol Rev</secondary-title><alt-title>Drug and alcohol review</alt-title></titles><periodical><full-title>Drug Alcohol Rev</full-title><abbr-1>Drug and alcohol review</abbr-1></periodical><alt-periodical><full-title>Drug Alcohol Rev</full-title><abbr-1>Drug and alcohol review</abbr-1></alt-periodical><pages>304-17</pages><volume>29</volume><number>3</number><edition>2010/06/23</edition><keywords><keyword>Humans</keyword><keyword>Marijuana Abuse/*complications</keyword><keyword>Meta-Analysis as Topic</keyword><keyword>Psychotic Disorders/*complications/*etiology</keyword></keywords><dates><year>2010</year><pub-dates><date>May</date></pub-dates></dates><isbn>1465-3362 (Electronic)&#xD;0959-5236 (Linking)</isbn><accession-num>20565524</accession-num><work-type>Review</work-type><urls><related-urls><url>. One meta-analysis concluded that early cannabis use is associated with a doubling of risk for schizophrenia ADDIN EN.CITE <EndNote><Cite><Author>Henquet</Author><Year>2005</Year><RecNum>56</RecNum><DisplayText><style face="superscript">28</style></DisplayText><record><rec-number>56</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">56</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Henquet, C.</author><author>Murray, R.</author><author>Linszen, D.</author><author>van Os, J.</author></authors></contributors><auth-address>Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, European Graduate School of Neuroscience, Maastricht University, Maastricht, the Netherlands. j.vanos@sp.unimaas.nl</auth-address><titles><title>The environment and schizophrenia: the role of cannabis use</title><secondary-title>Schizophr Bull</secondary-title><alt-title>Schizophrenia bulletin</alt-title></titles><periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></periodical><alt-periodical><full-title>Schizophr Bull</full-title><abbr-1>Schizophrenia bulletin</abbr-1></alt-periodical><pages>608-12</pages><volume>31</volume><number>3</number><edition>2005/06/25</edition><keywords><keyword>Genetic Predisposition to Disease</keyword><keyword>Humans</keyword><keyword>Marijuana Smoking/*adverse effects</keyword><keyword>Odds Ratio</keyword><keyword>Prognosis</keyword><keyword>Schizophrenia/*genetics/*physiopathology</keyword></keywords><dates><year>2005</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0586-7614 (Print)&#xD;0586-7614 (Linking)</isbn><accession-num>15976013</accession-num><work-type>Meta-Analysis</work-type><urls><related-urls><url>. This effect was still clear after controlling for self-medication, indicating that cannabis use as an attempt to alleviate distress is not satisfactory as a sole explanation for the increased risk. Another review article reported that cannabis use was associated with an increased risk of psychotic disorder and symptoms with an odds ratio between 1.5 and 2.0 ADDIN EN.CITE <EndNote><Cite><Author>Moore</Author><Year>2007</Year><RecNum>66</RecNum><DisplayText><style face="superscript">29</style></DisplayText><record><rec-number>66</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">66</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Moore, T. H.</author><author>Zammit, S.</author><author>Lingford-Hughes, A.</author><author>Barnes, T. R.</author><author>Jones, P. B.</author><author>Burke, M.</author><author>Lewis, G.</author></authors></contributors><auth-address>Academic Unit of Psychiatry, University of Bristol, Bristol, UK.</auth-address><titles><title>Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review</title><secondary-title>Lancet</secondary-title><alt-title>Lancet</alt-title></titles><periodical><full-title>Lancet</full-title><abbr-1>Lancet</abbr-1></periodical><alt-periodical><full-title>Lancet</full-title><abbr-1>Lancet</abbr-1></alt-periodical><pages>319-28</pages><volume>370</volume><number>9584</number><edition>2007/07/31</edition><keywords><keyword>Cohort Studies</keyword><keyword>Humans</keyword><keyword>Marijuana Abuse/*complications</keyword><keyword>Meta-Analysis as Topic</keyword><keyword>Mood Disorders/*etiology</keyword><keyword>Psychotic Disorders/*etiology</keyword></keywords><dates><year>2007</year><pub-dates><date>Jul 28</date></pub-dates></dates><isbn>1474-547X (Electronic)&#xD;0140-6736 (Linking)</isbn><accession-num>17662880</accession-num><work-type>Research Support, Non-U.S. Gov&apos;t&#xD;Review</work-type><urls><related-urls><url>(07)61162-3</electronic-resource-num><language>eng</language></record></Cite></EndNote>29. Although cannabis use seems to increase the risk of psychosis, it is important to note that from a public health perspective only a small proportion of those who use it will go on to develop psychotic disorder requiring clinical attention ADDIN EN.CITE <EndNote><Cite><Author>Picchioni</Author><Year>2007</Year><RecNum>34</RecNum><DisplayText><style face="superscript">21</style></DisplayText><record><rec-number>34</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">34</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Picchioni, M. M.</author><author>Murray, R. M.</author></authors></contributors><auth-address>King&apos;s College London, Institute of Psychiatry, Division of Psychological Medicine, London SE5 8AF. m.picchioni@iop.kcl.ac.uk</auth-address><titles><title>Schizophrenia</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>91-5</pages><volume>335</volume><number>7610</number><edition>2007/07/14</edition><keywords><keyword>Antipsychotic Agents/therapeutic use</keyword><keyword>Early Diagnosis</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Long-Term Care</keyword><keyword>Primary Health Care</keyword><keyword>Prognosis</keyword><keyword>Psychotherapy/methods</keyword><keyword>*Schizophrenia/diagnosis/etiology/therapy</keyword></keywords><dates><year>2007</year><pub-dates><date>Jul 14</date></pub-dates></dates><isbn>1756-1833 (Electronic)&#xD;0959-535X (Linking)</isbn><accession-num>17626963</accession-num><work-type>Review</work-type><urls><related-urls><url> central risk factor for this thesis concerns the exposure to an urban environment on the individual. In a meta analysis from 2008, Dana March et al. reviewed 20 studies where rates of psychosis were examined according to urbanicity ADDIN EN.CITE <EndNote><Cite><Author>March</Author><Year>2008</Year><RecNum>69</RecNum><DisplayText><style face="superscript">30</style></DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>March, D.</author><author>Hatch, S. L.</author><author>Morgan, C.</author><author>Kirkbride, J. B.</author><author>Bresnahan, M.</author><author>Fearon, P.</author><author>Susser, E.</author></authors></contributors><auth-address>Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA. dm2025@columbia.edu</auth-address><titles><title>Psychosis and place</title><secondary-title>Epidemiol Rev</secondary-title><alt-title>Epidemiologic reviews</alt-title></titles><periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></periodical><alt-periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></alt-periodical><pages>84-100</pages><volume>30</volume><edition>2008/08/02</edition><keywords><keyword>Humans</keyword><keyword>Psychotic Disorders/*epidemiology</keyword><keyword>*Residence Characteristics</keyword><keyword>Risk Factors</keyword><keyword>Urban Population</keyword></keywords><dates><year>2008</year></dates><isbn>0193-936X (Print)&#xD;0193-936X (Linking)</isbn><accession-num>18669521</accession-num><work-type>Research Support, N.I.H., Extramural&#xD;Research Support, Non-U.S. Gov&apos;t&#xD;Review</work-type><urls><related-urls><url>. All but two of these studies indicated an association between urban life and higher rates of psychosis. In the review, the studies were reported to define exposure to urbanicity in primarily two different ways: as dichotomies of urban and rural, or by degrees, with three or more categories of progressively larger population density ADDIN EN.CITE <EndNote><Cite><Author>March</Author><Year>2008</Year><RecNum>69</RecNum><DisplayText><style face="superscript">30</style></DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>March, D.</author><author>Hatch, S. L.</author><author>Morgan, C.</author><author>Kirkbride, J. B.</author><author>Bresnahan, M.</author><author>Fearon, P.</author><author>Susser, E.</author></authors></contributors><auth-address>Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA. dm2025@columbia.edu</auth-address><titles><title>Psychosis and place</title><secondary-title>Epidemiol Rev</secondary-title><alt-title>Epidemiologic reviews</alt-title></titles><periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></periodical><alt-periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></alt-periodical><pages>84-100</pages><volume>30</volume><edition>2008/08/02</edition><keywords><keyword>Humans</keyword><keyword>Psychotic Disorders/*epidemiology</keyword><keyword>*Residence Characteristics</keyword><keyword>Risk Factors</keyword><keyword>Urban Population</keyword></keywords><dates><year>2008</year></dates><isbn>0193-936X (Print)&#xD;0193-936X (Linking)</isbn><accession-num>18669521</accession-num><work-type>Research Support, N.I.H., Extramural&#xD;Research Support, Non-U.S. Gov&apos;t&#xD;Review</work-type><urls><related-urls><url>. In general, urbanicity was associated with an approximate twofold increase in risk of psychosis. The timing of urban exposure has been considered important. A few studies have reported an association between psychosis and population density of residency at illness onset e.g. PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaXJrYnJpZGU8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFy

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ADDIN EN.CITE.DATA 33, 34. For studies assessing urbanicity exposure prior to illness onset, there is good evidence that the increased risk of psychosis is not a simple effect of social drift ADDIN EN.CITE <EndNote><Cite><Author>March</Author><Year>2008</Year><RecNum>69</RecNum><DisplayText><style face="superscript">30</style></DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>March, D.</author><author>Hatch, S. L.</author><author>Morgan, C.</author><author>Kirkbride, J. B.</author><author>Bresnahan, M.</author><author>Fearon, P.</author><author>Susser, E.</author></authors></contributors><auth-address>Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA. dm2025@columbia.edu</auth-address><titles><title>Psychosis and place</title><secondary-title>Epidemiol Rev</secondary-title><alt-title>Epidemiologic reviews</alt-title></titles><periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></periodical><alt-periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></alt-periodical><pages>84-100</pages><volume>30</volume><edition>2008/08/02</edition><keywords><keyword>Humans</keyword><keyword>Psychotic Disorders/*epidemiology</keyword><keyword>*Residence Characteristics</keyword><keyword>Risk Factors</keyword><keyword>Urban Population</keyword></keywords><dates><year>2008</year></dates><isbn>0193-936X (Print)&#xD;0193-936X (Linking)</isbn><accession-num>18669521</accession-num><work-type>Research Support, N.I.H., Extramural&#xD;Research Support, Non-U.S. Gov&apos;t&#xD;Review</work-type><urls><related-urls><url>. In one of the only studies examining duration of exposure to urbanicity, risk was reported to increase cumulatively in the most urbanized areas ADDIN EN.CITE <EndNote><Cite><Author>Pedersen</Author><Year>2001</Year><RecNum>96</RecNum><DisplayText><style face="superscript">35</style></DisplayText><record><rec-number>96</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">96</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pedersen, C. B.</author><author>Mortensen, P. B.</author></authors></contributors><auth-address>National Centre for Register-Based Research, Aarhus University, Taasingegade 1, 8000 Aarhus C, Denmark. cbp@ncrr.au.dk</auth-address><titles><title>Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk</title><secondary-title>Arch Gen Psychiatry</secondary-title><alt-title>Archives of general psychiatry</alt-title></titles><periodical><full-title>Arch Gen Psychiatry</full-title><abbr-1>Archives of general psychiatry</abbr-1></periodical><alt-periodical><full-title>Arch Gen Psychiatry</full-title><abbr-1>Archives of general psychiatry</abbr-1></alt-periodical><pages>1039-46</pages><volume>58</volume><number>11</number><edition>2001/12/26</edition><keywords><keyword>Age Distribution</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Risk Factors</keyword><keyword>Schizophrenia/*epidemiology</keyword><keyword>Time Factors</keyword><keyword>*Urban Health</keyword><keyword>Urban Population/*statistics &amp; numerical data</keyword><keyword>*Urbanization</keyword></keywords><dates><year>2001</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>0003-990X (Print)&#xD;0003-990X (Linking)</isbn><accession-num>11695950</accession-num><work-type>Research Support, Non-U.S. Gov&apos;t</work-type><urls><related-urls><url>. The association between urbanicity and psychotic disorders appears to exist even after adjustment for confounding factors such as age, sex and ethnicityPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaXJrYnJpZGU8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFy

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ADDIN EN.CITE.DATA 26, 36.The risk of experiencing non-affective psychotic disorders seems to follow a spatial pattern within a specific cityPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaXJrYnJpZGU8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFy

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ADDIN EN.CITE.DATA 36. This effect might be caused by social factors, such as socioeconomic deprivation, ethnic density and social stress. The documented effects of both urbanicity and minority status position indicate that long-term experience of social disadvantage and isolation might be a defining risk factor for the development of psychotic disorder. Interestingly, the urban-psychosis association seems to manifest itself mainly for non-affective psychotic disorders, and not for their affective counterpartsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaXJrYnJpZGU8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFy

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ADDIN EN.CITE.DATA 37. As an example of this discrepancy, Pedersen and Mortensen demonstrated in 2001 a dose-response relationship between an urban upbringing and schizophrenia ADDIN EN.CITE <EndNote><Cite><Author>Pedersen</Author><Year>2001</Year><RecNum>96</RecNum><DisplayText><style face="superscript">35</style></DisplayText><record><rec-number>96</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">96</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pedersen, C. B.</author><author>Mortensen, P. B.</author></authors></contributors><auth-address>National Centre for Register-Based Research, Aarhus University, Taasingegade 1, 8000 Aarhus C, Denmark. cbp@ncrr.au.dk</auth-address><titles><title>Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk</title><secondary-title>Arch Gen Psychiatry</secondary-title><alt-title>Archives of general psychiatry</alt-title></titles><periodical><full-title>Arch Gen Psychiatry</full-title><abbr-1>Archives of general psychiatry</abbr-1></periodical><alt-periodical><full-title>Arch Gen Psychiatry</full-title><abbr-1>Archives of general psychiatry</abbr-1></alt-periodical><pages>1039-46</pages><volume>58</volume><number>11</number><edition>2001/12/26</edition><keywords><keyword>Age Distribution</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Risk Factors</keyword><keyword>Schizophrenia/*epidemiology</keyword><keyword>Time Factors</keyword><keyword>*Urban Health</keyword><keyword>Urban Population/*statistics &amp; numerical data</keyword><keyword>*Urbanization</keyword></keywords><dates><year>2001</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>0003-990X (Print)&#xD;0003-990X (Linking)</isbn><accession-num>11695950</accession-num><work-type>Research Support, Non-U.S. Gov&apos;t</work-type><urls><related-urls><url>, but reported two years later that they could not reproduce these results for bipolar affective disordersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3J0ZW5zZW48L0F1dGhvcj48WWVhcj4yMDAzPC9ZZWFy

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ADDIN EN.CITE.DATA 38. This did not support the possibility that the association between urban upbringing and schizophrenia was due to a lower “nosocomial” threshold, such as better access to services, because such mechanisms would apply to bipolar affective disorder as well as schizophrenia. The reason for the difference in spatial distribution between non-affective and affective disorders is so far unknown. One possibility could be that certain symptom dimensions within these groups might be more influenced by the environment than others. If these specific symptom dimensions would be more strongly correlated to non-affective psychotic disorders than the affective counterparts that could, at least partially, explain the difference in spatial distribution between the two syndrome groups. 1.4 Patophysiology and Possible Mechanisms Traditionally, one of the most wide-spread patophysiologic theories to explain the manifestation of psychotic symptoms has been the dopamine hypothesis of schizophrenia. Dopamine is a monoamine neurotransmitter with several physiological roles in humans, for example as a mediator of desire, creating “incentive salience” to reward-related stimuliPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CZXJyaWRnZTwvQXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+

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ADDIN EN.CITE.DATA 39. The dopamine hypothesis is based upon the belief that a disturbed or hyperactive dopamine signal transduction is responsible for some of the principal psychotic symptoms which underpin schizophrenia and similar psychotic disorders. The evidence is drawn from the effect of antipsychotic medicine, which mediates its effect by operating as a dopamine-receptor antagonist ADDIN EN.CITE <EndNote><Cite><Author>Ottosson</Author><Year>2009</Year><RecNum>108</RecNum><DisplayText><style face="superscript">40</style></DisplayText><record><rec-number>108</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">108</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Ottosson, Jan-Otto</author></authors></contributors><titles><title>Psykiatri, page 180</title></titles><edition>7th</edition><dates><year>2009</year></dates><publisher>Liber</publisher><urls></urls></record></Cite></EndNote>40. One argument for the dopamine hypothesis was based on the observation that drugs such as amphetamines, which can cause psychosis-like symptoms, increases dopamine levels in the brainPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LYXB1cjwvQXV0aG9yPjxZZWFyPjIwMDM8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 41. Similarly, patients using dopamine-enhancing levodopa for Parkinson’s disease might experience psychotic side effects of their treatment ADDIN EN.CITE <EndNote><Cite><Author>Moskovitz</Author><Year>1978</Year><RecNum>109</RecNum><DisplayText><style face="superscript">42</style></DisplayText><record><rec-number>109</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">109</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Moskovitz, C.</author><author>Moses, H., 3rd</author><author>Klawans, H. L.</author></authors></contributors><titles><title>Levodopa-induced psychosis: a kindling phenomenon</title><secondary-title>Am J Psychiatry</secondary-title><alt-title>The American journal of psychiatry</alt-title></titles><periodical><full-title>Am J Psychiatry</full-title><abbr-1>The American journal of psychiatry</abbr-1></periodical><alt-periodical><full-title>Am J Psychiatry</full-title><abbr-1>The American journal of psychiatry</abbr-1></alt-periodical><pages>669-75</pages><volume>135</volume><number>6</number><edition>1978/06/01</edition><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Chronic Disease</keyword><keyword>Confusion/chemically induced</keyword><keyword>Corpus Striatum/drug effects</keyword><keyword>Delusions/chemically induced</keyword><keyword>Dreams/drug effects</keyword><keyword>Female</keyword><keyword>Hallucinations/chemically induced</keyword><keyword>Humans</keyword><keyword>Levodopa/*adverse effects</keyword><keyword>Limbic System/drug effects</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Parkinson Disease/drug therapy</keyword><keyword>Psychoses, Substance-Induced/*etiology</keyword><keyword>Receptors, Dopamine/drug effects</keyword><keyword>Stimulation, Chemical</keyword><keyword>Time Factors</keyword></keywords><dates><year>1978</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>0002-953X (Print)&#xD;0002-953X (Linking)</isbn><accession-num>655276</accession-num><urls><related-urls><url>. Finally, several studies are reported to have shown that patients with schizophrenia experiencing psychosis have a higher synthesis of dopamine, a heightened release of dopamine in response to an impulse, and a heightened level of synaptic dopaminePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LYXB1cjwvQXV0aG9yPjxZZWFyPjIwMDM8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 41. Finally, the dopamine hypothesis was in the beginning seen as a theory for schizophrenia as a whole, without clear explanations of how or why the different symptoms associated with the syndrome occurredPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib3dlczwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 43. In 2009, Oliver Howes and Shitij Kapur presented an updated version of the dopamine hypothesis, in which they brought together updated evidence to suggest that dopaminergic function acted as the ‘last common pathway’ of schizophreniaPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib3dlczwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PFJl

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b3RlPn==

ADDIN EN.CITE.DATA 43. Since dopamine is important in judging the salience of environmental cues, or stimuli, they suggested that certain psychotic phenomena, such as hallucinations or delusions could be the aberrant attempts of the mind to interpret ordinarily neutral stimuli, in a process referred to as “aberrant salience” PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib3dlczwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 43. In other words; ‘dopamine is the wind of the psychotic fire’PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LYXB1cjwvQXV0aG9yPjxZZWFyPjIwMDM8L1llYXI+PFJl

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ADDIN EN.CITE.DATA 41. Howes and Kapur further argued that other aspects of schizophrenia, such as negative symptoms, might be caused by other factors. Under such a hypothesis, it is therefore possible that social exposures in the environment are more strongly related to certain psychotic symptoms – those hypothesized to be driven by dopaminergic dysregulation, such as the positive symptoms of psychosis – but not others, such as changes in affect (mania or depression). This idea is the focus of this thesis.1.5 Context and Significance of Thesis In 1939, researchers Robert E. Lee Faris and Henry Warren Dunham were pioneers in observing higher rates of schizophrenia “in the deteriorated regions in and surrounding the center of the city, no matter what race or nationality inhabited that region”, in conjunction with no such pattern for affective disordersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TaWx2ZXI8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 37. Since then, numerous studies have investigated environmental effects on patients diagnosed with schizophrenia, and/or other psychotic disorders, where some of the major findings have been presented under the “etiology” section of this thesis. We still do not understand why the differences between non-affective and affective psychoses with respect to place occur. In a paper from 2006, Kaymaz et al. presented results that indicated that for bipolar disorder, urbanicity was specifically associated with the level of psychosis, or so called positive symptoms, within the disorderPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LYXltYXo8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 45. An intriguing possibility is that urbanicity increases sensitivity to stress, which might increase the risk of experiencing psychosis. In a study from 2012, Mizrahi et al. presented findings that might support this hypothesis, demonstrating a stress-induced dopamine sensitization for schizophrenia patients, suggesting a link between urbanicity and psychosis through the dopamine hypothesisPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NaXpyYWhpPC9BdXRob3I+PFllYXI+MjAxMjwvWWVhcj48

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ADDIN EN.CITE.DATA 46. It is thus possible that the social environment has particular effects on certain symptom dimensions rather than at the level of disorder itself. No study has, to the best of my knowledge, addressed how individual- and neighbourhood-level variables are associated with specific symptom dimensions. Elucidation of such an issue might provide understanding of the geographical non-random variation of non-affective psychotic disorders, as well as the value of using symptom dimensions in the examination of etiology factors for psychotic disorders. 1.6 ObjectivesIn this thesis I sought to answer the following objectives:To investigate, in incident cases of first-episode psychosis, whether any symptom dimension differed significantly between two centers included in the AESOP study, using the dimensions identified by Demjaha et al in the same datasetPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZW1qYWhhPC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48

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ADDIN EN.CITE.DATA 47: Mania, Reality distortion, Negative symptoms, Depressive symptoms, and Disorganization. A specific sub-dimension related to paranoia was also investigated, given a strong a priori hypothesis that this subgroup of the reality distortion dimension would show neighbourhood level variance (see below). Given Howes and Kapur’s theory that environmental cues will lead to psychotic symptoms associated with dopaminergic activity, my primary hypothesis was that the reality distortion dimension would be positively and significantly associated with urbanicity. In contrast, I hypothesized that the four other dimensions would be much less strongly associated with dopaminergic activity and not show a significant variation with urbanicity. With regard to possible neighbourhood level variance, I speculated that factors related to social defeat or stress in the neighbourhood would be of importance. Within the reality distortion dimension, I posited that the paranoia cluster would be particularly significantly associated with urbanicity. Urban environments may have a greater prevalence of cues which can be interpreted as negative, threatening stimuli, fostering particularly paranoid thinking as a result of aberrant salience resulting from dopaminergic dysregulation.2. Methods 2.1. SampleWe included all subjects who presented as an incidence case of first episode psychosis over a two year period (1997-9) in the London and Nottingham centres of the Aetiology and Etnicity in Schizophrenia and other Psychoses (AESOP) study. Diagnoses included were ICD-10 coded F20-29 and F30-33, derived from the Schedules for Clinical Assessment in Neuropsychiatry (SCAN; WHO, 1992), and determined by a panel of clinicians who were presented the information blind to the ethnicity of the subject, by the lead clinician for care. Exclusion criteria were (i) the presence of a disorder of the central nervous system and (ii) moderate or severe learning disabilities as defined by the ICD-10. 2.2. Outcome data (psychotic symptom dimensions and cluster)We investigated Centre- and neighbourhood-level variation in five theoretically- and empirically-driven psychotic symptom dimensions and one a priori symptom cluster (paranoia). All dimensions and paranoia were obtained from symptom data provided in the SCAN Item Group Checklist (IGC). The SCAN itself covers a large number of symptoms and signs, determined by trained raters and derived based on clinical interview, case-note review, and information from informants, such as health professionals, close relatives or similar. The IGC algorithm combines scores on several SCAN items into particular groups of symptoms to make the number of symptom groups more manageable for statistical analyses. Item Group Checklists take the form of 0 if symptoms were absent, 1 if they were moderate or 2 if they were severe. Inter-rater reliability on SCAN diagnoses in AESOP ranged from 1.0 for all clinically relevant psychotic disorders (ICD-10 F10-33) to 0.63-0.75 for specific diagnosesPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GZWFyb248L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 47, which used principal axis factor analysis, has shown that the SCAN IGC data load onto five theoretically-driven symptom dimensions: reality distortion, negative symptoms, mania, depressive symptoms and disorganization. An overview of the items which load onto these symptom dimensions is given in Table 2. These symptom dimensions fitted well with underlying theoretical models of psychotic symptoms and other empirical researchPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZW1qYWhhPC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48

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ADDIN EN.CITE.DATA 47. The authors then investigated the association between individual level clinical factors (such as mode of onset or DUP) and any particular symptom dimension. They did not inspect variation by place. In that study, the researchers obtained subject dimension scores by summing each subject’s individual scores (0,1,2) from each item which loaded significantly on that factor (dimension). This approach led to ordinal factor scores for each dimension and ignored the contribution of items which had smaller factor loadings on a given dimension. To fully utilize the data available to us, and to overcome difficulties of fitting multilevel modeling on ordinal outcome data, we chose to re-run the principal axis factor analysis to predict continuous factor scores for each dimension for all subjects. We adopted the same initial approach as Demjaha et al., using principal axis factor analysis on all IGC items except delusions about the body, other speech abnormalities and catatonic behavior, all of which had very low endorsement in the AESOP sample (9.5, 7.5, 2%, respectively). Five a priori factors were obtained and applied orthogonal Varimax rotation to clarify the factor solution, as before. Fitted in Stata (v11), the five-factor solution explained 48.5% of variance in the symptom items. This was similar to previously reported (47%). Factor loadings (Table 2) were very similar to those previously reported by Demjaha et al. Unlike the previous study, continuous factor scores for all individuals in the study was predicted from this solution. Having obtained continuous factor scores, it was more computationally straightforward to fit multilevel linear regression models when symptom dimensions were treated as continuous rather than ordinal outcomes.In addition to the five symptom dimensions we also included paranoia as an a priori symptom cluster. This made it possible to test a prioir hypothesis that not only reality distortion, but specifically items related to paranoia would show particular neighbourhood variation. The paranoia cluster was created by summing up scores (0,1,2) for the two items in the SCAN IGC directly related to paranoid thinking (delusions of persecution and delusions of reference). This gave rise to an ordinal variable with minimum and maximum values in the range 0-4. Exchangeability of scores was assumed, so that someone scoring a 1 and 1 on each paranoia item was equivalent to someone scoring 2 and 0. Because this cluster was ordinal, different statistical methods were adopted to handle the multilevel analysis of this cluster.2.3. Individual level sociodemographic & clinical dataData regarding ethnicity, place of birth, gender, age and social class was collected using the Medical Research Council (MRC) Sociodemographic Schedule. Ethnicity was based on subject self-ascription using 2001 census categories. From these we categorized subjects into seven ethnic groups (White British, White other, Black Caribbean, Black African, Asian, Other, or Mixed, White & Black Caribbean) in order to achieve a reasonable number of subjects in each group for meaningful analyses. Place of birth was treated a dichotomous variable (UK born/not UK born). We geocoded all subjects to their residential neighbourhood at the time of first contact for psychosis to ascribe them to their study centre (categorical, London versus Nottingham) or their specific neighbourhood (electoral wards). Electoral wards are used for census and electoral purposes in England and have a mean population size of 6000 people. They have been widely used in previous research in this area; see for example Kirkbride et alPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaXJrYnJpZGU8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFy

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ADDIN EN.CITE.DATA 31. Subjects of no fixed abode or who could otherwise not be geocoded were excluded from the present analyses (see results). Mode of onset was determined using the WHO Personal and Psychiatric History Schedule, and divided into two categories: acute (psychotic symptoms appeared incrementally within one month) and insidious (psychotic symptoms appeared incrementally for longer than one month). The same schedule was also used for determining duration of untreated psychosis (DUP), in conjunction with interviews with the patient, and a close relative to the patient. Parental history of psychosis and mental illness was collected by interviews and case-notes using the Family Interview for Genetic Studies. Family history of mental illness and History of parental psychosis are dichotomous (yes/no), Mode of onset is dichotomous (acute <1 month/insidious >1 month).We obtained data on substance abuse prior to first contact using the Schedule for Drug Use Assessment,?which collated information on drug abuse from all available sources in the ?SOP study, including the SCAN, Personal & Psychiatric History Schedule [PPHS] and case note review. We derived a variable to indicate lifetime poly-drug use, categorized as definite evidence of “no use”, “single drug use” and “poly-drug use”. Participants with partially missing data were categorized into one of these groups based on available information. Those with completely missing data were handled in sensitivity analyses (see below).2.4. Neighbourhood level exposures and confounders Neighbourhood-level socio-economic risk factors were mainly obtained from nationally collected, routine sources. The 2001 census was used to measure population density (people per hectare) and ethnic density (black and minority ethnic (BME) population as part of total population). Deprivation was obtained for each CAS ward using the Index of Multiple Deprivation (IMD) (2004), an aggregated deprivation score composed of 37 indicators obtained from routinely-collected national surveys, generally estimated concomitantly with the case ascertainment period ADDIN EN.CITE <EndNote><Cite><Author>Noble</Author><Year>2004</Year><RecNum>581</RecNum><DisplayText><style face="superscript">49</style></DisplayText><record><rec-number>581</rec-number><foreign-keys><key app="EN" db-id="9zw99sx06a595nezaadvdws7fwxwvxtet0ax">581</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Noble, M, </author><author>Wright, G, </author><author>Dibben, C, </author><author>Smith, GAN, </author><author>McLennan, D, </author><author>Anttila, C, </author><author>Barnes, H,</author><author>Mokhtar, C, </author><author>Noble, S,</author><author>Avenell, D, </author><author>Gardner, J, </author><author>Covizzi, I, </author><author>Lloyd, M.</author></authors></contributors><titles><title>Indices of Deprivation 2004 </title></titles><keywords><keyword>IMD</keyword><keyword>indice</keyword><keyword>indices</keyword><keyword>multiple</keyword><keyword>deprivation</keyword><keyword>deprived</keyword><keyword>soci*</keyword><keyword>Socioeconomic</keyword></keywords><dates><year>2004</year></dates><pub-location>London</pub-location><publisher>ODPM</publisher><urls><related-urls><url> October, 2012</access-date></record></Cite></EndNote>49. Since deprivation scores were not published for wards directly, but at the nested ‘lower super output area’ [SOA] ward-level deprivation was estimated as the mean of SOA deprivation in each statistical ward, weighted by SOA population size. Voter turnout data, a proxy for social capital, was obtained at the 2002 local elections for each ward within the study area. See Kirkbride et alPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaXJrYnJpZGU8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFy

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ADDIN EN.CITE.DATA 51. G gave the extent of dispersion in income deprivation (at SOA-level) away from a theoretical distribution where income deprivation took the same value for all SOA in each ward (i.e. perfect equality). When G equalled zero there was perfect equality and when G was one, perfect inequality. 2.5. Statistical analysis To detect possible spatial variation for the symptom dimensions and cluster we undertook multilevel regression analyses in the statistical programme Stata (Version: MP 11.2) and adopted the following procedures:2.5.1. Symptom dimension overview and transformation Basic kernel density plots (histograms) were inspected to get a handle of the distribution of symptom dimensions in the sample. We also investigated the level of endorsement of items related to paranoia in the sample. To help potentially avoid violating the assumption of normality in the distribution of our residuals following multilevel linear regression, we first transformed outcome data for all symptom dimensions, except paranoia which was fitted using a non-linear approach. A certain type of logarithmic transformation (zero-skewness logarithm using the lnskew0 command in Stata) was used to handle this problem. The lnskew0 command determines the sign of the original values (+/-) and subtracts a calculated constant k, so that the skewness of the logarithm of the original value minus k, is zero. The formula can be written as: Yt=ln?±Y-kwhere Yt was the logarithmic transformation of the positive or negative value of our symptom dimension Y.2.5.2. Centre & Symptom dimension comparison We initially inspected whether values of the dimensions in our sample varied across neighbourhoods in the London and Nottingham centres of the AESOP study. Given evidence that symptom dimensions were highly skewed (see Results section), we inspected whether the median score on each dimension and cluster varied significantly between London and Nottingham, using a Wilcoxon rank-sum test. A skewness and kurtosis test for normality was also performed, using the sktest command in Stata. 2.5.3. Multilevel linear regression analysis approachFor each symptom dimension, we then adopted a multilevel linear regression to account for the fact that individuals were nested within neighbourhoods. A multilevel model, also called a hierarchical model, is a model where a dependent variable (e.g. the transformed variable for a specific symptom) is influenced by variables from different levels of causation, where the first level is usually (though does not have to always be) nested in the higher order ones (e.g. individuals nested within neighbourhoods or neighbourhoods nested in cities). The word “nested” is an attempt to illustrate the fact that the first level is influenced by the second level (e.g. individuals are more influenced by the neighbourhood they live in, than by other neighbourhoods). A multilevel approach is required in the presence of nested data because the standard errors associated with variables included in the model need to be adjusted; variances in individual level scores between and within our level-2 units may be different. In other words, it may not be safe to assume the individuals in our data sample are independent of each other (people living in the same community may be more similar than people in different communities). Multilevel models are characterized by fixed and random effects. With fixed effects, one is referring to those variables whose level would stay the same if the experiment was replicated (i.e. if one would create an experiment with the same number of subjects, the same distribution of age etc). Random effects would not stay the same if the experiment were to be replicated, i.e. they cannot be exactly controlled for. The simplest two-level model is a random intercepts model, which allows for the value of the intercept (i.e. the average symptom score) to vary between level-2 units (i.e. neighbourhoods). The influence of fixed effects on predicted symptom scores are assumed to be constant across neighbourhoods. A random slopes model relaxes this assumption, and allows for the influence of fixed effects on symptom score to vary between neighbourhoods. For this thesis, random intercepts linear regression models with individuals were nested within electoral wards (neighbourhoods).2.5.4. Model Building For our purposes we denote Yij as a transformed symptom dimension or cluster in the jth individual, in the ith neighbourhood. Our basic multilevel model is the following: Yij = βij + rijrij ~ N (0, σ2)where β denotes a regression equation, and can be expanded to represent all the available and relevant predictors. The normally distributed residual term rij represents individual-level error assumed to have a mean of zero and variance, σ2. If the multilevel model would include n different variables, then β would be modeled as: Βij?= γ + δ1xij1?+ δ2xi2 +?δnxijn?+?SiSi?~ N(0, τ2)where γ denotes the intercept and δ1..n denotes the coefficient for the first, second and nth variables. The x stands for the value of the variable for the jth individual and ith ward. The Si denotes the random effect for the ith ward, assumed to be normally distributed with a mean of zero and variance, τ2. This is a simple random intercepts model, where the variable xi2 is a neighbourhood-level variable in this example, since the value of δ2 only varies across i wards. Any residual variance (in the outcome data) would be represented as a significant random effect in the model. Therefore modeling a null, empty model (without individual- or neighbourhood level covariates) allows one to partition the variance in our outcome specifically due to neighbourhood level random effects. The proportion of variance in the outcome attributable to the neighbourhood level is defined as the intra-class correlation coefficient, ρ:ρ = τ2 . (σ2+ τ2)2.5.5 Analytical approach for symptom dimensionsStarting with an empty multilevel linear regression model, we investigated the proportion of variance attributable to the neighbourhood level (Stata command: xtmixed symptom || id: , var). A binary “centre” variable was put in to the model to examine the impact of living in London or Nottingham on our symptom dimensions, and how this diminished variance attributable to the neighbourhood. Individual variables were then added separately to investigate their contribution to their model. After adding our a-priori variables of age, sex, and, ethnicity, we used a forward fitting approach to identify the most parsimonious fit of the data to the model. From this model we sought to determine whether any residual variation in neighbourhood level random effects remained.We then sought to account for any significant residual neighbourhood variation in symptom dimensions by including neighbourhood variables in our model. Goodness-of-fit for each model was examined using Akaike’s information criterion (AIC). The AIC can be said to describe the tradeoff between bias and variance, or more loosely, the tradeoff between accuracy and complexity. For this measure, a simpler model that explains a certain amount of the variance might be more pertinent than a very complex model that only explains a little more of the examined variance. For the AIC, a lower score is an indication of a better model. In Stata, the command .estat ic. is used to request the AIC (and also provides the Bayesian information criterion, BIC). Ranksum tests were performed on all five dimensions to investigate whether subjects with missing data (on symptoms of neighbourhood) differed from subjects where data was available. 2.5.6. Analytical approach for paranoiaMultilevel linear regression was inappropriate for modeling the symptom cluster of paranoia, since this variable was ordinal. Instead we used multilevel ordinal logistic regression to inspect possible neighbourhood-level variance in the distribution of paranoia scores in our study. Multilevel models were fitted using the gllamm command in Stata using an ologit link function in the binomial family to fit the model. Model fitting proceeded in the same way as described above for symptom dimensions.2.6. Sensitivity analysis A potential confounder on our analysis of the spatial influence on psychotic disorder was life-time poly-drug use. Our data regarding this factor was not complete, and we therefore conducted a sensitivity analysis to investigate the risk that poly-drug use (and two other factors with missing data: mode of onset and parental history) might have confounded our results. We re-ran the analysis including these three variables. In the first re-run, any missing data was coded as the lowest possible value (baseline group). In the second re-run, missing data was coded to the most extreme value (i.e. poly-drug use, insidious onset, positive family history). Changes in the associations between neighbourhood-level or centre effects and symptom dimensions were reported under each scenario. 3. Results3.1 Sample characteristics 535 cases were documented within the AESOP study for London and Nottingham. Of these, there was sufficient information to complete IGCs for 484 subjects (90 %). From this group, 15 subjects were excluded because they were i) living outside the catchment areas at first referral, ii) had no fixed abode, or iii) their address at first presentation could not be otherwise established. Excluded subjects were more likely to be men (Chi2(1), p <0.01) and live in London (Chi2, p=0.06), but did otherwise not differ significantly regarding age (Ranksum, p=0.31), ethnicity (Fisher’s exact, p=0.27), dichotomous mode of onset (Chi2, p=0.40), social class (Fisher’s exact, p=0.27), or dimensional scores [Ranksum for all five: mania (p=0.35), reality distortion (p=0.11), negative symptoms (P=0.37), depressive symptoms (p=0.24), and disorganization (p=0.88)].Out of the resulting total sample of 469 subjects included in our analysis, 309 (66 %) subjects came from the South-East London area, and 160 (34 %) came from the Nottingham area. 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ADDIN EN.CITE.DATA 47 (Table 2), with no significant correlations between the five dimensions (see Table 4). The data for each dimension was highly skewed, with most subjects having low symptom scores, and a few with more serious psychopathology on each dimension. As a result of this skew, symptom dimensions were transformed using a zero-skewness logarithmic transformation. Figure 1 illustrates examples of the mania and reality distortion dimensions before and after transformation.3.2 Distribution of symptom dimensions between centresInitial inspection of the distribution of untransformed symptom dimensions suggested some differences in severity between centres. Our findings indicate that subjects from London were significantly more likely to have higher levels of reality distortion (Ranksum, p<0.01) and depressive symptoms (p=0.054) and lower levels of disorganization (p<0.01) than subjects from Nottingham. A summary of these findings is presented in Table 5. We next sought to understand whether these differences persisted following multilevel modeling. (For results regarding paranoia, see section 3.5.)3.3. Multilevel modeling of symptom dimensions Initial null multilevel linear regression models suggested that a small but significant variance in reality distortion (intraclass correlation coefficient [ICC]: 5.2%; Chi2 p=0.02) and disorganization (ICC: 3.3%; p=0.04) could be attributed to the neighbourhood level. A priori variables of age, sex and ethnicity were then added to each model, and a forward fitting approach was undertaken to identify significant individual-level predictors of each symptom dimension.The ICC variance diminished in the final models, with no ICC reaching significance for any dimension. Insidious mode of onset was associated with lower scores for mania (effect size [ES]: -0.53, 95 % CI: -0.79,-0.23; p<0.01) and living in Nottingham was associated with lower reality distortion score (ES: -0.17, 95 % CI: -0.27,-0.07; p<0.01), lower depressive symptoms scores (ES: -0.22, 95 % CI: -0.37,-0.06; p<0.01), and higher disorganization scores (ES: 0.05, 95% CI:0.02,0.09; p<0.01). Sex was associated with negative symptoms (ES: -0.17, 95 % CI: -0.33,-0.02; p=0.03), i.e. more common for males, and depressive symptoms (ES: 0.16, 95 % CI: 0.03,0.28; p=0.01), i.e. more common for females. The only clearly significant effect for ethnicity was for depressive symptoms, where subjects within the Black Caribbean category were associated with fewer symptoms (ES: -0.22, 95 % CI: -0.38,-0.05; p=0.01) (Table 6, overleaf).Next, we investigated whether neighbourhood variables (population density, ethnic density, deprivation, voter turnout data as a proxy for social capital, and inequality) could account for any of the centre effect for reality distortion, depressive symptoms, and disorganization, but could not find evidence for any variable improving the models. A skewness and kurtosis test for normality was performed of the residuals for each transformed dimension in our final models. These were non-significant for all dimensions except for the depressive dimension, where evidence remained that the residuals were non-normally distributed (p<0.001). Specifically, the normality of the kurtosis could not be ensured (kurtosis p<0.001, skewness p=0.74). See Figure 2 for a visualization of the residual distribution. 3.4. Sensitivity analysis A sensitivity analysis was conducted to investigate the potential confounding of poly-drug use, mode of onset and parental history on the centre variable. The two scenarios analyses did not significantly alter the centre effects for reality distortion, depressive symptoms and disorganization, see Table 7.3.5. Multilevel modeling of paranoiaMultilevel ordinal logistic regression suggested that very little variation in paranoid symptoms was attributable to the neighbourhood level in our null model (Variance <0.001). Nevertheless, there was evidence that the odds of increased paranoia were greater in London than Nottingham (OR per additional paranoia symptom: 1.85; 95% CI: 1.31, 2.61) after adjustment for age and sex, although this effect disappeared after further control for ethnicity (OR: 1.36; 95% CI: 0.90, 2.06). 3.6. Symptom dimension and paranoia differences by diagnostic categoryIn a post-hoc analysis, the difference in centre effect between subjects with non-affective (n=320) and affective (=128) psychotic disorder was investigated for the three dimensions identified as showing centre differences in the full sample: reality distortion, depressive symptoms and disorganization. Prior to considering centre differences in these dimensions in the two samples, an inspection of the distribution of these symptoms was undertaken in each set of disorders. Reality distortion was normally distributed in both non-affective and affective psychosis samples (Figure 3), with no evidence of skew or kurtosis in either group. However, a t-test revealed that the mean level of reality distortion (on the transformed scale) was significantly greater for people with non-affective (mean: 0.68, s.d.: 0.43) than affective psychoses (mean: 0.44; s.d.: 0.37; t-test p<0.001). The distribution of depressive symptoms within the non-affective sample was not skewed (left hand pane, Figure 4, p=0.64), though there was evidence of significant kurtosis (p<0.001), suggestive of fewer depressive symptoms in this sample. By contrast, the affective sample displayed a bimodal distribution of depressive scores (right hand pane, Figure 4), consistent with a sample containing people with both mania and depressive psychotic disorders, as confirmed in Figure 5. The median level of depressive symptoms was significantly lower in the non-affective sample than the mania sample (Ranksum test p<0.001), which were in turn significantly lower than in the depressive psychoses sample (Ranksum test p<0.001). Transformed disorganization symptoms were normally distributed for people with both non-affective and affective psychoses (Figure 6), with no evidence of skew or kurtosis in either sample. A t-test suggested that the mean level of disorganization was marginally higher in the non-affective sample (mean: 1.59; s.d.: 0.16) compared with the affective sample (mean 1.55; s.d. 0.13; t-test p=0.03).For people with non-affective psychosis, symptoms differences were stronger in London than Nottingham for all three dimensions, after control for age, sex and ethnicity [reality distortion (ES: -0.20, 95 % CI: -0.32,-0.08; p=<0.01), depressive symptoms (ES: -0.27, 95 % CI: -0.46,-0.09; p<0.01), disorganization (ES: 0.07, 95 % CI: 0.02, 0.11; p<0.01)]. By contrast, for the affective sample no centre differences were observed for either reality distortion (ES: 0.04, 95 % CI: -0.13, 0.21; p=0.62) or depressive symptoms (ES: -0.16, 95 % CI: -0.42, 0.10; p=0.23). A trend persisted for greater disorganized symptoms in Nottingham compared with London in people with affective psychosis, after control for age, sex and ethnicity (ES: 0.06, 95 % CI: -0.00, 0.12; p=0.051) (See Table 8).Finally, we tested whether these centre by disorder interactions reached statistical significance for any dimension in full multilevel model, restricted to the non-affective and affective samples (N=448). Multilevel modeling suggested differences in reality distortion between London and Nottingham were dependent on broad diagnosis (Wald p-value for interaction: p=0.06), though there was no evidence of such an interaction for either depressive (p=0.13) or disorganized symptoms (p=0.58).As for symptom dimensions, it was inspected whether the centre differences observed in regard to paranoia differed amongst people who had been diagnosed with either a non-affective of affective psychotic disorder. Initial inspection of paranoia in these two diagnostic groups suggested sufficient individual-level variation was present for paranoia in both diagnostic groups to inspect the effect of centre on paranoia separately for these disorders (see Figure 7). For people with a non-affective psychosis, weak evidence of a higher odds of reporting paranoid symptoms was observed in people from London compared with Nottingham, after controlling for age, sex and ethnic group (OR: 1.63; 95% CI: 0.97, 2.73; p=0.07). No such association was found for those people with affective psychoses (OR: 0.60; 95% CI: 0.27, 1.33). A full multilevel model fitted with an interaction between centre and broad diagnosis confirmed the risk of paranoia in London compared with Nottingham varied significantly by diagnosis (Wald p-value for interaction: p=0.02). Further inspection of this effect for the non-affective psychosis group suggested that differences in the odds of paranoia between London and Nottingham could be explained by increased population density (OR: 1.01; 95% CI: 1.00, 1.02; p=0.01) and less socioeconomic deprivation (OR: 0.68; 95% CI: 0.50, 0.93), after control for age, sex and ethnic group. 4. Discussion 4.1 Principal FindingsIn this study, two of five symptom dimensions commonly identified in psychotic disorders (reality distortion and disorganization) presented with small, but significant variation at the neighbourhood-level in our initial models. This variance diminished to non-significance in our final models, and could largely be attributed to centre differences in symptomatology between London and Nottingham, entered into the models as fixed effects. Thus, living in London compared with Nottingham was significantly associated with more reality distortion, more depressive symptoms, and less disorganization, after control for sex, age and ethnicity. In our post-hoc analysis, we found some evidence to suggest that the strength of the centre effect was stronger for people with non-affective psychoses than their affective counterparts for all three dimensions. This difference, however, only approached statistical significance (p=0.06) for an interaction between centre and diagnosis on reality distortion; this was the principal symptom dimension which was hypothesized to show urban-rural differences in manifestation.For paranoia, which included two of the ten symptom groups in the reality distortion dimension, we observed centre differences consistent with findings from the reality distortion analysis, with significantly higher odds of paranoia in London than Nottingham. As for reality distortion, differences by diagnostic categories showed a similar pattern, with a strong statistical interaction between centre and diagnosis on the odds of paranoia (p=0.02), such that rates of paranoia were only elevated in London for the non-affective sample. We do not believe that this difference could be attributed to a lack of variation in paranoia in the affective sample because the distribution of paranoia was similar in both samples. Further inspection of this post-hoc finding suggested that the increased odds of paranoid ideation in London compared with Nottingham could be attributed to increased population density and, independently, lower levels of socioeconomic deprivation. We noted that acute mode of onset was significantly associated with greater manic symptoms. Male sex was also significantly associated with more negative symptoms, while depressive symptoms were greater for women. The gender differences are consistent with some earlier studies, but not all; for an overview, see Ochoa et al [12] ADDIN EN.CITE <EndNote><Cite><Author>Ochoa</Author><Year>2012</Year><RecNum>143</RecNum><DisplayText><style face="superscript">55</style></DisplayText><record><rec-number>143</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">143</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ochoa, S.</author><author>Usall, J.</author><author>Cobo, J.</author><author>Labad, X.</author><author>Kulkarni, J.</author></authors></contributors><auth-address>Research and Developmental Unit of Parc Sanitari Sant Joan de Deu, CIBERSAM. GTRDSM, Sant Boi de Llobregat, 08330 Barcelona, Spain.</auth-address><titles><title>Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review</title><secondary-title>Schizophr Res Treatment</secondary-title><alt-title>Schizophrenia research and treatment</alt-title></titles><periodical><full-title>Schizophr Res Treatment</full-title><abbr-1>Schizophrenia research and treatment</abbr-1></periodical><alt-periodical><full-title>Schizophr Res Treatment</full-title><abbr-1>Schizophrenia research and treatment</abbr-1></alt-periodical><pages>916198</pages><volume>2012</volume><edition>2012/09/12</edition><dates><year>2012</year></dates><isbn>2090-2093 (Electronic)&#xD;2090-2093 (Linking)</isbn><accession-num>22966451</accession-num><urls><related-urls><url> Methodological considerations Our study has a number of limitations. First, while our analysis strategy ensured that the distribution of residuals following model fit was normal for 4 symptom dimensions, and paranoia, our models did not fit the data well for depressive symptoms, with residuals exhibiting substantial kurtosis following modeling. For this symptom dimension, we recommend caution in interpreting our results. Another limitation is that we did not have exposure data for any other levels than individual and neighbourhood level, such as family level data. One further potential limitation, as mentioned in Demjaha et alPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZW1qYWhhPC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48

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ADDIN EN.CITE.DATA 47[09], is that the sample in the AESOP study was not medication na?ve. We could therefore not exclude the possibility that medication could have influenced symptomatology and thereby the dimensional scores included here. This could have biased our results in two ways. First, if the proportion of medication na?ve participants was a non-differential bias i.e. present to an equal extent in our London and Nottingham centres or across neighbourhoods, this bias would have limited our ability to detect differences in symptom severity between centres or neighbourhoods for some dimensions. For example, treatment with anti-psychotic medication should reduce the level of positive symptoms, including reality distortion and paranoid ideation. Since we observed centre differences for such symptoms, we believe it is unlikely that this bias had a major effect on our findings. A second, more troublesome problematic issue, would occur if this bias (in the probability of receiving medication) was differential, and more likely to occur in one centre than another due to possible differences in the organization, policy and delivery of mental health care in South London versus Nottingham. If participants in Nottingham were more likely to receive antipsychotic medication prior to symptom assessment in the AESOP study than their London counterparts, this could explain inter-centre differences in reality distortion or paranoia. Fifteen subjects were excluded from the original sample with sufficient information to complete the IGC. The excluded subjects were more likely to be male and live in London, but did otherwise not differ significantly from the included cases. Because the symptom dimension scores of the excluded subjects did not differ significantly from the rest, the exclusion did likely not have a significant impact on our results.The AESOP study was cross-sectional, meaning that the potential individual change in dimensional structure over time has not been accounted for. Information of residency was at time of first contact, so the influence of social drift could also not be accounted for. Although the phenomenon cannot be ruled out completely, earlier studies have shown that at least for urbanicity exposure prior to illness the increased risk of psychosis is not just an effect of social drift ADDIN EN.CITE <EndNote><Cite><Author>March</Author><Year>2008</Year><RecNum>69</RecNum><DisplayText><style face="superscript">30</style></DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>March, D.</author><author>Hatch, S. L.</author><author>Morgan, C.</author><author>Kirkbride, J. B.</author><author>Bresnahan, M.</author><author>Fearon, P.</author><author>Susser, E.</author></authors></contributors><auth-address>Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA. dm2025@columbia.edu</auth-address><titles><title>Psychosis and place</title><secondary-title>Epidemiol Rev</secondary-title><alt-title>Epidemiologic reviews</alt-title></titles><periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></periodical><alt-periodical><full-title>Epidemiol Rev</full-title><abbr-1>Epidemiologic reviews</abbr-1></alt-periodical><pages>84-100</pages><volume>30</volume><edition>2008/08/02</edition><keywords><keyword>Humans</keyword><keyword>Psychotic Disorders/*epidemiology</keyword><keyword>*Residence Characteristics</keyword><keyword>Risk Factors</keyword><keyword>Urban Population</keyword></keywords><dates><year>2008</year></dates><isbn>0193-936X (Print)&#xD;0193-936X (Linking)</isbn><accession-num>18669521</accession-num><work-type>Research Support, N.I.H., Extramural&#xD;Research Support, Non-U.S. Gov&apos;t&#xD;Review</work-type><urls><related-urls><url>. This supports at least a partially casual role for the environment in schizophrenia, indicating that it is unlikely that our results are simply the results of drift. It might well be, however, that residency at earlier stages of life have stronger effects on mental illness, working as some sort of primer or sensitization factor. The comparison between London and Nottingham was not a classic urban-rural dichotomy. While the London area studied was exclusively “urban”, the Nottingham area was a mix of urban, suburban, and rural environments34. Our analysis of paranoia indicated, nevertheless, that population density could explain part of the difference between London and Nottingham, lending support to using centres as fixed effects. Our study also has a number of strengths. It is, to the best of our knowledge, the first study to investigate the role of urbanicity and neighbourhood-level factors on symptoms dimensions for a subject sample with first-episode psychotic disorders. The AESOP study is a large, population-based epidemiological study of first-episode psychosis study, and has produced reliable, valid findings on a range of epidemiological and neuroscientific issues. 4.3 Meaning of findings Our findings indicate that experiencing psychosis in a larger city is associated with more reality distortion (Including paranoia), more depressive symptoms, and less disorganization. This supports the possibility that where you live can have an influence on your mental health, and that there is some unknown factor in the urban environment that plays a role in the development of psychotic disorders. The urban factor could be an effect of the increased stimuli presumably expected when living in a larger city. If the sheer number of stimuli, and possibly the number of stressors, increases with the size of the city, this might have an impact on our mental health, perhaps through the dopamine system. Specifically, in more densely populated areas the opportunity to be exposed to a greater number of social interactions may increase, and if these social interactions are interpreted more negatively, they may give rise to greater levels of social stress, resulting in more reality distortion/paranoia and depressive symptoms.The epidemiology professor Michael Marmot has written that “How much control you have over your life – and the opportunity you have for full social engagement and participation are crucial for health, well-being, and longevity” ADDIN EN.CITE <EndNote><Cite><Author>Marmot</Author><Year>2005</Year><RecNum>145</RecNum><DisplayText><style face="superscript">56</style></DisplayText><record><rec-number>145</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">145</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Marmot, M</author></authors></contributors><titles><title>The Status Syndrome</title></titles><dates><year>2005</year></dates><publisher>Holt McDougal </publisher><urls></urls></record></Cite></EndNote>56. One can speculate that within a small community, any person is likely only a few steps away from the top of the social hierarchy ladder. In a much larger community, the risk of being distanced from the top is vastly greater. In such a position, one’s opportunity for full social engagement and participation might be diminished, resulting over time in social marginalization and a mentally more vulnerable state, with a lower threshold for the development of psychosis. Interestingly, our post-hoc findings indicate a difference of geographical influence between non-affective and affective psychotic disorders. Given that this finding is post-hoc it requires replication in further studies, and only tentative conclusions should be drawn as to the potential meaning of these findings. However, the pattern of our findings with respect to reality distortion, depressive symptoms and paranoia are remarkably consistent; centre effects only appear to be present for those people with a non-affective rather than affective psychosis. While we cannot rule out the possibility of Type-II error and encourage our findings to be replicated in larger samples, this finding supports the possibility that non-affective and affective psychotic disorders have different aetiological pathways. Van Os and Rutten have eloquently highlighted the importance of understanding the role of cognition in the development of psychotic disorders following exposure to environmental factors29. Interestingly, premorbid cognitive impairment is frequently seen amongst people with schizophrenia and other non-affective psychoses, but not their counterparts who go on to develop affective psychotic disordersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Lb2VuZW48L0F1dGhvcj48WWVhcj4yMDA5PC9ZZWFyPjxS

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ADDIN EN.CITE.DATA 58 . As such, subjects with impaired social cognition may be particularly vulnerable to the effects of stressful urban environments. Although we were unable to inspect the role of premorbid cognition directly in our data, the greater levels of reality distortion and paranoia observed in London compared with Nottingham in our non-affective but not our affective sample are consistent with this idea. The findings in this thesis are consistent with?non-affective disorders as disorders of aberrant salience, where people in more urban environments have greater?levels of reality distortion and paranoia?as a result of exposure to environmental cues that could lead to?dopaminergic dysregulation and misinterpretation. This possibility of a difference of geographical influence between non-affective and affective psychotic disorders indicates that even though Howes and Kapur might have demonstrated a valid model for the development of psychosis in schizophrenia, their model might not be applicable for psychosis in affective syndromes.The finding that paranoid ideation was significantly greater in less socioeconomically deprived (i.e. more affluent) neighbourhoods, independent of population density is perhaps not very intuitive, but could be consistent with a hypothesis such as social defeat or subordination. ADDIN EN.CITE <EndNote><Cite><Author>Selten</Author><Year>2005</Year><RecNum>442</RecNum><DisplayText><style face="superscript">59</style></DisplayText><record><rec-number>442</rec-number><foreign-keys><key app="EN" db-id="9zw99sx06a595nezaadvdws7fwxwvxtet0ax">442</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Selten, J. P.</author><author>Cantor-Graae, E.</author></authors></contributors><titles><title>Social defeat: risk factor for schizophrenia?</title><secondary-title>Br J Psychiatry</secondary-title><alt-title>Br J Psychiatry</alt-title></titles><periodical><full-title>British Journal of Psychiatry</full-title><abbr-1>Br J Psychiatry</abbr-1></periodical><alt-periodical><full-title>British Journal of Psychiatry</full-title><abbr-1>Br J Psychiatry</abbr-1></alt-periodical><pages>101-102</pages><volume>187</volume><number>2</number><dates><year>2005</year><pub-dates><date>August 1, 2005</date></pub-dates></dates><urls><related-urls><url>:\phd\library\ejournals\255Selten(2005)BJP.pdf</url><url>Paper Copy: S255</url><url>Box S2</url></pdf-urls></urls></record></Cite></EndNote>59 Thus, in more affluent neighbourhoods some individuals – and particularly those within the community who fall below the average level of affluence in the community – may feel particularly marginalized. Occupation of such a subordinate position, may, over time, lead to greater paranoid ideation. We cannot draw any definitive conclusions about this issue from our data, but suggest this possibility could become a testable hypothesis for future studies investigating these associations. Finally, our findings that certain symptom dimensions are associated with urbanicity, but that this association is largely dependent on diagnostic category lends support to the notion that both the categorical and the dimensional approach have their place in the research of psychotic disorders. 5. Appendix Table 1: Simplified presentation of selected diagnostic groups of psychotic disorders. Non-Affective ICD codeDescriptionSchizophrenia F20At least two of the following symptoms for the duration of at least one month: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. Affective syndrome, organic etiology and drug abuse cancelled out as causing factors.Schizotypal disorderF21Cold and inadequate affect, peculiar behavior, tendency to be by him/herself and “aloofness”. Sometimes bizarre ideas, suspiciousness, and vague language. Reminiscent of schizophrenia but do not contain full-blown schizophrenic symptoms ADDIN EN.CITE <EndNote><Cite><Author>Ottosson</Author><Year>2009</Year><RecNum>16</RecNum><DisplayText><style face="superscript">60</style></DisplayText><record><rec-number>16</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">16</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Ottosson, Jan-Otto</author></authors></contributors><titles><title>Psykiatri, page 169</title></titles><edition>7th</edition><dates><year>2009</year></dates><publisher>Liber</publisher><urls></urls></record></Cite></EndNote>60. Delusional Disorder F22Continuous non-bizarre delusions (such as persecutory delusions, delusions of reference, and hypochondriac delusions), without other criterion for schizophrenia ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>14</RecNum><DisplayText><style face="superscript">12</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1061</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>12.Transient psychotic disorder F23Psychosis with a duration of maximum one month (three months for certain subgroups) and at least one psychotic symptom ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>14</RecNum><DisplayText><style face="superscript">12</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1061</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>12. Psychotic symptoms may be stable or variable and rapidly changing.Schizoaffective disorderF25Prominent depression and/or mania concurrent with schizophrenic symptoms as well as a duration of two weeks or more where schizophrenic symptoms were apparent without affective symptoms ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>14</RecNum><DisplayText><style face="superscript">12</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department) </author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1061</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>12. Criteria for this diagnosis differs in part between DSM IV and ICD 10Affective Manic episode F30Elevated, expansive or irritable mood for at least one week, as well as (for psychotic mania) episodes of hallucinations or delusions. Three or four of the following symptoms: Hyperactivity, fleeing thoughts, reduced inhibitions, reduced need for sleep, heightened self-esteem and grandiosity, reduced stringency of thoughts, irresponsible behavior, and increased libido ADDIN EN.CITE <EndNote><Cite><Author>Ottosson</Author><Year>2009</Year><RecNum>17</RecNum><DisplayText><style face="superscript">61</style></DisplayText><record><rec-number>17</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">17</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Ottosson, Jan-Otto</author></authors></contributors><titles><title>Psykiatri, page 235</title></titles><edition>7th</edition><dates><year>2009</year></dates><publisher>Liber</publisher><urls></urls></record></Cite></EndNote>61. Bipolar disorder F31Fluctuating periods of mania and depression, with depression often having a larger share ADDIN EN.CITE <EndNote><Cite><Author>L?kemedelsverket</Author><Year>2011-2012</Year><RecNum>15</RecNum><DisplayText><style face="superscript">62</style></DisplayText><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>L?kemedelsverket, (The Swedish Phamaceuticals Department)</author></authors></contributors><titles><title>L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1037</title></titles><dates><year>2011-2012</year></dates><urls></urls></record></Cite></EndNote>62, as well as (in psychotic cases) episodes of hallucinations or delusions.Depressive episode or disorderF32-33Involving elements such as: depressed mood, lack of interest, reduced energy, lowered self-confidence and self-esteem, recurrent thoughts of death and suicide, reduced cognitive ability, sleep disturbance, reduced or increased appetite ADDIN EN.CITE <EndNote><Cite><Author>Ottosson</Author><Year>2009</Year><RecNum>13</RecNum><DisplayText><style face="superscript">63</style></DisplayText><record><rec-number>13</rec-number><foreign-keys><key app="EN" db-id="zxd9aepp3ax5ddeewsv5twevv0zdwwpadt0f">13</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Ottosson, Jan-Otto </author></authors></contributors><titles><title>Psykiatri, page 225</title></titles><edition>7th</edition><dates><year>2009</year></dates><publisher>Liber</publisher><urls></urls></record></Cite></EndNote>63. Table 2: Psychopathological dimensions in the AESOP study following principal-axis factor analysis1Dimensions (% variance)Factors12345Manic (17%)Heightened subjective functioning0.86-0.08-0.08-0.06-0.04Rapid subjective tempo0.83-0.04-0.06-0.030.01Expansive mood0.82-0.07-0.07-0.06-0.04Expansive delusions & hallucinations0.630.13-0.07-0.070.07Overactivity0.62-0.010.01-0.080.24Socially embarrassing behaviour0.400.160.110.120.22Reality distortion (10%)Altered perception0.120.31-0.01-0.060.03Non-specific auditory hallucinations-0.090.550.100.06-0.33Non-specific psychotic experiences0.010.34-0.020.01-0.01Non-affective auditory hallucinations-0.080.610.11-0.14-0.30Experience of disordered form of thoughts0.050.480.03-0.080.12Delusions of control-0.060.37<0.01-0.030.14Bizarre delusions & interpretations-0.090.41-0.04-0.150.23Miscellaneous delusions0.080.38-0.080.080.07Delusions of reference0.110.46>-0.010.210.09Delusions of persecutions-0.080.43-0.070.030.18Negative (9%)Flat & incongruous affect-0.110.020.650.010.12Poverty of speech-0.07-0.110.69-0.01-0.04Non-verbal communication0.09-0.030.730.17-0.04Self neglect-0.010.090.370.020.19Motor retardation-0.090.010.610.36-0.18Depressive (9%)Special features of depressed mood-0.060.040.130.84-0.06Depressed mood-0.17-0.060.040.82-0.05Depressive delusions & hallucinations-0.090.010.130.58-0.09Disorganisation (4%)Emotional turmoil0.160.120.23-0.020.39Incoherent speech0.100.06<0.01-0.120.461All item group checklist items were included in the factor analysis and contributed to factor scores. For clarity of presentation and comparability with Demjaha et al., only items which had high factor loadings on at least one factor are reported here. High factor loadings (≥±0.30) are presented in bold.Table 3: Characteristics for included subjects from the AESOP study (no:469)Characteristics Number (percent) Age - Median 29 - IQR22-36Gender - Male 266 (56.7) - Female 203 (43.3) Ethnicity - White British 223 (43.1)- White other35 (6.7)- Black Caribbean 137 (26.5)- Black African64 (12.4)- Asian 19 (3.7)- Other29 (5.6)- Mixed, White and Black Carib.10 (1.9)Diagnosis - Drug-induced psychosis 21 (4.5)- Non-affective psychosis320 (68.2)- Affective psychosis 128 (27.3)Centre- London 309 (65.9) - Nottingham 160 (34.1) Mode of onset - Acute 211 (45.0)- Insidious 222 (47.3)- NA36 (7.7)Table 4: Correlation between dimensionsManiaReality DistortionNegativesymptomsDepressivesymptomsDisorganizationMania1.000Reality Distortion-0.012(p: 0.78)1.000Negativesymptoms-0.014(p: 0.76)0.010(p : 0.84)1.000Depressivesymptoms-0.019(p: 0.68)-0.010(p: 0.82)0.047(p: 0.30)1.000Disorganization0.025(p: 0.62)-0.004(p: 0.93)-0.002(p: 0.97)-0.053(p: 0.24)1.000Figure 1: Mania and Reality distortion before and after transformation Distribution of scores for mania (left column) and reality distortion (right column), before (top row) and after transformation (bottom row).Table 5: Centre differences for symptom dimensionsMean (Sd)Median (IQR)Ranksum(Wilcoxon)LondonNottinghamLondonNottinghamMania 0.03(1.00)-0.06(0.82)-0.37(-0.50,-0.18)-0.36(-0.47,-0.14)0.53 Real.Dist0.13(0.90)-0.27(0.75)-0.04(-0.52,0.68)-0.50(-0.78,0.13)<0.01Negative -0.03(0.90)0.05(0.88)-0.37(-0.59,0.18)-0.27(-0.57,0.38)0.13Depressive0.05(0.94)-0.10(0.86)-0.40(-0.62,0.50)-0.49(-0.66,0.25)0.05Disorg. -0.09(0.77)0.18(0.70)-0.13(-0.62,0.34)0.04(-0.30,0.60)<0.01Figure 2: Distribution of residuals for depressive symptoms Residuals of depressive symptoms plotted against normality, using the qnorm command in StataTable 6: Results of empty and final model for symptom dimensionsMania Reality Distortion NegativeDepressiveDisorganizationEmpty modelICC0.88 %5.20 %0.91 % 0.00 %3.30 % χ2 p-value0.310.020.321.000.04AIC16155451165944-415Final modelICC0.25 %0.01 %0.29 %0.00 %0.06 %χ2 p-value0.440.500.441.000.37AIC16255701192974-357Variables Age -0.01(-0.02,0.05)0.00(-0.00,0.00)0.00(-0.01,0.01)0.00(-0.00,0.01)0.00(-0.00,0.00)Sex0.22(-0.03,0.47)-0.03(-0.11,0.05)-0.17*(-0.33,-0.02)0.16*(0.03,0.28)-0.02(-0.05,0.00)Insidious onset of psychosis -0.53**(-0.79,-0.28)NANANANACentreNA-0.17**(-0.27,-0.07)NA-0.22**(-0.37,-0.06)0.05**(0.02,0.09)Ethnicity○White Other-0.25(-0.73,0.23)0.11(-0.05,0.27)0.05(-0.25,0.35)-0.07(-0.31,0.18)0.01(-0.05,0.07)Black Caribbean -0.08(-0.39,0.21)0.04(-0.07,0.15)-0.10(-0.28,0.09)-0.22*(-0.38,-0.05)0.00(-0.04,0.04)Black African 0.23(-0.15,0.60)0.12(-0.01,0.26)0.03(-0.21,0.27)-0.15(-0.36,0.06)-0.01(-0.06,0.03)Asian -0.31(-1.02,0.41)-0.10(-0.33,0.13)-0.23(-0.67,0.22)0.05(-0.30,0.40)-0.01(-0.09,0.07)Other0.07(-0.46,0.61)0.01(-0.16,0.19)0.06(-0.28,0.39)0.01(-0.26,0.28)0.00(-0.07,0.06)Mixed, White, & Black.Carib.0.29(-0.55,0.12)-0.20(-0.46,0.07)0.52(-0.00,1.05)-0.03(-0.44,0.39)0.04(-0.06,0.13)Variables included in final model of each dimension are displayed. ICC: Intraclass Correlation Coefficient | AIC: Akaike Information Criterion * P <0.05, ** P <0.01 |○ Baseline: White British Table 7: Centre effect – sensitivity analysisReality distortion Depressive symptoms Disorganization Original -0.17(-0.27,-0.07)-0.22(-0.37,-0.06)0.05(0.02,0.09)Scenario 1○-0.15(-0.25,-0.05)-0.23(-0.38,-0.09)0.06(0.02,0.10)Scenario 2○-0.15(-0.26.0.05)-0.27(-0.42,-0.12)0.06(0.03,0.10)○ Scenario 1: Missing values coded to baseline group (no drug use, acute onset, no parental history). Scenario 2: Missing values coded to highest exposure category (poly-drug use, insidious onset, positive parental history of psychosis)Figure 3: Distribution of reality distortion by diagnostic categoryICD 20-29: Non-affective psychotic disorder, ICD 30-33: Affective psychotic disorderFigure 4: Distribution of depressive symptoms by diagnostic category 9525296545Figure 5: Distribution of depressive symptoms - bipolar and depressive psychotic disorderFigure 6: Distribution of disorganization by diagnostic category Table 8: Centre effect (living in Nottingham) on dimensions where centre was part of final model.Reality Dist.DepressiveDisorganizationCentre effect Full sample (No: 469)-0.17 (-0.27,-0.07)-0.22(-0.37,-0.06)0.05(0.02,0.09)Non-affective (No: 320*)-0.20(-0.32,-0.08)-0.27(-0.46,-0.09)0.07(0.02,0.11)Affective (No: 128*)0.04(-0.13,0.21)-0.16(-0.42,0.10)0.06(-0.00,0.12)Numbers indicating coefficient value and 95 % confidence interval.* 21 subjects with drug-induced psychosis (ICD10-19) were not included in this analysisFigure 7: Distribution of paranoia by ICD-10 diagnostic group6. References ADDIN EN.REFLIST 1.Cullberg J. Psykoser - Ett integrerat perspektiv (Psychoses - An integrative perspective) 2nd ed: Natur och Kultur 2005.2.L?kemedelsverket TSPD. L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1057. 2011-2012.3.L?kemedelsverket TSPD. L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1059. 2011-2012.4.L?kemedelsverket TSPD. L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1067. 2011-2012.5.Gustavsson A, Svensson M, Jacobi F, et al. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol Oct 2011;21(10):718-779.6.Herlofson J. Psykiatri, page 285. 1st ed: Studentlitteratur 2009.7.van Os J, Kapur S. Schizophrenia. Lancet Aug 22 2009;374(9690):635-645.8.Heinrichs RW. Historical origins of schizophrenia: two early madmen and their illness. J Hist Behav Sci Fall 2003;39(4):349-363.9.Stotz-Ingenlath G. Epistemological aspects of Eugen Bleuler's conception of schizophrenia in 1911. Med Health Care Philos 2000;3(2):153-159.10.American Psychiatry Association: (Data last confirmed January 14th 2013). 11.World Health Organization: (Data last confirmed January 14th 2013). 12.L?kemedelsverket TSPD. L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1061. 2011-2012.13.Web page: internetmedicin.se, search word: "Schizofreni", author: Eva Lindstr?m (Data last confirmed January 14th 2013). 14.Crow TJ. Positive and negative schizophrenic symptoms and the role of dopamine. The British journal of psychiatry : the journal of mental science Oct 1980;137:383-386.15.Crow TJ. Molecular pathology of schizophrenia: more than one disease process? British medical journal Jan 12 1980;280(6207):66-68.16.Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia bulletin 1987;13(2):261-276.17.van Os J. Is there a continuum of psychotic experiences in the general population? Epidemiologia e psichiatria sociale Oct-Dec 2003;12(4):242-252.18.Liddle PF. The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy. The British journal of psychiatry : the journal of mental science Aug 1987;151:145-151.19.Potuzak M, Ravichandran C, Lewandowski KE, Ongur D, Cohen BM. Categorical vs dimensional classifications of psychotic disorders. Comprehensive psychiatry Jun 7 2012.20.Cullberg J. Psykoser - Ett integrerat perspektiv (Psychoses - An integrative perspective), page 64. 2nd ed: Natur och Kultur; 2005.21.Picchioni MM, Murray RM. Schizophrenia. BMJ Jul 14 2007;335(7610):91-95.22.Kendler KS, McGuire M, Gruenberg AM, O'Hare A, Spellman M, Walsh D. The Roscommon Family Study. I. Methods, diagnosis of probands, and risk of schizophrenia in relatives. Archives of general psychiatry Jul 1993;50(7):527-540.23.Cardno AG, Marshall EJ, Coid B, et al. Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Archives of general psychiatry Feb 1999;56(2):162-168.24.Ottosson J-O. Psykiatri. 7th ed: Liber; 2009.25.Bhugra D. Migration and schizophrenia. Acta psychiatrica Scandinavica Supplementum 2000(407):68-73.26.van Os J, Kenis G, Rutten BP. The environment and schizophrenia. Nature Nov 11 2010;468(7321):203-212.27.Minozzi S, Davoli M, Bargagli AM, Amato L, Vecchi S, Perucci CA. An overview of systematic reviews on cannabis and psychosis: discussing apparently conflicting results. Drug and alcohol review May 2010;29(3):304-317.28.Henquet C, Murray R, Linszen D, van Os J. The environment and schizophrenia: the role of cannabis use. Schizophrenia bulletin Jul 2005;31(3):608-612.29.Moore TH, Zammit S, Lingford-Hughes A, Barnes TR, Jones PB, Burke M, Lewis G. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet Jul 28 2007;370(9584):319-328.30.March D, Hatch SL, Morgan C, Kirkbride JB, Bresnahan M, Fearon P, Susser E. Psychosis and place. Epidemiologic reviews 2008;30:84-100.31.Kirkbride JB, Fearon P, Morgan C, et al. Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Archives of general psychiatry Mar 2006;63(3):250-258.32.Sundquist K, Frank G, Sundquist J. Urbanisation and incidence of psychosis and depression: follow-up study of 4.4 million women and men in Sweden. The British journal of psychiatry : the journal of mental science Apr 2004;184:293-298.33.Mortensen PB, Pedersen CB, Westergaard T, Wohlfahrt J, Ewald H, Mors O, Andersen PK, Melbye M. Effects of family history and place and season of birth on the risk of schizophrenia. The New England journal of medicine Feb 25 1999;340(8):603-608.34.van Os J, Pedersen CB, Mortensen PB. Confirmation of synergy between urbanicity and familial liability in the causation of psychosis. The American journal of psychiatry Dec 2004;161(12):2312-2314.35.Pedersen CB, Mortensen PB. Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk. Archives of general psychiatry Nov 2001;58(11):1039-1046.36.Kirkbride JB, Fearon P, Morgan C, Dazzan P, Morgan K, Murray RM, Jones PB. Neighbourhood variation in the incidence of psychotic disorders in Southeast London. Social psychiatry and psychiatric epidemiology Jun 2007;42(6):438-445.37.Silver E, Mulvey EP, Swanson JW. Neighborhood structural characteristics and mental disorder: Faris and Dunham revisited. Soc Sci Med Oct 2002;55(8):1457-1470.38.Mortensen PB, Pedersen CB, Melbye M, Mors O, Ewald H. Individual and familial risk factors for bipolar affective disorders in Denmark. Archives of general psychiatry Dec 2003;60(12):1209-1215.39.Berridge KC. The debate over dopamine's role in reward: the case for incentive salience. Psychopharmacology Apr 2007;191(3):391-431.40.Ottosson J-O. Psykiatri, page 180. 7th ed: Liber; 2009.41.Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. The American journal of psychiatry Jan 2003;160(1):13-23.42.Moskovitz C, Moses H, 3rd, Klawans HL. Levodopa-induced psychosis: a kindling phenomenon. The American journal of psychiatry Jun 1978;135(6):669-675.43.Howes OD, Kapur S. The dopamine hypothesis of schizophrenia: version III--the final common pathway. Schizophrenia bulletin May 2009;35(3):549-562.44.Kaymaz N, Krabbendam L, de Graaf R, Nolen W, Ten Have M, van Os J. Evidence that the urban environment specifically impacts on the psychotic but not the affective dimension of bipolar disorder. Social psychiatry and psychiatric epidemiology Sep 2006;41(9):679-685.45.Lederbogen F, Kirsch P, Haddad L, et al. City living and urban upbringing affect neural social stress processing in humans. Nature Jun 23 2011;474(7352):498-501.46.Mizrahi R, Addington J, Rusjan PM, et al. Increased stress-induced dopamine release in psychosis. Biological psychiatry Mar 15 2012;71(6):561-567.47.Demjaha A, Morgan K, Morgan C, et al. Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? Psychological medicine Dec 2009;39(12):1943-1955.48.Fearon P, Kirkbride JB, Morgan C, et al. Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychological medicine Nov 2006;36(11):1541-1550.49.Noble M, Wright G, Dibben C, et al. Indices of Deprivation 2004 London: ODPM; 2004.50.Kirkbride JB, Morgan C, Fearon P, Dazzan P, Murray RM, Jones PB. Neighbourhood-level effects on psychoses: re-examining the role of context. Psychological medicine Oct 2007;37(10):1413-1425.51.Kawachi I, Kennedy BP. The relationship of income inequality to mortality: Does the choice of indicator matter? Social Science &amp; Medicine 1997;45(7):1121-1127.52.Addington D, Addington J, Patten S. Gender and affect in schizophrenia. Canadian journal of psychiatry Revue canadienne de psychiatrie Jun 1996;41(5):265-268.53.Larsen TK, McGlashan TH, Moe LC. First-episode schizophrenia: I. Early course parameters. Schizophrenia bulletin 1996;22(2):241-256.54.Szymanski S, Lieberman JA, Alvir JM, et al. Gender differences in onset of illness, treatment response, course, and biologic indexes in first-episode schizophrenic patients. The American journal of psychiatry May 1995;152(5):698-703.55.Ochoa S, Usall J, Cobo J, Labad X, Kulkarni J. Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophrenia research and treatment 2012;2012:916198.56.Marmot M. The Status Syndrome: Holt McDougal 2005.57.Koenen KC, Moffitt TE, Roberts AL, Martin LT, Kubzansky L, Harrington H, Poulton R, Caspi A. Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis. Am J Psychiatry Jan 2009;166(1):50-57.58.Rietschel M, Georgi A, Schmael C, et al. Premorbid adjustment: a phenotype highlighting a distinction rather than an overlap between schizophrenia and bipolar disorder. Schizophr Res May 2009;110(1-3):33-39.59.Selten JP, Cantor-Graae E. Social defeat: risk factor for schizophrenia? Br J Psychiatry August 1, 2005 2005;187(2):101-102.60.Ottosson J-O. Psykiatri, page 169. 7th ed: Liber; 2009.61.Ottosson J-O. Psykiatri, page 235. 7th ed: Liber; 2009.62.L?kemedelsverket TSPD. L?kemedelsboken (The Swedish Pharmaceuticals Book), page 1037. 2011-2012.63.Ottosson J-O. Psykiatri, page 225. 7th ed: Liber; 2009. ................
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