A 6-year follow-up study in a community-based population: Is neighbourhood-level social capital associated with the risk of emergence and persistence of psychotic experiences and transition to psychotic disorder?

C. Ergul*, M. Drukker, T. Binbay, U. Kirli, H. Elbi, K. Alptekin, J. van Os

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Social capital is thought to represent an environmental factor associated with the risk of psychotic disorder (PD). This study aims to investigate the association between neighbourhood-level social capital and clinical transitions within the spectrum of psychosis. Methods In total, 2175 participants, representative of a community-based population, were assessed twice (6 years apart) to determine their position within an extended psychosis spectrum: no symptoms, subclinical psychotic experiences (PE), clinical PE, PD. A variable representing change between baseline (T1) and follow-up (T2) assessment was constructed. Four dimensions of social capital (informal social control, social disorganisation, social cohesion and trust, cognitive social capital) were assessed at baseline in an independent sample, and the measures were aggregated to the neighbourhood level. Associations between the variable representing psychosis spectrum change from T1 to T2 and the social capital variables were investigated. Results Lower levels of neighbourhood-level social disorganisation, meaning higher levels of social capital, reduced the risk of clinical PE onset (OR 0.300; z = -2.75; p = 0.006), persistence of clinical PE (OR 0.314; z = -2.36; p = 0.018) and also the transition to PD (OR 0.136; z = -2.12; p = 0.034). The other social capital variables were not associated with changes from T1 to T2. Conclusions Neighbourhood-level social disorganisation may be associated with the risk of psychosis expression. Whilst replication of this finding is required, it may point to level of social disorganisation as a public health target moderating population psychosis risk.
Original languageEnglish
Article number0033291722000642
Pages (from-to)3974-3986
Number of pages13
JournalPsychological Medicine
Volume53
Issue number9
Early online date18 Mar 2022
DOIs
Publication statusPublished - Jul 2023

Keywords

  • neighbourhood
  • psychosis
  • psychotic disorder
  • psychotic experiences
  • social capital
  • social disorganisation
  • INTERNATIONAL DIAGNOSTIC INTERVIEW
  • EXTENDED PSYCHOSIS
  • SCHIZOPHRENIA
  • CONTINUUM
  • ENVIRONMENT
  • SYMPTOMS
  • PHENOTYPE
  • IZMIR
  • INSTRUMENT
  • SPECTRUM

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