Urbanization and psychosis: a study of 1942–1978 birth cohorts in The Netherlands

1998 ◽  
Vol 28 (4) ◽  
pp. 871-879 ◽  
Author(s):  
M. MARCELIS ◽  
F. NAVARRO-MATEU ◽  
R. MURRAY ◽  
J.-P. SELTEN ◽  
J. VAN OS
Keyword(s):  
Urban Areas ◽  
Incidence Rate Ratio ◽  
Age Of Onset ◽  
Linear Trend ◽  
Birth Cohorts ◽  
Psychiatric Admission ◽  
Affective Psychosis ◽  
Case Register ◽  
Diagnostic Categories ◽  
Successive Generations

Background. Urban birth is associated with later schizophrenia. This study examined whether this finding is diagnosis-specific and which individuals are most at risk.Methods. All live births recorded between 1942 and 1978 in any of the 646 Dutch municipalities were followed-up through the National Psychiatric Case Register for first psychiatric admission for psychosis between 1970 and 1992 (N=42115).Results. Urban birth was linearly associated with later schizophrenia (incidence rate ratio linear trend (IRR), 1·39; 95% confidence interval (95% CI), 1·36–1·42), affective psychosis (IRR, 1·18; 95% CI, 1·15–1·21) and other psychosis (IRR, 1·27; 95% CI, 1·24–1·30). Individuals born in the highest category of the three-level urban exposure were around twice as likely to develop schizophrenia. Associations were stronger for men and for individuals with early age of onset. The effect of urban birth was also stronger in the more recent birth cohorts.Conclusions. There are quantitative differences between diagnostic categories in the strength of the association between urban birth and later psychiatric disorder. High rates of psychosis in urban areas may be the result of environmental factors associated with urbanization, the effect of which appears to be increasing over successive generations.

Social indicators and psychiatric admission rates: a case-register study in the Netherlands

1991 ◽  
Vol 21 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Sjoerd Sytema
Keyword(s):  
Relative Risk ◽  
Social Indicators ◽  
The Other ◽  
Logit Models ◽  
Need For Care ◽  
Psychiatric Admission ◽  
Case Register ◽  
Independent Variables ◽  
Admission Rates ◽  
The Relationship

SYNOPSISEnvironmental as well as individual socio-demographic and illness characteristics are related to the risk of admission. This paper addresses the problem of the interrelationships of these factors to admission rates. Using the Groningen Psychiatric Case Register, admission rates (during 1986 and 1987) from 34 administrative areas were calculated. Logit models were fitted in order to test the relationship between the relative risk of being admitted and sex, age, marital status, diagnosis, urbanization and distance from facilities. The effect of urbanization remains under the control of the other independent variables. The concept of ‘need for care’, related to ‘true’ and ‘treated’ incidence, is discussed.

scholarly journals Time Series Analysis of the Pollutants Imissions in Urban Areas

1970 ◽  
Vol 66 (2) ◽  
Author(s):  
Carmen Leane NICOLESCU ◽  
Daniel DUNEA ◽  
Virgil MOISE ◽  
Gabriel GORGHIU
Keyword(s):  
Time Series ◽  
Air Quality ◽  
Urban Areas ◽  
Linear Trend ◽  
Moving Average ◽  
Quality Parameters ◽  
Temporal And Spatial Distribution ◽  
Simple Exponential Smoothing ◽  
Environmental Air ◽  
Local Agencies

Environmental pollution of urban areas is one of the key factors that local agencies and authorities have to consider in the decision-making process. To succeed a sustainable management of the environment, there is necessary to use different kinds of instruments in order to evaluate and forecast the evolution of the environmental state. Understanding temporal and spatial distribution of air quality is essential in making decisions for regional management. In this paper a model for urban air quality forecasting using time series of monthly averages concentrations is presented. Sedimentable dusts (SD), total suspended particulates (TSP), nitrogen dioxide (NO2), and sulfur dioxide (SO2), imissions, recorded between 1995 and 2008 in the urban area of Târgovişte city are used as inputs in the model. The measured pollutant data from the local Environmental Agency database were statistically analyzed in time series including monthly patterns using the auto-regressive integrated moving average (ARIMA) method, linear trend, simple moving average of three terms and simple exponential smoothing. There was discussed the efficiency of using this method in forecasting the environmental air quality. In general, ARIMA technique scores well in predicting the analysed environmental air quality parameters.

scholarly journals T170. GENE AND ENVIRONMENT INTERPLAY AMONG DIAGNOSTIC CATEGORIES IN THE EUGEI STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S296-S296
Author(s):  
Victoria Rodriguez ◽  
Luis Alameda ◽  
Diego Quattrone ◽  
Giada Tripoli ◽  
Charlotte Gayer-Anderson ◽  
...  
Keyword(s):  
Childhood Trauma ◽  
Risk Score ◽  
Environmental Risk ◽  
Cannabis Use ◽  
Spectrum Disorder ◽  
Schizophrenia Spectrum Disorder ◽  
Affective Psychosis ◽  
Diagnostic Categories ◽  
Schizophrenia Spectrum ◽  
Increased Risk

Abstract Background The importance of inherited factors in the development of affective psychosis, which includes bipolar disorder and major depression disorder, is widely accepted, but the fact that monozygotic twin concordance is substantially less than 100% suggests that environmental factors (ERF) are likely to play an important role as well. While the link between a variety of ERF and schizophrenia-spectrum disorder is well established, less is known about how these ERF impact in affective psychosis. In the current study we aim to analyse the role of environmental risk factors in the expression of affective disorder compared with schizophrenia-spectrum disorder, and its interaction with the genetic risk by using polygenic risk score (PRS). Methods DNA was obtained from most participants (73.6% of 1130 cases and 78.5% of 1499 controls) among 16 European cities as part of the EUGEI case-control study. PRS for SZ, BD and MDD were built using the latest available data from the Psychiatric Genomic Consortium (PGC). Multinomial logistic regression models were used to test whether the association of genetic load (by PRSs) with different diagnostic categories based on DSMIV from OPCRIT items were greater if there was also evidence of ERF (urbanicity, migration, cannabis use and childhood trauma) through the inclusion of interaction terms between the different PRSs and the ERF. Analyses were conducted for each environmental factor separately and for a combined poly-environmental risk score based on Maudsley Environmental Score (MPES) will be calculated. Results Being 1st generation migrant was not associated with any of the diagnostic categories, nor independently nor in interaction with PRSs. Living in urban environment increases the risk of SSD (RRR=1.68, 95% CI 1.06 – 2.67), but without interacting with any genetic measure. Regarding cannabis use, having ever used cannabis is independently significantly associated with SSD (RRR=2.26, 95% CI 1.69 – 3.02) and BD (RRR=5.3, 95% CI 2.69 – 10.46), showing as well in the latter group an interaction with PRS MDD (RRR=2.3, 95% CI 1.18 – 4.49). Although daily use of cannabis strongly predicted risk of SSD and BD, having use more than once a week only increased risk for SSD. Neither having used cannabis more than once a week or daily interacted with any of the PRSs. Having been exposed to any childhood trauma was independently significantly associated with all three diagnostic groups, but did not show any significant interaction with PRSs. Lastly, despite MPES increased risk for SSD and BD, it didn’t interact significantly with any PRSs. Discussion These results suggest that despite evidence of both PRSs on one hand and urbanicity, cannabis and childhood trauma overall increase risk of belonging to any psychotic diagnostic category separately, we only found some suggestion of potential interaction between genetic vulnerability to MDD and cannabis use associated with BD. Nonetheless, due to most of the interactions showing the expected trend, analyses examining interactions between PRSs and ERF with the different diagnostic groups with bigger samples are warranted.

scholarly journals Left-censored dementia incidences in estimating cohort effects

2020 ◽  
Author(s):  
Rafael Weißbach ◽  
Yongdai Kim ◽  
Achim Dörre ◽  
Anne Fink ◽  
Gabriele Doblhammer
Keyword(s):  
Linear Trend ◽  
Information Matrix ◽  
Standard Errors ◽  
Insurance Company ◽  
Birth Cohorts ◽  
Large Sample Theory ◽  
Dementia Incidence ◽  
Matrix Equality ◽  
Censored Observations ◽  
Conditional Information

Abstract We estimate the dementia incidence hazard in Germany for the birth cohorts 1900 until 1954 from a simple sample of Germany’s largest health insurance company. Followed from 2004 to 2012, 36,000 uncensored dementia incidences are observed and further 200,000 right-censored insurants included. From a multiplicative hazard model we find a positive and linear trend in the dementia hazard over the cohorts. The main focus of the study is on 11,000 left-censored persons who have already suffered from the disease in 2004. After including the left-censored observations, the slope of the trend declines markedly due to Simpson’s paradox, left-censored persons are imbalanced between the cohorts. When including left-censoring, the dementia hazard increases differently for different ages, we consider omitted covariates to be the reason. For the standard errors from large sample theory, left-censoring requires an adjustment to the conditional information matrix equality.

scholarly journals Medical mimics: Differential diagnostic considerations for psychiatric symptoms

2016 ◽  
Vol 6 (6) ◽  
pp. 289-296 ◽  
Author(s):  
Jerry McKee ◽  
Nancy Brahm
Keyword(s):  
Psychiatric Symptoms ◽  
Age Of Onset ◽  
Medical Condition ◽  
Clinical Situation ◽  
Symptom Presentation ◽  
Psychiatric Symptomatology ◽  
Statistical Manual ◽  
Diagnostic Categories ◽  
Diagnostic And Statistical Manual ◽  
Underlying Medical Condition

Abstract Patients with underlying medical disease can present to the health care system with psychiatric symptoms predominating. Identification of an underlying medical condition masquerading as a psychiatric disorder can be challenging for clinicians, especially in patients with an existing psychiatric condition. The term medical mimic or secondary psychosis has been used to describe this clinical situation. Diagnostic categories from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, that may encompass medical mimics include substance-induced disorders, which includes medications, and unspecified mental disorder due to another medical condition in situations where the clinician may lack needed information for a complete diagnosis. At this time, there is no single diagnostic test or procedure available to differentiate primary versus secondary psychosis on the basis of psychopathology presentation alone. When considering a diagnosis, clinicians should evaluate for the presence of atypical features uncharacteristic of the psychiatric symptoms observed; this may include changes in functionality and/or age of onset and symptom presentation severity. The purpose of this work is to provide a structured clinical framework for evaluation for medical mimics, identify groups considered to be at highest risk for medical mimics, and present common syndromic features suggestive of a medical mimic. Selected case scenarios are used to illustrate key concepts for evaluating and assessing a patient presenting with acute psychiatric symptomatology to improve judgment in ruling out potential medical causality.

Assistenza psichiatrica e monitoraggio dei servizi. Il Registro dei casi di Caltagirone 1987–1990

1992 ◽  
Vol 1 (1) ◽  
pp. 45-60 ◽  
Author(s):  
Gaetano Interlandi ◽  
Maria Grazia Sotera
Keyword(s):  
Psychiatric Service ◽  
Similar Rate ◽  
Outpatient Clinics ◽  
Case Register ◽  
Diagnostic Categories ◽  
Community Psychiatric ◽  
Multiple Structures ◽  
Community Psychiatric Service ◽  
Made In

RiassuntoSono descritte, con la stessa metodologia impiegata in altre 4 aree italiane sedi di Registro Psichiatrico dei Casi (RPC), le caratteristiche della catchment-aerea, del RPC, della struttura e dei principi del Dipartimento di Psichiatria di Caltagirone. II monitoraggio della domanda su 4 anni evidenzia che i tassi di prevalenza annua (763/100000 residenti adulti) e un giorno (223/100000 residenti adulti) hanno valori inferiori ai RPC europei. I tassi di incidenza (281/100000 residenti adulti) indicano un afflusso di nuovi casi appartenenti a tutte le categorie diagnostiche. II RPC di Caltagirone monitora l'attività svolta in strutture e servizi a differente gradiente assistenziale: residenziale ospedaliera, residenziale non ospedaliera, semiresidenziale, ambulatoriale, domiciliare, ecc. II rapporto tra prevalenza annua non ospedaliera e ospedaliera è nel 1990 di 4,4 a 1. II tasso di lungoassistiti è di 122/100000 residenti adulti, con una tendenza ad un accumulo per quelli che vivono nel territorio, mentre vi è un calo di quelli che sono in Comunità. II costo del Dipartimento, che è andato riducendosi dal 1987 al 1990, è in buona parte da addebitare alle giornate di assistenza in Comunità.Parole chiaveservizi psichiatrici territoriali, registri psichiatrici dei casi, utilizzazione dei servizi.SummaryThe principles, structure, Psychiatric Case Register (PCR) and catchment-area of the Community Psychiatric Service of Caltagirone are described, using the same methodology employed in 4 other Italian PCRs. The monitoring of the demand over 4 years shows that the year prevalence (763'100000 adult inhabitants) and day prevalence (248'100000 adult inhabitants) rates are lower than those of other European PCRs. Incidence rate (248'100000 adult inhabitants) shows that new patients belong to all diagnostic categories. The PCR records data of the activities made in multiple structures and services, offering different degrees of care: residential in and outside the hospital, semiresidential, care in outpatient clinics, domiciliary care, etc. The ratio between non-hospitalized and hospitalized users is 4.3 to 1. The rate of long-term patients is 122'100000 adult inhabitants; the rate of long-term patients living in the community is increasing over the years, whereas the similar rate of patients living in the sheltered apartments is decreasing. The costs of the Service (which have decrease from 1987 to 1990) have to be attributed mainly to the costs of the treatment in sheltered apartments.

scholarly journals F81. AGE OF ONSET OF CANNABIS USE AND COGNITIVE FUNCTION IN FIRST EPISODE NON-AFFECTIVE PSYCHOSIS PATIENTS: 3-YEAR FOLLOW-UP OUTCOME

2018 ◽  
Vol 44 (suppl_1) ◽  
pp. S251-S251
Author(s):  
Esther Setién-Suero ◽  
Diana Tordesillas-Gutierrez ◽  
Benedicto Crespo-Facorro ◽  
Rosa Ayesa-Arriola
Keyword(s):  
Cognitive Function ◽  
Age Of Onset ◽  
Cannabis Use ◽  
First Episode ◽  
Affective Psychosis

Suicide and other causes of mortality after post-partum psychiatric admission

1998 ◽  
Vol 173 (3) ◽  
pp. 209-211 ◽  
Author(s):  
Louis Appleby ◽  
Preben B. Mortensen ◽  
E. Brian Faragher
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Hospital ◽  
Post Partum ◽  
High Rate ◽  
First Year ◽  
Psychiatric Admission ◽  
Case Register ◽  
Postnatal Women ◽  
Causes Of Mortality ◽  
One Year

BackgroundThe risk of suicide in postnatal women is low and those suicides that occur appear to be associated with severe psychiatric illness. No previous study has specifically studied the risk of suicide following post-partum psychiatric disorder.MethodWe calculated standardised mortality ratios (SMRs) for suicide, unnatural deaths and deaths from natural causes for women admitted to psychiatric hospital in the first year after childbirth, using computerised cross-linkages between the Danish Psychiatric Case Register and the Danish registers of birth and causes of death for 1973–1993.ResultsDuring the study period 1567 women were admitted to psychiatric hospital of whom 107 (6.8%) died. The SMRs (compared with 100) were 1719 (95% CI 1284–2254) for suicide, 1329 (95% CI 1038–1676) for all unnatural causes and 238 (95% CI 167–329) for natural causes. Suicides and deaths from all unnatural causes were most likely to occur in the first year after childbirth, the SMR for suicide within one year being 7216 (95% CI 3945–12 108).ConclusionsAlthough postnatal women as a whole appear to have a low rate of suicide, severe post-partum psychiatric disorder is associated with a high rate of deaths from natural and unnatural causes, particularly suicide. The risk is especially high in the first postnatal year, when the suicide risk is increased 70-fold. Close clinical superivision at this time is indicated.

Assistenza psichiatrica a Firenze. Indagine “ad hoc” sulla prevalenza dei casi in trattamento nei servizi psichiatrici pubblici (1991)

1995 ◽  
Vol 4 (3) ◽  
pp. 187-197
Author(s):  
Annibale Biggeri ◽  
Lucia Bilanci ◽  
Lucia Caselli ◽  
Stefano Lucarelli ◽  
Carlo Niccolai ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Community Mental Health Services ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Case Register ◽  
Large Variability ◽  
Psychiatric Illnesses ◽  
Diagnostic Categories ◽  
Clinical Records ◽  
Sectional Analysis

SummaryObjective - The aim of our research is to evaluate the prevalence of psychiatric illnesses by means of data collected at the Florence municipality community mental health services encompassing all hospital and extramural activities, providing the same kind of information given by Psychiatric Case Register (PCR) covered areas. Design - It has been carried out a one week prevalence assessment through a cross-sectional analysis of clinical records gathered by psychiatric services of the submitted area. Population studied - The inquiry has considered the area of USL (Administative Local Authority of National Health Service) 10/A, 10/B, 10/C and 10/D, which constituite togheter with USL 10/E, the Florence municipality area. Results - Total and specific rates for diagnostic categories, sex and age reveal a large variability among the four considered USLs confirmed by standardized rates: the 10/A and 10/B USLs, that include the historic centre of Florence, present the highest standardized rates (10/A 207/100.000, 10/B 189/100.000), especially for the most severe disorders (Schizophrenia: 10/A 110/100.000, 10/B 87/100.000; Major Affective Disorders: 10/A 32/100.000, 10/B 38/100.000; Organic Psichosys: 10/A 6/100.000, 10/B 9/100.000). Conclusion - In the present study, the prevalence rate for all diagnoses for the whole area considered, is about 150.6/100.000, quite close to the estimate calculated in Verona-Sud (200/100.000). As to the different rates among USLs we have to bear in mind the development of the delivery care system, and the available clinical settings (on day hospital and residentials activities for long-term patients).

scholarly journals Conduct problems, gender and adult psychiatric outcome of children with attention-deficit hyperactivity disorder

2002 ◽  
Vol 181 (5) ◽  
pp. 416-421 ◽  
Author(s):  
Søren Dalsgaard ◽  
Preben Bo Mortensen ◽  
Morten Frydenberg ◽  
Per Hove Thomsen
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Conduct Problems ◽  
Attention Deficit ◽  
Psychiatric Admission ◽  
Case Register ◽  
Hyperactivity Disorder ◽  
Psychiatric Admissions ◽  
Girls With Adhd ◽  
Psychiatric Outcome

BackgroundAttention-deficit hyperactivity disorder (ADHD) is a common childhood condition, and is more prevalent in boys. The adult outcome of girls with ADHD has never been studied.AimsTo identify predictors for adult psychiatric outcome of children with ADHD, including gender and comorbidity.MethodChildren aged 4–15 years, referred for hyperactivity/inattention and treated with stimulants were included (n=208). The Psychiatric Case Register provided follow-up data on psychiatric admissions in adulthood until a mean age of 31 years.ResultsA total of 47 cases (22.6%) had a psychiatric admission in adulthood. Conduct problems in childhood were predictive (hazard ratio HR=2.3; 95% CI 1.22–4.33). Girls had a higher risk compared with boys (HR=2.4; 95% CI 1.1–5.6).ConclusionsGirls with ADHD had a higher risk of adult psychiatric admission than boys. Conduct problems were also associated with a higher risk. Girls with ADHD with conduct problems had a very high risk of a psychiatric admission in adulthood.

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