Psychosis and urbanicity: a review of the recent literature from epidemiology to neurourbanism

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Abstract

PURPOSE OF REVIEW: Epidemiological studies associate city living with an elevated psychosis risk. Urban (social/economic) stress and exposure to environmental toxins, pollution or disease agents have been proposed to underlie this association. This review provides an update on the recent evidence (May 2017 - November 2018). RECENT FINDINGS: Of 647 screened studies, 17 on: urbanicity-psychosis associations in worldwide high, middle and low-income countries; explanatory mechanisms, including nature exposure, social and economic stressors and genetic risk; urbanicity effects on the brain and coping; and urbanicity and resources, were included. The reviewed evidence revealed complex patterns of urbanicity-psychosis associations with considerable international variation within Europe and between low, middle and high-income countries worldwide. Social and economic stressors (e.g. migration, ethnic density and economic deprivation), nature exposure and access to resources could only explain part of the urbanicity effects. Risk factors differed between countries and between affective and non-affective psychosis. SUMMARY: Urbanicity-psychosis associations are heterogeneous and driven by multiple risk and protective factors that seem to act differently in different ethnic groups and countries. Interdisciplinary research combining approaches, for example from experimental neuroscience and epidemiology, are needed to unravel specific urban mechanisms that increase or decrease psychosis risk.

Original languageEnglish
Pages (from-to)232-241
Number of pages10
JournalCurrent opinion in psychiatry
Volume32
Issue number3
DOIs
Publication statusPublished - 1 May 2019

Funding

A.K.F. was supported by a NARSAD Young Investigator Grant from the Brain & Behaviour research Foundation (24138). L.K. was supported by a VICI grant from the Netherlands Organization for Scientific Research (NWO) [452-07-007,453-11-005]; and an ERC Consolidator grant (648082 SCANS).

FundersFunder number
Brain & Behaviour Research Foundation24138
Netherlands Organization for Scientific Research
National Alliance for Research on Schizophrenia and Depression
Horizon 2020 Framework Programme648082
European Research Council
Nederlandse Organisatie voor Wetenschappelijk Onderzoek452-07-007,453-11-005

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