The association of inequality with the incidence of schizophrenia--an ecological study.
BACKGROUND
Socio-economic factors are known to be associated with schizophrenia, but no studies have investigated the effect of inequality on incidence rates of schizophrenia. The aim of the study was to determine whether those electoral wards with greater inequality have a higher incidence of schizophrenia.


METHODS
An ecological study was carried out involving a retrospective case record study to calculate the incidence of schizophrenia across wards in Camberwell, South London for the period 1988-1997, and an index of inequality within each ward was calculated.


RESULTS
There was no significant effect of inequality overall. However, in the group of deprived wards, the incidence of RDC schizophrenia increased as inequality increased (IRR 3.79, 95 %CI 1.25.11.49 p = 0.019 after adjusting for age, sex, absolute deprivation, ethnicity, proportion of ethnic minorities and the interaction between individual ethnicity and proportion of ethnic minorities.


CONCLUSIONS
Increased inequality is associated with increasing incidence of schizophrenia, but only in the most deprived areas. This is independent of other known social risk factors.
Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. j.boydell@iop.kcl.ac.uk
J
J
Boydell
J
J
van Os
K
K
McKenzie
R M
RM
Murray
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D011610:Psychosocial Deprivation; D012189:Retrospective Studies; D012559:Schizophrenia / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*