title: Why Are Children in Urban Neighborhoods at Increased Risk for Psychotic Symptoms? Findings From a UK Longitudinal Cohort Study.
abstract: Urban upbringing is associated with a 2-fold adulthood psychosis risk, and this association replicates for childhood psychotic symptoms. No study has investigated whether specific features of urban neighborhoods increase children's risk for psychotic symptoms, despite these early psychotic phenomena elevating risk for schizophrenia and other psychiatric disorders in adulthood.
  
  
  
  Analyses were conducted on over 2000 children from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of UK-born twins. Neighborhood-level characteristics were assessed for each family via: a geodemographic discriminator indexing neighborhood-level deprivation, postal surveys of over 5000 residents living alongside the children, and in-home interviews with the children's mothers. Children were interviewed about psychotic symptoms at age 12. Analyses were adjusted for important family-level confounders including socioeconomic status (SES), psychiatric history, and maternal psychosis.
  
  
  
  Urban residency at age-5 (OR = 1.80, 95% CI = 1.16-2.77) and age-12 (OR = 1.76, 95% CI = 1.15-2.69) were both significantly associated with childhood psychotic symptoms, but not with age-12 anxiety, depression, or antisocial behavior. The association was not attributable to family SES, family psychiatric history, or maternal psychosis, each implicated in childhood mental health. Low social cohesion, together with crime victimization in the neighborhood explained nearly a quarter of the association between urbanicity and childhood psychotic symptoms after considering family-level confounders.
  
  
  
  Low social cohesion and crime victimization in the neighborhood partly explain why children in cities have an elevated risk of developing psychotic symptoms. Greater understanding of the mechanisms leading from neighborhood-level exposures to psychotic symptoms could help target interventions for emerging childhood psychotic symptoms.
authors.affiliation: MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Newbury
authors.affiliation: MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Arseneault
authors.affiliation: MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Centre for Genomic and Computational Biology, Duke University, Durham, NC.
authors.forename: Avshalom
authors.initials: A
authors.lastname: Caspi
authors.affiliation: MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Centre for Genomic and Computational Biology, Duke University, Durham, NC.
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Moffitt
authors.affiliation: Center for Child and Family Policy and the Sanford School of Public Policy, Duke University, Durham, NC.
authors.forename: Candice L
authors.initials: CL
authors.lastname: Odgers
authors.affiliation: MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; helen.2.fisher@kcl.ac.uk helen.2.fisher@kcl.ac.uk.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
mesh_terms: D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003415:Crime / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology; D011618:Psychotic Disorders / Q000453:epidemiology / Q000209:etiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012923:Social Class; D006113:United Kingdom; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: childhood psychotic symptoms; neighborhood characteristics; psychosis; social cohesion; urbanicity