title: Neighbourhood level social deprivation and the risk of psychotic disorders: a systematic review.
abstract: The incidence of psychotic disorders varies according to the geographical area, and it has been investigated whether neighbourhood level factors may be associated with this variation. The aim of this systematic review is to collate and appraise the literature on the association between social deprivation and the incidence or risk for psychotic disorders.
  
  
  
  A systematic review was conducted, and studies were included if they were in English, provided a measure of social deprivation for more than one geographically defined area and examined either the correlation, rate ratio or risk of psychotic disorder. A defined search strategy was undertaken with Medline, CINAHL Plus and PsychInfo databases.
  
  
  
  A total of 409 studies were identified in the search, of which 28 fulfilled the inclusion criteria. Of these, four examined the association between social deprivation at the time of birth, three examined the putative prodrome of psychosis or those at ultra-high risk (UHR) for psychosis, and 23 examined the time at presentation with a first episode of psychosis (FEP) (one study examined two time points and one study included both UHR and FEP). Three of the studies that examined the level of social deprivation at birth found an association with a higher risk for psychotic disorders and increased social deprivation. Seventeen of the 23 studies found that there was a higher risk or rate of psychotic disorders in more deprived neighbourhoods at the time of presentation; however, adjusting for individual factors tended to weaken this association. Limited research has been conducted in the putative prodromal stage and has resulted in conflicting findings.
  
  
  
  Research conducted to date has not definitively identified whether the association is a result of social causation or social drift; however, the findings do have significant implications for service provision, such as the location and access of services.
authors.affiliation: Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia. briannoelodonoghue@gmail.com.|Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar rd, Parkville, VIC, 3052, Australia. briannoelodonoghue@gmail.com.|University College Dublin, Belfield, Dublin 4, Ireland. briannoelodonoghue@gmail.com.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Donoghue
authors.affiliation: University College Dublin, Belfield, Dublin 4, Ireland.|DETECT Early Intervention for Psychosis Service, Dublin, Ireland.
authors.forename: Eric
authors.initials: E
authors.lastname: Roche
authors.affiliation: University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Abbie
authors.initials: A
authors.lastname: Lane
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D012111:Residence Characteristics; D012307:Risk Factors; D012934:Social Isolation / Q000523:psychology*; D055815:Young Adult
keywords: Affective psychotic disorders; Deprivation; Inequality; Poverty; Psychosis; Schizophrenia