title: Spatial distribution of psychotic disorders in an urban area of France: an ecological study.
abstract: Previous analyses of neighbourhood variations of non-affective psychotic disorders (NAPD) have focused mainly on incidence. However, prevalence studies provide important insights on factors associated with disease evolution as well as for healthcare resource allocation. This study aimed to investigate the distribution of prevalent NAPD cases in an urban area in France. The number of cases in each neighbourhood was modelled as a function of potential confounders and ecological variables, namely: migrant density, economic deprivation and social fragmentation. This was modelled using statistical models of increasing complexity: frequentist models (using Poisson and negative binomial regressions), and several Bayesian models. For each model, assumptions validity were checked and compared as to how this fitted to the data, in order to test for possible spatial variation in prevalence. Data showed significant overdispersion (invalidating the Poisson regression model) and residual autocorrelation (suggesting the need to use Bayesian models). The best Bayesian model was Leroux's model (i.e. a model with both strong correlation between neighbouring areas and weaker correlation between areas further apart), with economic deprivation as an explanatory variable (OR = 1.13, 95% CI [1.02-1.25]). In comparison with frequentist methods, the Bayesian model showed a better fit. The number of cases showed non-random spatial distribution and was linked to economic deprivation.
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.|CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille, 59000, France.
authors.forename: Baptiste
authors.initials: B
authors.lastname: Pignon
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.|UPEC, Université Paris-Est, Faculté de médecine, Créteil, 94000, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Schürhoff
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.|Université François-Rabelais de Tours, PAV EA 2114, Tours, 37000, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Baudin
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.
authors.forename: Aziz
authors.initials: A
authors.lastname: Ferchiou
authors.affiliation: INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.
authors.forename: Jean-Romain
authors.initials: JR
authors.lastname: Richard
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.
authors.forename: Ghassen
authors.initials: G
authors.lastname: Saba
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.|UPEC, Université Paris-Est, Faculté de médecine, Créteil, 94000, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Division of Psychiatry, UCL, London, W1T 7NF, UK.
authors.forename: James B
authors.initials: JB
authors.lastname: Kirkbride
authors.affiliation: AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil, 94000, France.|INSERM, U955, team 15, Créteil, 94000, France.|Fondation FondaMental, Créteil, 94000, France.
authors.forename: Andrei
authors.initials: A
authors.lastname: Szöke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004467:Economics; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011618:Psychotic Disorders / Q000453:epidemiology*; D062206:Spatial Analysis; D019371:Topography, Medical; D014505:Urban Population; D055815:Young Adult