ArticleSocial psychiatry and psychiatric epidemiology2006
Evidence that the urban environment specifically impacts on the psychotic but not the affective dimension of bipolar disorder.
Article in Social psychiatry and psychiatric epidemiology, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Specificity of environmental risk factors for schizophrenia, bipolar disorders, and depressive disorders - umbrella review.Psychological medicine · 2025Pooled it
- Defining Urbanicity in the Context of Psychosis Research: A Qualitative Systematic Literature Review.Schizophrenia bulletin · 2025Pooled it
- Environmental Risk Factors in Bipolar Disorder and Psychotic Depression: A Systematic Review and Meta-Analysis of Prospective Studies.Schizophrenia bulletin · 2021Pooled it
- Environmental risk factors for schizophrenia and bipolar disorder from childhood to diagnosis: a Swedish nested case-control study.Psychological medicine · 2024Article
- Bipolar affective disorder in India: A multi-site population-based cross-sectional study.Indian journal of psychiatry · 2023Article
- Social Deprivation and Population Density Trajectories Before and After Psychotic Disorder Diagnosis.JAMA psychiatry · 2023Article
- A comparison of neighbourhood level variation and risk factors for affective versus non-affective psychosis.Schizophrenia research · 2023Article
- Environmental Risk Factors for Schizophrenia and Bipolar Disorder and Their Relationship to Genetic Risk: Current Knowledge and Future Directions.Frontiers in genetics · 2021Review
- Article
- The Role of Individual and Neighborhood Characteristics on Mental Health after a Period of Economic Crisis in the Lisbon Region (Portugal): A Multilevel Analysis.International journal of environmental research and public health · 2019Article
- Epidemiology and risk factors for bipolar disorder.Therapeutic advances in psychopharmacology · 2018Review
- Evidence That the Urban Environment Moderates the Level of Familial Clustering of Positive Psychotic Symptoms.Schizophrenia bulletin · 2017Article
- A genetic variant in CAMKK2 gene is possibly associated with increased risk of bipolar disorder.Journal of neural transmission (Vienna, Austria : 1996) · 2016Article
- From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms.Social psychiatry and psychiatric epidemiology · 2014Review
- Prevalence of bipolar spectrum disorder in Korean college students according to the K-MDQ.Neuropsychiatric disease and treatment · 2013Article
- The LEARn model: an epigenetic explanation for idiopathic neurobiological diseases.Molecular psychiatry · 2009Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesHigh rates of psychotic disorders and psychotic symptoms have been found in urban environments but reports for bipolar affective illness have been inconsistent, possibly due to failure to stratify for comorbid psychotic symptoms. It was hypothesised, therefore, that any effect of urbanicity on the bipolar phenotype would be moderated by comorbid psychotic symptoms.
methodsIn a random, representative population cohort of 7049 adults with no history of non-affective psychotic disorder, the cumulative incidence of bipolar and psychotic symptoms and syndromes, assessed with the CIDI, was examined over five levels of population density of place of residence. Similarly, the degree of comorbidity between broadly and narrowly defined bipolar phenotypes on the one hand, and the dichotomous presence of broadly (17.2%) and narrowly defined (3.8%) psychotic symptoms on the other, was examined as a function of population density of place of residence.
resultsThe rate of bipolar disorder, however defined, was progressively higher in more urbanised areas. However, in models of bipolar phenotypes, a strong interaction between comorbid psychosis and level of urbanicity was apparent, indicating that the greater the degree of psychotic comorbidity, the greater the effect size of the urban environmental factor. For bipolar disorder without psychosis, no effect of urbanicity was apparent.
conclusionsThe results suggest differential environmental causal effects on affective and cognitive dimensions of bipolar psychopathology that are nevertheless strongly comorbid within the same categorically defined disorder, possibly due to the effect of shared genetic risk factors.
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