Living environments and mental symptoms and disorders.

backgroundWe live in different environments with distinct effects on mental health. However, the complex associations between living environments and mental symptoms and disorders remain elusive. This study aimed to comprehensively investigate how multiple environmental factors relate to mental symptoms and predict the onset of psychiatric disorders.

methodsUsing data from the UK Biobank, we systematically characterized ten living environmental exposures, encompassing both built and natural environment features. We comprehensively examined their associations with symptoms of anxiety, depression, and bipolar disorder, evaluating not only the overall effects but also stratified effects across sex and age subgroups to capture potential demographic-specific vulnerabilities. Furthermore, we investigated the predictive value of these baseline environmental exposures for the subsequent onset of eight major psychiatric disorders over time. To enhance precision, all analyses were complemented by subgroup-specific models, allowing us to identify both shared and distinct patterns of environmental influence across demographic strata.

resultsWe identified 18 significant associations between environmental exposures and baseline mental symptoms, with area deprivation showing the most significant associations with depression and anxiety symptoms. Destination accessibility and slope emerged as novel protective factors, while area deprivation and air pollution accounted for more than 80% of the environmental contribution to model explanatory power. One sex-specific and three age-specific associations were observed, particularly for street network accessibility and area deprivation. Longitudinal analyses identified 25 significant associations between environmental predictors and incident mental disorders, involving eight environmental factors across eight disorders. Specially, destination accessibility was associated with a 56.6% reduced risk of schizophrenia. Two sex-specific and four age-specific predictions were also found.

conclusionsThis study uncovers previously unrecognized potential environmental factors associated with mental health outcomes and highlights distinct vulnerability patterns across demographic groups. By elucidating these nuanced associations, our findings offer a foundation for precision public health initiatives and underscore the potential of evidence-informed urban and environmental planning to mitigate mental health risks at the population level. CLINICAL TRIAL NUMBER: Not applicable.