Hostname: page-component-7dd5485656-frp75 Total loading time: 0 Render date: 2025-10-31T05:38:50.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Schizophrenia and City Residence

Published online by Cambridge University Press:  06 August 2018

Hugh Freeman
Hugh Freeman*
Affiliation:
University of Salford, and Salford Health Authority, 21 Montagu Square, London W1H 1RE
Get access Rights & Permissions [Opens in a new window]

Abstract

It has long been thought that rates of mental illness are higher in cities than elsewhere, because of crowding and resultant stress. In the case of schizophrenia, there are some marked exceptions to generally higher prevalence rates in industrialised cities. Factors such as migration, culture, infectious disease, demographic rates, and other social processes may affect geographical differences in rates. The excess of schizophrenia in central city areas has been given two opposing explanations – the ‘breeder’ hypothesis and ‘social drift’. Data on incidence from three cities are compared, but do not reveal a clear common picture. Environmental factors connected with urban living are of two main types – social and non-social – which are not mutually exclusive; ‘urban’ may also have a variety of meanings. Rather than ‘urbanicity’ being an independent aetiological factor in schizophrenia, its effect may be largely explained in terms of migration and social class.

Information

Type
Research Article
Information
The British Journal of Psychiatry , Volume 164 , Issue S23: Integrated Approach to Schizophrenia , April 1994 , pp. 39 - 50
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Andersen, T. (1975) Physical and mental illness in a Lapp and Norwegian population. Acta Psychiatrica Scandinavica, suppl. 263, 47–56.Google Scholar
Astrup, C. & Odegard, O. (1961) Internal migration and mental illness in Norway. Psychiatric Quarterly, 34, 116–130.Google Scholar
Babigian, H. M. (1985) Schizophrenia epidemiology. In Comprehensive Textbook of Psychiatry IV (eds Kaplan, H. I. & Saddock, B. J.). Baltimore: Williams & Wilkins.Google Scholar
Bamrah, J. S., Freeman, H. L. & Goldberg, D. P. (1991) Epidemiology of schizophrenia in Salford, 1974–84: changes in an urban community over ten years. British Journal of Psychiatry, 159, 802–810.Google Scholar
Blazer, D., George, L. K., Landerman, R., et al (1985) Psychiatric disorders: a rural/urban comparison. Archives of General Psychiatry, 42, 651–656.CrossRefGoogle ScholarPubMed
Brown, G. W. & Birley, J. L. T. (1968) Crisis and life changes and the onset of schizophrenia. Journal of Health and Social Behaviour, 9, 203–214.Google Scholar
Brown, G. W. & Prudo, R. (1981) Psychiatric disorder in a rural and an urban population. 1. Aetiology of depression. Psychological Medicine, 11, 581–599.CrossRefGoogle Scholar
Burnam, M. A., Hough, R. L., Escobar, J. I., et al (1987) Six-month prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles. Archives of General Psychiatry, 44, 687–694.Google Scholar
Cabot, M. R. (1990) The incidence and prevalence of schizophrenia in the Republic of Ireland. Social Psychiatry and Psychiatric Epidemiology, 25, 210–215.Google Scholar
Castle, D. & Murray, R. M. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine, 21, 565–575.CrossRefGoogle ScholarPubMed
Castle, D., Scott, K., Wessely, S., et al (1993) Does social deprivation during gestation and early life predispose to later schizophrenia? Social Psychiatry and Psychiatric Epidemiology, 28, 1–4.Google Scholar
Cooper, J. E. & Sartorius, N. (1977) Cultural and temporal variations in schizophrenia: a speculation on the importance of industrialisation. British Journal of Psychiatry, 130, 50–55.Google Scholar
Cooper, J. E., Giggs, J. & Howat, J. (1987) Schizophrenia and the ecological structure of Nottingham. British Journal of Psychiatry, 151, 627–633.CrossRefGoogle Scholar
Dauncey, K., Giggs, J., Baker, K., et al (1993) Schizophrenia in Nottingham: lifelong residential mobility of a cohort. British Journal of Psychiatry, 163, 613–619.CrossRefGoogle ScholarPubMed
Davies, M. A. (1989) Community adjustment of chronic schizophrenic patients in urban and rural settings. Hospital and Community Psychiatry, 8, 824–830.Google Scholar
Dunham, H. W. (1965) Community of Schizophrenia. Detroit: Wayne State University Press.Google Scholar
Dunham, H. W. (1969) City core and suburban fringe distribution patterns of mental illness. In Changing Perspectives in Mental Illness (eds Plog, S. C. & Edgerton, R. B.), pp. 337–363. New York: Holt, Reinhardt & Winston.Google Scholar
Eaton, W. W. (1974) Residence, social class and schizophrenia. Journal of Health and Social Behavior, 102, 627–633.Google Scholar
Eaton, W. W. (1980) A formal theory of selection for schizophrenia. American Journal of Sociology, 86, 149–158.Google Scholar
Eaton, W. W. (1986) Epidemiology of schizophrenia. Epidemiological Review, 7, 105–126.Google Scholar
Faris, R. E. L. & Dunham, H. W. (1939) Mental Disorders in Urban Areas. Chicago: University of Chicago Press.Google Scholar
Freeman, H. L. (1984) The scientific background. In Mental Health and the Environment (ed. Freeman, H. L.). London: Churchill Livingstone.Google Scholar
Freeman, H. L. & Alpert, M. (1986a) Prevalence of schizophrenia in an urban population. British Journal of Psychiatry, 149, 603–611.Google Scholar
Freeman, H. L. & Alpert, M. (1986b) Prevalence of schizophrenia: geographical variations in an urban population. British Journal of Clinical and Social Psychiatry, 4, 67–75.Google Scholar
Frumkin, R. M. (1954) Comparative rates of mental illnesses for urban and rural populations in Ohio. Rural Sociology, 19, 70–72.Google Scholar
Galle, O., Gove, W. & MacPherson, J. (1972) Population density and pathology: what are the relationships for Man? Science, 176, 23–30.Google Scholar
Giggs, J. A. (1980) Mental health and the environment. In Environmental Medicine (eds Howe, G. M. & Loraine, J. A.). London: Heinemann Medical.Google Scholar
Giggs, J. A. (1983) Schizophrenia and ecological structure in Nottingham. In Geographical Aspects of Health (eds McGlashan, N. D. & Blunden, J. R.), pp. 197–222. London: Academic Press.Google Scholar
Giggs, J. A. (1984) Residential mobility and mental health. In Mental Health and the Environment (ed. Freeman, H. L.). London: Churchill Livingstone.Google Scholar
Goldberg, E. M. & Morrison, S. L. (1963) Schizophrenia and social class. British Journal of Psychiatry, 108, 785–802.Google Scholar
Goldman, H. H. (ed.) (1983) International perspectives in deinstitutionalization. International Journal of Mental Health, 11, 3–165.Google Scholar
Häfner, H. & Reimann, H. (1970) Spatial distribution of mental disorders in Mannheim, 1965. In Psychiatric Epidemiology (eds Hare, E. H. & Wing, J. K.). Oxford: Oxford University Press.Google Scholar
Häfner, H. & Heiden, Ander (1986) The contribution of European case registers to research on schizophrenia. Schizophrenia Bulletin, 12, 26–51.Google Scholar
Hammer, M., Makiesky-Barron, S. & Gutwirth, L. (1978) Social networks and schizophrenia. Schizophrenia Bulletin, 4, 522–545.Google Scholar
Harpham, T. (1993) Urbanization and mental disorder. In Principles of Social Psychiatry, (eds Bhugra, D. & Leff, J.). Oxford: Blackwell.Google Scholar
Harrison, G., Holten, A., Neilson, D., et al (1989) Severe mental disorders in Afro-Caribbean patients: some social, demographic, and service factors. Psychological Medicine, 19, 683–696.Google Scholar
Harrison, G. & Mason, P. (1993) Schizophrenia – falling incidence and better outcome? British Journal of Psychiatry, 163, 535–541.Google Scholar
Helgason, T. (1964) Epidemiology of mental disorders in Iceland. Acta Psychiatrica Scandinavica, 173 (suppl. 40), 1–258.Google Scholar
Henderson, A. S. (1988) Introduction to Social Psychiatry. Oxford: Oxford University Press.Google Scholar
Herbert, D. T. & Johnston, R. J. (eds) (1976) Social Areas in Cities. Chichester: Wiley.Google Scholar
Hollingshead, A. B. & Redlich, F. C. (1958) Social Class and Mental Illness: a Community Study. New York: Wiley.CrossRefGoogle Scholar
Jablensky, A. (1986) Epidemiology of schizophrenia: a European perspective. Schizophrenia Bulletin, 12, 52–73.Google Scholar
Jablensky, A. (1988) Schizophrenia and environment. In Handbook of Social Psychiatry (eds Henderson, A. S. & Burrows, G. D.). Amsterdam: Elsevier.Google Scholar
Jablensky, A. (1993) The epidemiology of schizophrenia. Current Opinion in Psychiatry, 6, 43–52.Google Scholar
Jaco, E. G. (1954) The Social Epidemiology of Mental Disorders: a Psychiatric Study of Texas. New York: Russell Sage Foundation.Google Scholar
Keatinge, C. (1987) Schizophrenia in rural Ireland: a case of service overutilisation. International Journal of Social Psychiatry, 33, 186–194.Google Scholar
Klusmann, D. & Angermeyer, M. C. (1987) Urban ecology and psychiatric admission rates: results from a study in the city of Hamburg. In From Social Class to Social Stress (ed. Angermeyer, M. C.), pp. 16–45. Berlin: Springer-Verlag.Google Scholar
Kohn, M. L. (1976) The interaction of social class and other factors in the aetiology of schizophrenia. American Journal of Psychiatry, 133, 177–180.Google Scholar
Lapouse, R., Monk, M. & Terris, M. (1956) The drift hypothesis in sociological differentials in schizophrenia. American Journal of Public Health, 46, 978–986.Google Scholar
Lawrence, J. E. S. (1974) Science and sentiment: overview of respect on crowding and human behaviour. Psychological Bulletin, 81, 712–720.CrossRefGoogle Scholar
Lei, T. J., Butler, E. W., Rowitz, L., et al (1974) An ecological study of agency labelled retardates. American Journal of Mental Deficiency, 79, 22–31.Google Scholar
Lemert, E. M. (1948) An exploratory study of mental disorder in a rural problem area. Rural Society, 13, 48–64.Google Scholar
Levy, L. & Rowitz, L. (1973) The Ecology of Mental Disorder. New York: Behavioral Publications.Google Scholar
Lewis, G., David, A., Andreasson, S., et al (1992) Schizophrenia and city life. Lancet, 340, 137–140.Google Scholar
Lin, T. Y., Rin, H., Yeh, E. K., et al (1969) Mental disorders in Taiwan, fifteen years later. In Mental Health Research in Asia and the Pacific (eds Caudill, W. & Lin, T. Y.). Honolulu: East-West Center Press.Google Scholar
Machon, R. A., Mednick, S. F. & Schulsinger, F. (1983) The interaction of seasonality, place of birth, genetic risk and subsequent schizophrenia in a high-risk sample. British Journal of Psychiatry, 143, 383–388.Google Scholar
Magaziner, J. (1988) Living density and psychopathology: a re-examination of the negative model. Psychological Medicine, 18, 419–431.CrossRefGoogle ScholarPubMed
Malzberg, B. (1955) The distribution of mental diseases in New York State 1949–1951. Psychiatric Quarterly, 29 (suppl. 2), 209–238.Google Scholar
Maylath, E., Weyerer, S. & Häfner, H. (1989) Spatial concentration of the incidence of treated psychiatric disorders in Mannheim. Acta Psychiatrica Scandinavica, 80, 650–656.Google Scholar
McGlashan, T. H. (1989) A selective review of recent North American long-term follow-up studies of schizophrenia. Schizophrenia Bulletin, 14, 515–542.Google Scholar
Murphy, J. E. (1976) Social causes: the independent variable. In Further Explorations in Social Psychiatry, (eds Kaplan, B. H., Wilson, R. N. & Leighton, A. H.). New York: Basic Books.Google Scholar
Murray, R. M., Lewis, S. W., Owen, M. J., et al (1988) The neurodevelopmental origins of dementia praecox. In Schizophrenia: the Major Issues (eds Bebbington, P. & McGuffin, P.). London: Heinemann.Google Scholar
O'Callaghan, E., Sham, P., Takei, N., et al (1991) Schizophrenia after prenatal exposure to 1957 A2 influenza epidemic. Lancet, 337, 1248–1250.CrossRefGoogle ScholarPubMed
O'Callaghan, E., Colgan, K., Cotter, D., et al (1992) Evidence for confinement of winter birth excess to those born in cities. Schizophrenia Research, 6, 102.CrossRefGoogle Scholar
Ohta, Y., Nakane, Y., Nishihara, J., et al (1992) Ecological structure and incidence rates of schizophrenia in Nagasaki City. Acta Psychiatrica Scandinavica, 86, 113–120.Google Scholar
Pasamanick, B. & Knobloch, H. (1961) Epidemiologic studies on the complications of pregnancy and the birth process. In Prevention of Mental Disorders in Children (ed. Coplan, G.). New York: Basic Books.Google Scholar
Rutter, M. L. (1981) The city and the child. American Journal of Orthopsychiatry, 51, 610–625.Google Scholar
Schweitzer, L. & Su, W. H. (1977) Population density and the rate of mental illness. American Journal of Public Health, 67, 1165–1172.CrossRefGoogle ScholarPubMed
Shur, E. (1988) The epidemiology of schizophrenia. British Journal of Hospital Medicine, 7, 38–45.Google Scholar
Stefansson, C. G. (1984) Map analysis of psychiatric services: the application of a computerized psychiatric case register to geographical analysis. Acta Psychiatrica Scandinavica, 70, 515–522.Google Scholar
Stewart, D. D. (1953) A note on mental illness in rural Arkansas. Social Problems, 1, 57–60.Google Scholar
Stromgren, E. (1987) Changes in the incidence of schizophrenia? British Journal of Psychiatry, 150, 1–7.Google Scholar
Swedish Government (1971) Urban conglomerates as psycho-social human stressors. Report to the UN Conference on the Human Environment, Stockholm.Google Scholar
Takei, N., O'Callaghan, E., Sham, P., et al (1992) Winter birth excess in schizophrenia: its relationship to place of birth. Schizophrenia Research, 6 (special issue), 102.Google Scholar
Taylor, S. & Chave, S. W. P. (1964) Mental Health and Environment. London: Longmans.Google Scholar
Taylor, S., Bisoffi, G., de Salvia, D., et al (1993) Urban–rural differences in the associations between social deprivation and psychiatric service utilization in schizophrenia and all diagnoses: a case-register study in Northern Italy. Psychological Medicine, 23, 487–496.Google Scholar
Torrey, E. F. (1987) Prevalence studies of schizophrenia. British Journal of Psychiatry, 150, 598–608.Google Scholar
Torrey, E. F. & Bowler, A. (1991) Geographical distribution of insanity in America: evidence for an urban factor. Schizophrenia Bulletin, 16, 591–604.Google Scholar
Waddington, J. L. & Youssef, H. A. (1993) Evidence for a gender-specific decline in rate of occurrence of schizophrenia in rural Ireland over a fifty-year period. British Journal of Psychiatry, 164, 171–176.Google Scholar
Weyerer, S. & Häfner, H. (1989) The stability of the ecological distribution of the incidence of treated mental disorders in the city of Mannheim. Social Psychiatry and Psychiatric Epidemiology, 24, 57–62.Google Scholar
Weyerer, S. & Häfner, H. (1992) The high incidence of treated disorders in the inner city of Mannheim. Social Psychiatry and Psychiatric Epidemiology, 27, 142–146.Google Scholar
White, W. A. (1903) The geographical distribution of insanity in the United States. Journal of Nervous and Mental Disease, 30, 257–279.Google Scholar
Widerlöv, B., Borgå, P., Cullberg, J., et al (1989) Epidemiology of long-term functional psychosis in three different areas in Stockholm County. Acta Psychiatrica Scandinavica, 80, 40–46.Google Scholar
Wilcox, J. A. & Nasrallah, H. A. (1987) Childhood head trauma and psychosis. Psychiatry Research, 21, 303–307.Google Scholar
Wing, J. K. (1989) The concept of negative symptoms. British Journal of Psychiatry, 155, 10–14.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.