Effect of social class at birth on risk and presentation of schizophrenia: case-control study.

F Mulvany, E O'Callaghan, N Takei, M Byrne, P Fearon, C Larkin
Author Information
  1. F Mulvany: Stanley Foundation Research Unit, Department of Adult Psychiatry, Hospitalier Order of St. John of God, Cluain Mhuire Family Centre, Blackrock, Co Dublin, Ireland.

Abstract

OBJECTIVES: To examine if low parental social class increases children's risk of subsequently developing schizophrenia or modifies the presentation.
DESIGN: Case-control study with historical controls.
SETTING: Geographically defined region in south Dublin.
PARTICIPANTS: 352 patients with first presentation of schizophrenia matched with the next registered same sex birth from the same birth registration district.
MAIN OUTCOME MEASURES: Social class at birth. Age at presentation to psychiatric services, admission to hospital, and diagnosis of schizophrenia.
RESULTS: Risk of schizophrenia was not increased in people from lower social classes. There was a slight excess risk among people in highest social classes (odds ratio 0.59, 95% confidence interval 0.40 to 0.85). However, the mean age at presentation was 24.8 years for patients whose parents were in the highest social class compared with 33.1 years for those in the lowest social class at birth.
CONCLUSIONS: Although social class of origin does not seem to be an important risk factor for schizophrenia, it partially determines the age at which patients receive treatment. The relation between low social class at birth and poor outcome may be at least partially mediated through treatment delay.

References

  1. Nutr Health. 1994;9(4):303-15 [PMID: 8065668]
  2. Schizophr Res. 1997 Feb 28;23(3):245-52 [PMID: 9075303]
  3. Br J Psychiatry. 1995 Jun;166(6):759-67 [PMID: 7663824]
  4. Psychol Med. 2000 Jan;30(1):177-85 [PMID: 10722188]
  5. Br J Psychiatry. 1963 Nov;109:785-802 [PMID: 14080574]
  6. New Dir Ment Health Serv. 1987 Winter;(36):33-45 [PMID: 3325810]
  7. Am Sociol Rev. 1967 Feb;32(1):104-13 [PMID: 6040686]
  8. Arch Gen Psychiatry. 1992 Dec;49(12):983-8 [PMID: 1449385]
  9. BMJ. 1999 Feb 13;318(7181):421-6 [PMID: 9974454]
  10. BMJ. 1999 Mar 6;318(7184):642-6 [PMID: 10066207]
  11. Science. 1992 Feb 21;255(5047):946-52 [PMID: 1546291]
  12. Br J Prev Soc Med. 1961 Jan;15:31-41 [PMID: 13695297]
  13. Am J Psychiatry. 1992 Sep;149(9):1183-8 [PMID: 1503130]
  14. Schizophr Bull. 1989;15(1):9-43 [PMID: 2655069]
  15. Br J Psychiatry. 1995 Dec;167(6):786-93 [PMID: 8829748]
  16. Br J Psychiatry. 1992 Apr;160:461-6 [PMID: 1294066]
  17. BMJ. 1999 Dec 4;319(7223):1469-70 [PMID: 10582929]
  18. Acta Psychiatr Scand. 1999 Aug;100(2):96-104 [PMID: 10480195]
  19. Br J Psychiatry. 1972 Nov;121(564):515-34 [PMID: 5084338]
  20. Psychol Med. 1971 May;1(3):209-21 [PMID: 5148529]
  21. Br Med J (Clin Res Ed). 1987 Sep 19;295(6600):681-2 [PMID: 3117295]
  22. Br J Psychiatry. 1993 Jan;162:65-71 [PMID: 8425142]
  23. Arch Gen Psychiatry. 2000 Jun;57(6):593-600 [PMID: 10839338]
  24. Psychol Med. 1983 Feb;13(1):141-50 [PMID: 6844459]

MeSH Term

Adult
Age Factors
Age of Onset
Case-Control Studies
Female
Hospitalization
Humans
Infant, Newborn
Ireland
Male
Odds Ratio
Patient Acceptance of Health Care
Risk Factors
Schizophrenia
Social Class

Word Cloud

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