Urban living and psychosis – An overview
Susanta K. Padhy, Siddharth Sarkar, Triveni Davuluri, Bichitra N. Patra
Asian Journal of Psychiatry
September 29, 2014
•Causal relationship seems to exist between urbanicity and schizophrenia.
•Many factors like pollution, genetics and ethnicity mediate this relationship.
•Neurobiological mechanisms have possibly been implicated to explain the association.
•Extrapolation of this association to developing countries needs caution.
Since more than half a century, the association of urbanicity with psychosis has been explored. The research interest initially stemmed from the finding of a higher proportion of cases of psychotic disorder coming for treatment from the inner parts of cities. Subsequently, interest in the relationship of urbanicity and schizophrenia expanded and various facets of this association were explored. This narrative review provides an overview of the relationship between urbanicity and psychosis, and evaluates the link from the standpoint of causality. The review further delves into the possible risk factors and mechanisms explaining this association; both biological ones like genetic vulnerability and infections, as well as environmental ones like pollution. Since the literature has primarily emerged from the developed western countries, the review draws attention to the caveats while extrapolating the results to a developing country scenario.