Social disadvantage and psychosis: a case control study on italian First-Episodes of Psychosis (FEP)

Introduction: A growing body of literature suggests that people affected by psychotic disorders are more likely to be unemployed, tend to live alone, have a poor social network, and are not able to establish long-term relationships (Morgan et al., 2008). Aims: To investigate social disadvantage in a sample of first-episode of psychosis patients and geographically matched controls. Methods: The study sample consists of 52 healthy controls and 37 FEP who were assessed using the MRC Sociodemographic Schedules. Results: Preliminary results suggest that, consistently with the literature, cases are more exposed than controls to social disadvantage. They tend to reach a lower education degree (OR 6.66; CI 95%, 1.67-26.50, p 0.005) and to have an underpaid job 5 years before the onset (OR 2.84; CI 95%, 1.08-7.45, p 0.03). Furthermore, cases are more likely to live longer with their parents rather than independently (OR 3.33; CI 95%, 1.25- 8.86, p 0.01) and are more exposed to house overcrowding (OR 3.92; CI 95%, 1.03-14.93, p 0.05). It was also found that an higher percentage of cases have never been in a stable relationship in the previous 5 years (OR 2.61; CI 95%, 1.08-6.27, p 0.03). Conclusions: In line with the previous literature, we found that lower educational and occupational status and poor relationship status are associated to risk for psychosis. However, in contrast with North European cases, Italian FEP are more likely to live with their family rather than alone and, therefore, to be exposed to house overcrowding. Morgan C, Kirkbride J, Hutchinson G, Craig T, Morgan K, Dazzan P, Boydell J, Doody GA, Jones PB, Murray RM, Leff J, Fearon P. Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychol Med. 2008; 38(12):1701-15.