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Schizophrenia and education in Chinese metropolises: a population-based study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objective

Schizophrenia is a public concern in metropolises. Increases in city size may strengthen the correlation between prevalence of schizophrenia and indices of socioeconomic status, such as education. This study used population-based data of adults to investigate the association between education and schizophrenia in Chinese metropolises and its differences between inner city areas and outer suburbs.

Methods

Data was obtained from the Second China National Sample Survey on Disability in 2006, and analysis was restricted to 189,143 participants aged 18 years or older in all counties (districts) of Beijing, Shanghai, and Tianjin. Schizophrenia diagnoses were ascertained according to the International Statistical Classification of Diseases, 10th Revision. Logistic regression models were fitted to examine the association between education and schizophrenia.

Results

An inverse U-shaped pattern between education and schizophrenia was found in inner city areas of Chinese metropolises. Compared with the primary school or below group, the odds ratios of junior high school group and senior high school or above group was 2.79 (95% CI 1.96, 3.96) and 1.45(95% CI 0.99, 2.13), respectively. In outer suburbs, junior high school (OR = 0.87, 95% CI 0.63, 1.19) and senior high school or above groups (0.58, 95% CI 0.38, 0.87) were less likely to develop schizophrenia than the primary school or below group.

Conclusions

This study showed an association between education and schizophrenia in Chinese metropolises. In inner city areas, the association was an inverse U-shaped pattern between education and schizophrenia, whereas in suburban areas, the association was a negative linear pattern. Our findings can help identify high-risk populations of schizophrenia in Chinese metropolises. Programs for prevention and early intervention of schizophrenia will need to consider the socioeconomic disparities between inner city and outer suburban areas. Public policies can help improve mental health by developing social security for migrants in inner city areas and promoting regional equality.

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Funding

This work was supported by the State Key Funds of Social Science Project of China (Grant no. 09&ZD072), National Natural Science Foundation of China (Grant no. 71661167003), Changjiang Scholar Incentive Program of Ministry of Education and Postdoctoral Science Foundation under Grant no. 2019M660344.

Author information

Author notes

  1. Yanan Luo and Ping He contributed equally to this study.

Authors and Affiliations

  1. Institute of Population Research, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing, 100871, People’s Republic of China

    Yanan Luo, Lei Zhang, Lihua Pang, Chao Guo & Xiaoying Zheng

  2. APEC Health Science Academy, Peking University, Beijing, China

    Yanan Luo, Lei Zhang, Lihua Pang, Chao Guo & Xiaoying Zheng

  3. Advanced Systems Analysis, International Institute for Applied Systems Analysis, Laxenburg, Austria

    Yanan Luo

  4. China Center for Health Development Studies, Peking University, Beijing, China

    Ping He

  5. Department of Integrative Biology and Physiology, University of California, Los Angeles, USA

    Richard Liang

Authors
  1. Yanan Luo
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  2. Ping He
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  3. Lei Zhang
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  4. Lihua Pang
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  5. Chao Guo
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  6. Richard Liang
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  7. Xiaoying Zheng
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Contributions

Yanan Luo and Ping He contributed equally to this study. Yanan Luo: drafting the manuscript, study concept and design, data analysis and interpretation. Ping He: study concept, critical revision of article for important intellectual content. Lei Zhang, Lihua Pang and Chao Guo: study concept and design. Richard Liang: revision of article. Xiaoying Zheng: study concept and design, critical revision of article for important intellectual content. All authors gave final approval of the version to be published.

Corresponding author

Correspondence to Xiaoying Zheng.

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The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

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Luo, Y., He, P., Zhang, L. et al. Schizophrenia and education in Chinese metropolises: a population-based study. Soc Psychiatry Psychiatr Epidemiol 55, 1563–1569 (2020). https://doi.org/10.1007/s00127-020-01898-6

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  • DOI: https://doi.org/10.1007/s00127-020-01898-6

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