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Comprehensive spatial distribution of patients with first-episode psychosis (FEP) and its relation to socio-economic factors

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Abstract

Background

The functional-cognitive impact of first-episode psychosis (FEP) is extremely relevant and implies dysfunction from early life stages like adolescence and youth. Like other illnesses, FEP incidence is also influenced by environmental factors. It is necessary to attend to this age group with early interventions and to act on the environmental factors that the literature correlates with increased FEP incidence: socio-economic aspects, social adversity, bullying at school or cannabis use. In this context, identifying the areas of cities where FEP patients concentrate is important to perform early interventions. The spatial analysis of patient distribution in a whole city is one way to identify the most vulnerable areas and to propose psycho-social interventions for the possible prevention and/or early detection of FEP by improving urban mental health.

Methods

An epidemiological study of point patterns to determine the areas of a city with a higher incidence of patients with FEP. To do so, the addresses of FEP cases were georeferenced from 1 January 2016 to 31 October 2022, and 109 FEP patients were analysed. Data from a random sample of 383 controls, comprising their addresses, age, and sex, were randomly obtained from the official city council database. By GIS, the areas with higher FEP incidence were analysed to see if they coincided with the zones where inhabitants with lower incomes lived.

Results

The risk ratio of the FEP patients was compatible with the constant risk ratio in Albacete (p = 0.22). When performing the process separately with cases and controls only in men and women, the results were not significant for both distributions (p value: 0.12 and 0.57, respectively). Nonetheless, areas within the city had a significantly higher risk. These groups of cases coincided with those who had lower income and more inequality for women, but this pattern was not clear for men.

Conclusions

Classifying city areas per income can help to determine the zones at higher risk of FEP, which would allow early healthcare and preventive measures for these zones.

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Data availability

The data presented in this study are available on request from the corresponding authors.

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Author notes

  1. Luz María González Gualda, Jesus Gonzalez-Rubio, Alberto Najera and Karen Nieto Rodríguez contributed equally.

Authors and Affiliations

  1. Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain

    Luz María González Gualda

  2. Department of Medical Sciences. Faculty of Medicine of Albacete, University of Castilla-La Mancha, School of Medicine, Calle Almansa 14, 02008, Albacete, Spain

    Jesus Gonzalez-Rubio, Alberto Najera, María Jesús Montes Lozano & Karen Nieto Rodríguez

  3. Centre for Biomedical Research (CRIB), University of Castilla-La Mancha, Albacete, Spain

    Jesus Gonzalez-Rubio & Alberto Najera

  4. Servicio de Salud Mental, Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain

    María Aliño Dies, Rubén Roig Cremades, Javier Bajen Espuña, Carmen Escobar Alarcón, Noelia Navarro Sirvent, María Jesús Montes Lozano & Karen Nieto Rodríguez

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Contributions

LMG and KN had the idea for and designed the study and had full access to all data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. LMG, JGR, KN, and AN drafted the paper. JGR and AN contributed to the statistical analysis. LMG, KN, MA, RR, JB, CE, NN, and MJM collected the data. All authors contributed to data acquisition, data analysis, or data interpretation, and reviewed and approved the final version.

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Correspondence to Jesus Gonzalez-Rubio or Alberto Najera.

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Gualda, L.M.G., Gonzalez-Rubio, J., Najera, A. et al. Comprehensive spatial distribution of patients with first-episode psychosis (FEP) and its relation to socio-economic factors. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02675-5

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