Urbanization and psychosis: an update of recent evidence

Curr Opin Psychiatry. 2024 May 1;37(3):191-201. doi: 10.1097/YCO.0000000000000931. Epub 2024 Mar 4.

Abstract

Purpose of review: Urbanization, a complex global phenomenon, has a significant bearing on schizophrenia/psychosis burden through various socioeconomic and environmental factors. This review focuses on recent evidence (2019-2023) linking urbanization, schizophrenia, and the role of green space.

Recent findings: This review analyzed 43 articles that examined the correlation between urban birth or upbringing, urban living (urbanicity), and various schizophrenia/psychosis-related outcomes such as incidence, psychotic experiences, etc. The studies showed differing results across geographical locations. Socioeconomic factors like area deprivation, migrant status (ethnic density) and social fragmentation were independently associated with the risk of schizophrenia/psychosis irrespective of urbanicity. More recently, environmental factors such as green space reduction and air pollution have been explored in urban living conditions and were positively associated with an increased risk of schizophrenia/psychosis.

Summary: There is a need for further investigation in low and middle-income countries. The impact of urbanization-related factors and green space on the risk of schizophrenia/psychosis calls for appropriate governmental commitments toward structured and healthy urban planning.

Publication types

  • Review

MeSH terms

  • Air Pollution*
  • Humans
  • Psychotic Disorders* / epidemiology
  • Psychotic Disorders* / etiology
  • Risk Factors
  • Schizophrenia* / epidemiology
  • Schizophrenia* / etiology
  • Socioeconomic Factors
  • Urbanization