Understanding psychosis complexity through a syndemic framework: A systematic review

Uzma Zahid; Erin Grace Lawrence; Daniela Fonseca de Freitas; Lois A Parri; Wesley Quadros; Phuong Hua; Eli Harriss; Dominic Oliver; Georgina M Hosang; Kamaldeep Bhui

doi:10.1016/j.neubiorev.2024.105614

Understanding psychosis complexity through a syndemic framework: A systematic review

Neurosci Biobehav Rev. 2024 Apr:159:105614. doi: 10.1016/j.neubiorev.2024.105614. Epub 2024 Mar 2.

Authors

Affiliations

¹ Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK. Electronic address: uzma.zahid@kcl.ac.uk.
² Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
³ Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
⁴ Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
⁵ Department of Psychiatry, University of Oxford, Oxford, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
⁶ Department of Psychiatry, University of Oxford, Oxford, UK; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
⁷ Bodleian Health Care Libraries, University of Oxford, Oxford, UK; Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, Oxford, UK.
⁸ Department of Psychiatry, University of Oxford, Oxford, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford OX3 7JX, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
⁹ Department of Psychiatry, University of Oxford, Oxford, UK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK; Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford OX3 7JX, UK; Queen Mary University London Global Policy Institute, London, UK; Collaborating Centre of World Psychiatric Association, Oxford, UK. Electronic address: kam.bhui@psych.ox.ac.uk.

PMID: 38432448
DOI: 10.1016/j.neubiorev.2024.105614

Abstract

Psychotic conditions pose significant challenges due to their complex aetiology and impact on individuals and communities. Syndemic theory offers a promising framework to understand the interconnectedness of various health and social problems in the context of psychosis. This systematic review aims to examine existing literature on testing whether psychosis is better understood as a component of a syndemic. We conducted a systematic search of 7 databases, resulting in the inclusion of five original articles. Findings from these studies indicate a syndemic characterized by the coexistence of various health and social conditions, are associated with a greater risk of psychosis, adverse health outcomes, and disparities, especially among ethnic minorities and deprived populations. This review underscores the compelling need for a new paradigm and datasets that can investigate how psychosis emerges in the context of a syndemic, ultimately guiding more effective preventive and care interventions as well as policies to improve the health of marginalised communities living in precarity.

Keywords: Framework; Interdisciplinarity; Methodology; Psychosis; Syndemic.

Publication types

Systematic Review
Review

MeSH terms

Humans
Psychotic Disorders*
Syndemic*

Grants and funding

G0501284/MRC_/Medical Research Council/United Kingdom