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Title: The impact of adverse social experiences in a sample of first episode psychosis patients
Author: Stilo, Simona Ausilia
ISNI:       0000 0004 5368 3060
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2015
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The robust evidence that the incidence of psychosis is elevated in many migrant and minority ethnic population, especially the black population in the UK, has led to a resurgence of interest in the potential role of socio-environmental factors. A growing body of evidence suggests that experiences of social adversity can increase risk of psychosis, particularly in the presence of other known risk factors (e.g. genetic risk). The aims of this thesis are to investigate the relationship between psychosis and a number of current and long-term indicators of childhood and adulthood social adversity in patients suffering their first episode of psychosis (n = 507) and in a control sample (425). Detailed data on social adversity were collected as part of the GAP and EU-GEI studies. Across all the domains considered, cases were more likely to report social adversity than were controls. Social adversity, especially in the case of cumulative exposure, was associated with up to a 9 fold increased risk of psychosis, independent of potential confounders. Greater number of indicators present and longer exposure result in progressively greater risk (linear relationship). Contrary to my hypothesis, no evidence was found that social adversity was more common in Black and other minority groups compared to White British subjects. However, going beyond the study of each risk factor individually, I found evidence that childhood adversity and adulthood adversity combined synergistically to increase the odds of psychosis, and social adversity in adulthood, combine with cannabis use, conferring a greater risk than would be expected if each worked through a separate causal pathway. Although the results were not significant, there was a trend towards an additive interaction between adversity in adulthood and psychosis family history.
Supervisor: Morgan, Craig ; Murray, Robin MacGregor Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available