OBJECTIVE Recent years have witnessed growing interest in the role of the social environment in the development and outcomes of schizophrenia. We investigated whether neighborhood characteristics are associated with two important prognostic factors in early-course psychosis, age at onset of psychosis (AOP) and duration of untreated psychosis (DUP). METHODS Data were collected from patients admitted to the hospital for first-episode schizophrenia-spectrum disorder. We collected data on perceived neighborhood disorder during childhood/adolescence and extracted data on 13 neighborhood characteristics from the American Community Survey based upon individual addresses. Four neighborhood-level factors were derived from factor analysis. Multiple logistic regression analyses assessed the association between specific neighborhood characteristics and the two prognostic factors (earlier AOP and longer DUP) in early-course psychosis. RESULTS 143 participants had valid addresses geo-coded. Neighborhood-level residential instability was associated with an earlier AOP (OR = 1.760; p = 0.022) even after controlling for known risk factors (OR = 2.026; p = 0.020) and also after controlling for individual-level residential instability (OR = 1.917; p = 0.037). The general socioeconomic status neighborhood factor (OR = 1.119; p = 0.019) and perceived neighborhood disorder (OR = 1.075; p = 0.005) were associated with a longer DUP. But only perceived neighborhood disorder (OR = 1.146; p = 0.011) remained significant, and general socioeconomic status was close to significant (OR = 1.215; p = 0.062), after controlling for individual-level predictors and socioeconomic status. CONCLUSIONS This study found evidence that neighborhood-level characteristics (in this case, residential instability) may be associated with earlier AOP, and perceptions of neighborhood disorder are associated with a longer treatment delay. Socioenvironmental factors should be more consistently considered going forward in research on early psychotic disorders.

中文翻译：

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邻里水平的首发精神病患者未治疗精神病的发病年龄和持续时间的预测因子

目标 近年来，人们对社会环境在精神分裂症的发展和结果中的作用越来越感兴趣。我们调查了邻里特征是否与早期精神病的两个重要预后因素有关，即精神病发病年龄 (AOP) 和未经治疗的精神病持续时间 (DUP)。方法 从因首发精神分裂症谱系障碍入院的患者中收集数据。我们收集了儿童/青春期感知邻里障碍的数据，并根据个人地址从美国社区调查中提取了 13 个邻里特征的数据。四个邻里层面的因素来自因子分析。多元逻辑回归分析评估了特定社区特征与早期精神病的两个预后因素（较早的 AOP 和较长的 DUP）之间的关联。结果 143 名参与者具有经过地理编码的有效地址。即使在控制了已知的风险因素（OR = 2.026；p = 0.020）并且控制了个体水平的住宅不稳定（OR = 1.917）之后，社区级别的住宅不稳定与较早的 AOP（OR = 1.760；p = 0.022）相关; p = 0.037)。一般社会经济地位邻里因素 (OR = 1.119; p = 0.019) 和感知邻里障碍 (OR = 1.075; p = 0.005) 与较长的 DUP 相关。但只有感知到的邻里障碍（OR = 1.146；p = 0.011）仍然显着，一般社会经济地位接近显着（OR = 1.215；p = 0。062)，在控制了个体水平的预测因素和社会经济地位之后。结论 本研究发现证据表明，社区层面的特征（在这种情况下，住宅不稳定）可能与较早的 AOP 相关，而对社区混乱的看法与较长的治疗延迟相关。在对早期精神障碍的研究中，应更加一致地考虑社会环境因素。