Journal
SCHIZOPHRENIA RESEARCH
Volume 238, Issue -, Pages 137-144Publisher
ELSEVIER
DOI: 10.1016/j.schres.2021.09.025
Keywords
Clinical high risk for psychosis; Prodrome; Residential instability
Categories
Funding
- Alpha Omega Alpha Postgraduate Fellowship
- National Institute of Mental Health (NIMH) [R25-MH101079, U01 MH081902, P50 MH066286, U01 MH081857, U01 MH82022, U01 MH066134, U01 MH081944, R01 U01 MH066069, R01 MH076989, U01 MH081988]
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Evidence suggests that both individual-level and area-level residential instability may be associated with conversion to psychosis among adolescents at clinical high risk.
Objective: Accumulating evidence supports an association between residential instability and increased risk for psychosis, but the association between residential instability and conversion to psychosis among adolescents at clinical high risk (CHR) is unclear. In this study, we determined whether individual-level and area-level residential instability and their interaction are associated with conversion to psychosis within two years. Methods: Data were collected as part of the North American Prodrome Longitudinal Study Phase 2. Individuallevel residential instability, defined as having ever moved during lifetime, was derived from the Life Events Scale. Area-level residential instability, defined as the percentage of people who were not living in the same house five years ago, was derived from the U.S. Decennial Censuses. Results: This study included 285 adolescents at CHR (including 36 subjects who later converted to full psychosis). We found that individual-level residential instability was associated with conversion (adjusted OR = 2.769; 95% CI = 1.037-7.393). The interaction between individual-level and area-level residential instability was significant (p = 0.030). In a subgroup of CHR participants who have never moved (n = 91), area-level residential instability during childhood was associated with conversion (adjusted OR = 1.231; 95% CI = 1.029-1.473). Conversely, in a subgroup of CHR participants who resided in residentially stable areas during childhood (n = 142), the association between individual-level residential instability and conversion remained significant (adjusted OR = 15.171; 95% CI = 1.753-131.305). Conclusions: These findings suggest that individual-level and area-level residential instability may be associated with conversion to psychosis.
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