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Association between schizophrenia and social inequality at birth: case-control study
G Harrison1, D Gunnell, C Glazebrook
1Division of Psychiatry, University of Bristol, 41 St Michael's Hill, Bristol BS8 3JT, UK.
Background:
The association between social inequality at birth and subsequent risk of schizophrenia is uncertain.
Aims:
To investigate the relationship between adult-onset schizophrenia and two indicators of social inequality at birth: social class and area of residence.
Method:
A matched case-control design was used with data from birth certificates of first-episode cases and age- and gender-matched controls.
Results:
Risk increased with increasing levels of deprivation at birth. Subjects whose fathers were social class IV-V or who were born in deprived areas were at increased risk of schizophrenia (odds ratio=2.1; 95% Cl=0.8-5.5). Risk was greater in those with both of these indicators (odds ratio=8.1; 95% Cl=2.7-23.9). There was some evidence that associations were stronger in older subjects. Exclusion of African-Caribbeans or cases with positive family history somewhat attenuated the association.
Conclusions:
Indicators of social inequality at birth are associated with increased risk of adult-onset schizophrenia, suggesting that environmental factors are important determinants of schizophrenic disorders.
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