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Urbanicity, Psychosis, and Developing Countries

JAMA Psychiatry; ePub 2018 May 16; DeVylder, et al

Urbanicity, a well-established risk factor for psychosis, may not be associated with elevated odds for psychosis in developing countries, according to a recent study. This international population-based study used cross-sectional survey data collected as part of the World Health Organization (WHO) World Health Survey from May 2, 2002, through December 31, 2004. Participants included nationally representative general population probability samples of adults (≥18 years) residing in 42 low- and middle-income countries (LMICs) (n=215,682). Researchers found:

  • Among total participants (50.8% women and 49.2% men; mean [SD] age, 37.9 [15.7] years), urban residence was not associated with psychotic experiences or psychotic disorder.
  • Results of all pooled analyses and meta-analyses of within-country effects approached a null effect, with overall odds ratio (OR) of 0.97, OR for low-income countries of 0.98, and OR for middle-income countries of 0.96 for psychotic experiences, and an overall OR of 0.92, OR for low-income countries of 0.92, and OR for middle-income countries of 0.92 for psychotic disorder.


DeVylder JE, Kelleher I, Lalane M, Link BG, Koyanagi A. Association of urbanicity with psychosis in low- and middle-income countries. [Published online ahead of print May 16, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.0577.