Theses Doctoral

Examining the association between urbanicity and first episode psychosis in Chile

Mascayano, Franco

This dissertation sought to characterize the association between urbanicity and incidence of first-episode psychosis (FEP) in Chile by using data from national registries, including a national FEP registry, as well as other health and social databases. Numerous large, well-controlled studies from Northern European countries (e.g., Denmark) have found that being born or brought up in urban environments increases the odds of developing psychosis.

Given the strength and consistency of these findings over decades, the urbanicity-psychosis association is considered one of the fundamental epidemiologic findings on environment and psychosis, and full-fledged research programs have been examining potential mechanisms. Yet it now appears that the association may not be universal. Studies from some European countries, Latin America, and China have reported null results.

These findings have started to change our understanding of the urbanicity-psychosis association and have raised important questions regarding how the association works in understudied, lesser-resourced settings. Chile, with its unique juxtaposition of substantial infrastructure (national registries) and shared challenges with other Latin American countries, offers an unprecedented context for developing such research.

Accordingly, the specific aims of this dissertation were to 1) conduct a qualitative systematic literature review on the definitions of urbanicity and community-level social factors in the context of psychosis research, 2) examine whether urbanicity at birth and at admission is associated with increased risk of FEP, and 3) examine the moderation effects of social deprivation in the association between urbanicity and incidence of FEP.


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More About This Work

Academic Units
Thesis Advisors
Susser, Ezra S.
Ph.D., Columbia University
Published Here
February 21, 2024