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Post by Admin on Jul 27, 2016 11:04:50 GMT -4
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Raghda Al Anbari (MS4)
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Post by Raghda Al Anbari (MS4) on Jul 27, 2016 13:31:41 GMT -4
I believe this article has more depth to it, if we do simple math, we will purely reach the fact that cities have more population than other areas and of course this is one of the reason why researches show high incidence of mental health illness in the cities than other places.
Sick Cities, I would like to call it this way because it really makes you sick!! Repeated stress and worries about work and family is thought to lead to dopamine alters in ones brain, and life issues might be part of the reason why a person's dopamine production starts to go wrong in the first place. And dopamine is holding the answer of developing many of the psychotic illness, so when its level is not normal or the other chemicals balance in ones brain get off the scale, developing psychotic symptoms will be most likely. While many mental disorders are thought to have a genetic component to some degree, the addition of stress may be able to bring out an underlying mental illness. And of course, cities are stressful. Specifically, cities produce social stress, the stress of living around and being seen (or feeling you're being seen) by lots of people, constantly.
Also the socioeconomic level in cities played an important role, both people of very high or very low socio-economic classes have a higher risk for developing psychiatric disease. People are more subjects for substance use in cities and that is also one of the reasons of developing mental health illness. So generally speaking, number of factors, including elements of the social environment (such as variation and isolation) and physical stressors (such as pollution and noise) could explain how the city erodes well-being and ended up with psychiatric disease.
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Post by Kimber Johnsen MS3 on Jul 27, 2016 18:56:59 GMT -4
This article mentions epidemiological studies but does not list the results of these studies. This leaves me wondering if these results are per capita to account for the fact that cities have more people in a smaller area than their rural counterparts? If this was not taken into account, then this notion of more schizophrenia diagnoses in cities is skewed. Just about anything would appear more in an area with a greater population including crime.
I found it interesting that the researchers considered the possibility that those with schizophrenia tend to move cities. If one were to really think about this, it would seem strange since those with schizophrenia have a disconnect between their thoughts and their emotions and behavior. While these patients might have the an idea to move to the city, would this association have proven true, what are the chances that they would have but that thought into action unless this was the only environment they could afford to live in?
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Post by Anjani Singh MS4 on Jul 28, 2016 9:27:15 GMT -4
This article explains a lot about the human psyche and its surroundings. It is that age old question about whether genetics or your surroundings affect behavior and personality. I found it interesting that the article not only pointed out that genetics can cause a personality change such as schizophrenia, but it emphasized that it can affect your choice of surroundings that can lead to schizophrenia. Although evidence is not completely confirmed, it is a good observation and somewhat makes sense. Schizophrenia can happen in people of a wide range of ages and socioeconomic statuses. With urban populations, maybe people gather to be around others of the same nature. Because there is so many people, it could be just the relative size of the population versus an actual migration to the city. There are definitely a large amount of personalities in urban cities due to the amount of things to do in an urban city, which could definitely alter a person’s perception and overall thinking, leading to something like schizophrenia. I would definitely be intrigued to know more about this association and if they find conclusive evidence, but researchers seem to be on the right track accounting for several different factors such as genetics and overall social life factors.
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Ali Reza Ahmed (MS4)
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Post by Ali Reza Ahmed (MS4) on Jul 28, 2016 9:46:23 GMT -4
What a fantastic thought provoking article. I always found nature vs nature topics pertaining to psychiatric illnesses and disorders to be extremely intellectually stimulating. It forces us in the scientific community to look at the broader issues surrounding mental illness and how such issues have to assessed in conjunction with social sciences, population studies, anthropology, geography, and economics. This is only speculation based on articles I've read, personal knowledge of medical sciences as well as having a background in Social sciences; things like "social drift" where one can observe a decline in social status in relation to mental illness have to be addressed and taken into account. I would also like to add that excessive stimuli (visual, auditory) of living in a concrete urban jungle could also manifest in behaviors that overlap with signs and symptoms often associated with the spectrum of schizophrenia, i.e. hallucinations, disassociation, withdrawal, isolation, disorganized thoughts, etc. Population studies, especially of large dense environments like cities are perfect petri dishes for observing human behaviors.
Movie recommendations which show the impact of urban environments on individuals with mental illnesses: Taxi Driver Fight Club As Good As it Gets Seven The Fisher King
-AA (MS4)
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Post by Dan Nguyen (MS3) on Jul 28, 2016 12:10:33 GMT -4
It stands to reason that being confined to a small space overcrowded with people would be a drive for the development of any type of mental illness. Whether it be prisons, cities, or that one family reunion I went to when I was 12. Although what I found interesting, was that they noticed an increased prevalence of schizophrenia but not other forms of mental illness. So what is it that makes the development of schizophrenia unique to urban environments.
In so many words, I believe the article is simply saying they do not know what to make of their findings. They have proven that there is an correlation with urban environments and schizophrenia, but have not proven cause and effect. However, the article did propose several theories. They suggested that people in urban environments may not be at an increased risk of developing schizophrenia, but that people with schizophrenia are more likely to go there.
Schizophrenia is a multifactorial disease process, and not entirely understood. That is what makes the study of it and psychiatry, as a whole, so interesting to study.
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Post by AZ on Jul 28, 2016 14:06:34 GMT -4
One of the highlights stated in this article people who are already experiencing paranoia are likely to have intensified it by moving to the city. This could make sense because one could think that people are moving to cities, for example, Nyc to pursue a certain career that can't be as successful elsewhere I.e Wall Street. This leads to a job that most likely is more stressful than the job they had previously.
However, I feel as though it's hard to exactly pinpoint why these individuals develop schizophrenia or schizophrenia like symptoms. We can't go based on this article that an urban lifestyle causes increased stressed level and social anxiety. Cities have more people, therefore, more diagnoses.
A lot more plays into the fact that there are increased cases of schizophrenia in the urban population compared to non-urban areas since the 1900s. One could even say that there are more Caucasian males now in the urban cities leading to increased diagnoses. One could also say that psychiatric illnesses are more accepted in society and better understood now increasing diagnoses as well. This could also be related to more psychiatrist in urban places, which correlates with efficiency on correct diagnosis and treatment. There's just so much that has been overlooked!
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Post by Lauren Eppert on Jul 28, 2016 14:12:20 GMT -4
This article highlights many of the observations researchers have identified when correlating a schizophrenia diagnosis and a demographic; however, I agree with Fitzgerald's comment at the conclusion of the paper: "You can't just talk about social life without some accounting for its richness, its complexity, its contests, its ambiguity." Each argument listed throughout the paper could probably be related to a portion of patients with a schizophrenia diagnosis, but it is more likely that each diagnosis is due to a combination of causes. Another possible reason there may be more schizophrenics identified in the cities is because there are resources for mental health or researchers focusing on the area; rarely do studies hone in on small, rural populations of people who may not have access to healthcare or may not be aware of their conditions. Sure though, a handful of patients may have moved to the city due to cheaper living, and others may have been influenced by their familial upbringing. Regardless, when interviewing and assessing patients individually, no one has an identical story/background as another. Because of this, it's hard to definitively state the reasoning for the highest population being identified in large cities. So, with the information we have, rather than trying to hammer out a reason for the incidence, I believe the most valuable use of our resources is to then isolate the group and treat them to the best of our ability – if successful, perhaps the demographics will change, and ideally, these people living in social housing projects or on the streets will have the opportunity to lead more independent lifestyles.
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Shadi Jafari-Esfahani (MS3)
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Post by Shadi Jafari-Esfahani (MS3) on Jul 28, 2016 15:57:40 GMT -4
I believe psychosis or any mental illness such as Schizophrenia is multifactorial and to simply finding causality between them and a factor such as city living is a difficult task. The question remains that whether living in the city can cause psychosis or people with psychotic features are attracted more towards city living. The article points at different research studies and their perspectives regarding genetic and hereditary effects on mental illness. Based on my experience working at a mental health institution I think it is safe to say that genetics, childhood mental health disorders, congenital defects, the environment where an individual is raised in, as well as the personality and traits and their social history all contribute to whether or not a person develops psychosis. Based on this article It would be more insightful to know if those diagnosed with psychosis or Schizophrenia were initially born and raised in the city center or they had moved after they have been diagnosed with the disorder. Another factor to consider is from those diagnosed with Schizophrenia who is experiencing more outburst or symptoms people who are experiencing the city living or those living further away from all the hassles that comes with city living.
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Post by Veronique Pryce on Jul 28, 2016 17:04:20 GMT -4
Quite a stirring read indeed. What gripped me right away about this write up was the correlation between the socioeconomic status and schizophrenia. The thought that genetics may play a role, so that those who are not academically inclined are deemed less intelligent, work for less therefore they end up in an area such as the inner city's concrete jungle, continuing the cycle over generations is a bit daunting. According to Amir Sariaslan, the idea that genetics could influence something so complex as finding a house might seem counter-intuitive but Sariaslan explaind that it is best understood in terms of limiting life choices rather than affecting decision making.
There are good reasons to think that city living may be the cause of some of problems such as social isolation and social threats. Understandably so, there are psychological and physical benefits associated with tranquility that inner-city-neighborhoods can not offer and those deprived seem to be at some type of disadvantage. But here is where the cultural cliché breaks down, because the effect is surprisingly selective.This is a great area for a more detailed research because as it stands it is a "mystery of urban psychosis", as the title implied.
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Prashanthi Varatharajan MS4
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Post by Prashanthi Varatharajan MS4 on Jul 28, 2016 22:23:25 GMT -4
Patients who have schizophrenia have several factors that lead them to a diagnosis. Urban cities generate several different types of stimuli that can lead to such a personality change. Schizophrenia is extremely complex like an urban city. Complexities of an urban city can only lead to complex diagnoses. Genetics play a large role in the complexity of what a personality entails, therefore contributing a large role in what schizophrenia entails.
In addition to genetics, studies show that there is a correlation between marijuana use, ADHD, stimulants such as Adderall, and the development of schizophrenia. As the study suggests, urban cities and inner city populations frequently medicate "unruly" children under the pretense diagnosis of ADHD with stimulants and the long term adverse effects of stimulants lead to complications such as schizophrenia. Therefore, one can conclude that this theory may contribute to the association with urban cities and schizophrenia.
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Post by Meika Shah on Jul 28, 2016 23:55:10 GMT -4
This article was interesting in some ways, but did not feel like much other than an opinionated rant due to the lack of hard facts. I feel as though the author cherry picked quotes, rather than data, to back his claim. It felt like a long opinion rather than a factual article. In regards to the article, I found it interesting that the author mentioned that urban living had a correlation with schizophrenia and not depression or mood instability. I feel as though there can be overlap in schizophrenia and mood instability, especially as depression can look a lot like negative schizophrenic symptoms and vice versa. In that case, maybe the urban environment is really just affecting ones well being and it's not just a correlation to schizophrenia? "The two big psychological negatives of city living, social isolation and social threat, are already well studied in mental health." next, I feel as though social isolation and threat has an inevitable effect on ones mental wellbeing, whether that lead to schizophrenia or depression. The bigger cause of concern is the lack of a solution. With such a correlation, wouldn't it be better to eliminate the large city crowds and fear of harm to ones life by budgeting more towards small family housing rather than theme parks and shopping malls? Lastly, I enjoyed the brief discussion on the social drift hypothesis--did the schizophrenics move to these urban, overcrowded neighborhoods, or did they turn schizophrenic from simply living in one? A new spin on what came first, the chicken or the egg.
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Michael Sorrenti (MS3) - UMHS
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Post by Michael Sorrenti (MS3) - UMHS on Jul 29, 2016 20:09:37 GMT -4
I found this article interesting. I remembered reading something about “geographical drift” in undergrad; Glyn Lewis et al. titled it “Schizophrenia and city life”. It essentially described this phenomenon, but it concluded that schizophrenics were not more inclined to move to cities and that it must be these “environmental” factors found in the cities, that increase the risk for schizophrenia.
Personally, I agree with what most students have said here on the forum, in the sense that schizophrenia is an illness with many different facets and it is difficult to draw many conclusions from one factor of the illness, mainly location. I think what is important is that there may be a correlation between city living and this type of mental illness but correlation does not always mean causation. With that being said, I think that G. Lewis et al. were correct in saying that many different “environmental factors” whatever they are, must be at play here.
Overall, I think that any evidence in the matter may be interesting but not life changing. For example, low SES is associated with many conditions, such as CAD but moving someone from a low SES to high SES will not change the dx of the pt. Lets put our time, effort and money into improving medical management of these patients, instead of sedating them to the point of catatonia.
Lewis, Glyn, et al. "Schizophrenia and city life." The Lancet 340.8812 (1992): 137-140.
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Post by Mustaf Shariff on Jul 30, 2016 15:12:44 GMT -4
The article suggests that its perhaps the structure and function of cities that make individuals more prone to psychological effects and in particular Schizophrenia. At first glance this notion seems like a foreign and intriguing idea without considering the complexity and circumstances which lead to those conclusions. It is this same complexity and multi-factorial nature of Schizophrenia that made me raise an eye brow while reading the article and and question the conclusion. Surely correlation by itself does not imply causation. I believe there is not enough evidence to suggest city living is solely to blame for the correlation witnessed or suggested by the author.
Perhaps there are confounding variables by nature which draws people to cities. Certainly the idea of cognitive reasoning and choice of living is one, which itself has a complexity, suggesting someones level of intellect is influenced by the level of education which intern is influenced by their genetic make up. I tend to take the simple reasoning that the structure and function of a city will tend to draw the destitute for the sole purpose of more resources that are available in the city, i.e public restrooms, foot traffic for pan handling, bridges to sleep under, and easy mobility. The rate of Schizophrenia might by diagnosed at a higher rate due to the fact more people take notice of bizar behavior in the middle of a city and patients are able to be diagnosed. When compared to areas where symptoms go unnoticed.
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Post by Huaihui (Extern) on Jul 30, 2016 23:30:21 GMT -4
I agree with the main point of this article : urbanization may increase the incidence of psychosis. However, I think there are 2 misleading information in this article.
1st, the article cited 5 publications all conducted in Europe, but presented with a big picture of crowded Chinese city. I don't think most cities in Europe are so insanely crowded. BTW, my apartment in Shanghai is only 5-min-drive far away from Naning Pedestrian Street in this picture, in fact, such a crowed condition only happens in holidays, when lots of travelers come into Shanghai, the biggest city of China.
2nd, James Kirkbride’s study aim is to determine whether the incidence of psychotic disorders varied within an urban area, but this article distorted it as “studies that have found higher rates of psychosis in cities”. Moreover, the sample size (295 cases divided into 33 wards) of James Kirkbride’s study is not big enough as an epidemiology study.
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