Why City Life Adds to Your Risk of Psychosis

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Life in the big city can be tough, and as many urban dwellers know, it can lead to feelings of isolation and even promote a greater risk of developing a mental disorder such as depression.

But what accounts for that increased risk? Is it something about the city itself, or is it unique to the people who gravitate to the intense pace of urban life?

Stanley Zammitt, a psychiatry professor at Cardiff University in Wales and University of Bristol in England, says it’s the city. Zammitt led a group of researchers in a study of Swedish citizens born in 1972 and 1977, and found that the isolation and social fragmentation common to urban life added to people’s risk of developing psychotic disorders such as schizophrenia.

Zammit also studied individual, school and geographical characteristics that contribute to risk, and found that while the development of psychoses is driven primarily by individual risk factors — such as genetics or personal circumstances — the disconnectedness of urban living could help explain why rates of psychotic disorders were higher in the city than in rural areas. “There are some [city] neighborhoods where there is a lot of migration in and out of those areas and a lot of single parent households,” says Zammit. “We took that as reflecting poorer social networks, areas where there is less social stability.”

The good news is that the isolating effect of city life can be counteracted with stronger community programs and efforts to build social networks and relationships among city residents. While more research needs to be done to confirm how effective such programs may be in reducing the risk of psychoses, Zammit believes it may be helpful. “To the extent that the lack of social relationships has this effect,” he says, “to shore that up would likely be helpful. Living in a supportive environment is likely better for you than living where there are few social networks.”