Urbanicity

How is urbanicity related to bipolar disorder?

There is evidence that urban settings are associated with higher rates of some psychiatric disorders. Studies of urbanicity have defined exposure to urban environs in various ways, either consisting of urban-rural comparisons or defined according to population density which can include mixed urban-suburban-rural areas. The majority define urbanicity by degrees of population density, defined either as population per square kilometer or as the number of inhabitants within a defined location (e.g., capital, city, or town). It is not clear whether urban living is itself associated with a higher risk for bipolar disorder, as other factors may influence this association such as social class and access to treatment. Time of exposure also varies in different studies. Exposure may be assessed at birth, during upbringing or at illness onset.

What is the evidence for urbanicity as a risk factor for bipolar disorder?

Moderate to low quality evidence suggests there may higher risk of bipolar disorder in adulthood in people who were born in urban areas rather than rural areas, however there may be decreased risk of affective psychoses in general (a broader diagnostic category) with urban birth.

April 2019

Last updated at: 4:41 am, 4th April 2019
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