REVIEW ARTICLE
Urbanicity: The need for new avenues to explore the link between urban living and psychosis
Lilith Abrahamyan Empson,
Philipp S. Baumann,
Ola Söderström,
Zoé Codeluppi,
Dag Söderström, Philippe Conus,
Corresponding Author
Lilith Abrahamyan Empson
Treatment and early Intervention in Psychosis Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Correspondence
Lilith Abrahamyan Empson, Département de Psychiatrie, Service de Psychiatrie Générale, Hôpital Psychiatrique de Cery, 1008 Prilly, Switzerland.
Email: [email protected]
Search for more papers by this authorPhilipp S. Baumann
Treatment and early Intervention in Psychosis Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Search for more papers by this authorOla Söderström
Institute of Geography, University of Neuchâtel, Neuchâtel, Switzerland
Search for more papers by this authorZoé Codeluppi
Institute of Geography, University of Neuchâtel, Neuchâtel, Switzerland
Search for more papers by this authorPhilippe Conus
Treatment and early Intervention in Psychosis Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Search for more papers by this authorLilith Abrahamyan Empson,
Philipp S. Baumann,
Ola Söderström,
Zoé Codeluppi,
Dag Söderström, Philippe Conus,
Corresponding Author
Lilith Abrahamyan Empson
Treatment and early Intervention in Psychosis Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Correspondence
Lilith Abrahamyan Empson, Département de Psychiatrie, Service de Psychiatrie Générale, Hôpital Psychiatrique de Cery, 1008 Prilly, Switzerland.
Email: [email protected]
Search for more papers by this authorPhilipp S. Baumann
Treatment and early Intervention in Psychosis Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Search for more papers by this authorOla Söderström
Institute of Geography, University of Neuchâtel, Neuchâtel, Switzerland
Search for more papers by this authorZoé Codeluppi
Institute of Geography, University of Neuchâtel, Neuchâtel, Switzerland
Search for more papers by this authorPhilippe Conus
Treatment and early Intervention in Psychosis Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
Search for more papers by this authorFunding information Leenaards Foundation; Swiss National Science Foundation, Grant/Award Number: 153320
Abstract
Aim
A growing body of evidence suggests that urban living contributes to the development of psychosis. However, the mechanisms underlying this phenomenon remain unclear. This paper aims to explore the best available knowledge on the matter, identify research gaps and outline future prospects for research strategies.
Method
A comprehensive literature survey on the main computerized medical research databases, with a time limit up to August 2017 on the issue of urbanicity and psychosis has been conducted.
Results
The impact of urbanicity may result from a wide range of factors (from urban material features to stressful impact of social life) leading to “urban stress.” The latter may link urban upbringing to the development of psychosis through overlapping neuro- and socio-developmental pathways, possibly unified by dopaminergic hyperactivity in mesocorticolimbic system. However, “urban stress” is poorly defined and research based on patients' experience of the urban environment is scarce.
Conclusions
Despite accumulated data, the majority of studies conducted so far failed to explain how specific factors of urban environment combine in patients' daily life to create protective or disruptive milieus. This undermines the translation of a vast epidemiological knowledge into effective therapeutic and urbanistic developments. New studies on urbanicity should therefore be more interdisciplinary, bridging knowledge from different disciplines (psychiatry, epidemiology, human geography, urbanism, etc.) in order to enrich research methods, ensure the development of effective treatment and preventive strategies as well as create urban environments that will contribute to mental well-being.
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