Culture and Psychosis
The phenomena of urban psychosis remains a mystery
About a century ago, psychologists began to notice that patients in asylums were significantly more likely to come from densely populated urban areas.
That seems like it should make sense — there are more people in urban areas, so there are more people who suffer from mental illness. But as Ed Yong writes in a fascinating new story in The Atlantic, modern studies have shown that it's not so simple.
Yong points to decades of peer-reviewed research showing that it's not just a numbers game.
"The data shows that urban environments reliably increase the chances of being diagnosed with schizophrenia or having related experiences like paranoia or hallucinations," he writes.
If it were an issue of better access to mental health resources, you might expect to see a similar uptick in diagnoses for depression or mood disorders, but the data doesn't bear that out — numbers for those problems stay stable.
Some psychologists explain the link through the "social drift" hypothesis. The reasoning goes that the havoc severe mental illness can wreak on a person's life can make them drift down through the economic classes, eventually finding themselves among the urban poor.
Researchers are divided on the subject of social drift — some studies have turned up . What's more, children growing up in cities show the same prevalence of psychotic features as adults, but, obviously, children haven't had a lifetime to drift from suburban affluence to urban poverty.
A recent study of children in London found evidence for an alternate explanation: The stress of living in a city (and being economically disadvantaged) is associated with an increased risk of developing psychotic symptoms.
Scientists already know that adults who suffer from paranoia are negatively affected by busy streets and crowds — a study found that for these patients, going outside was tied to increased anxiety, depression, and even delusions. Add that to the growing body of knowledge showing that stress may trigger latent mental illness, and cities could be a perfect storm.
That's not to say, of course, that living in citiescausesschizophrenia or any other mental health issue. Scientists are still untangling the knot of how environment, genetics, and mental health play out in the lives of individuals and throughout generations.
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