Schizophrenia and education in Chinese metropolises: a population-based study
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ORIGINAL PAPER
Schizophrenia and education in Chinese metropolises: a population‑based study Yanan Luo1,2,3 · Ping He4 · Lei Zhang1,2 · Lihua Pang1,2 · Chao Guo1,2 · Richard Liang5 · Xiaoying Zheng1,2 Received: 9 September 2018 / Accepted: 9 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Schizophrenia is a public concern in metropolises. Increases in city size may strengthen the correlation between prevalence of schizophrenia and indices of socioeconomic status, such as education. This study used population-based data of adults to investigate the association between education and schizophrenia in Chinese metropolises and its differences between inner city areas and outer suburbs. Methods Data was obtained from the Second China National Sample Survey on Disability in 2006, and analysis was restricted to 189,143 participants aged 18 years or older in all counties (districts) of Beijing, Shanghai, and Tianjin. Schizophrenia diagnoses were ascertained according to the International Statistical Classification of Diseases, 10th Revision. Logistic regression models were fitted to examine the association between education and schizophrenia. Results An inverse U-shaped pattern between education and schizophrenia was found in inner city areas of Chinese metropolises. Compared with the primary school or below group, the odds ratios of junior high school group and senior high school or above group was 2.79 (95% CI 1.96, 3.96) and 1.45(95% CI 0.99, 2.13), respectively. In outer suburbs, junior high school (OR = 0.87, 95% CI 0.63, 1.19) and senior high school or above groups (0.58, 95% CI 0.38, 0.87) were less likely to develop schizophrenia than the primary school or below group. Conclusions This study showed an association between education and schizophrenia in Chinese metropolises. In inner city areas, the association was an inverse U-shaped pattern between education and schizophrenia, whereas in suburban areas, the association was a negative linear pattern. Our findings can help identify high-risk populations of schizophrenia in Chinese metropolises. Programs for prevention and early intervention of schizophrenia will need to consider the socioeconomic disparities between inner city and outer suburban areas. Public policies can help improve mental health by developing social security for migrants in inner city areas and promoting regional equality. Keywords Metropolis · Schizophrenia · Education · Inner city areas · Outer suburbs
Introduction
Yanan Luo and Ping He contributed equally to this study. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00127-020-01898-6) contains supplementary material, which is available to authorized users. * Xiaoying Zheng [email protected] 1
2
Institute of Population Research, Peking University, No. 5 Yiheyuan Road Haidian District, Beijing 100871, People’s Republic of China APEC Health Science Academy, Peking University, Beijing, China
China has experienced the rapid urbanization and
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