Psychosis Prevalence and Syndemic Localisation in English Neighbourhoods: Impacts of Adverse Neighbourhood Behavioural Environments

Psychosis Prevalence and Syndemic Localisation in English Neighbourhoods: Impacts of Adverse Neighbourhood Behavioural Environments | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Psychosis Prevalence and Syndemic Localisation in English Neighbourhoods: Impacts of Adverse Neighbourhood Behavioural Environments Peter Congdon, Jeremy Coid This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9461497/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose. There is a need for environmentally explicit measures of neighbourhood psychosis risk, going beyond the black box of urbanicity. We investigate adverse environments defined by high crime and risky behaviours such as substance use, how they may be mutually associated via a syndemic perspective, and how their influence on psychosis compares to existing widely used area characteristics (e.g. area socioeconomic status). Methods. We develop a composite measure of adverse neighbourhood behaviours (criminality; substance dependence; and risky sexual behaviour) and consider its impact on psychosis using regression and clustering techniques. We aim to establish its explanatory role as compared to existing commonly used neighbourhood risk measures. We consider adverse environment impacts in tandem with those of neighbourhood cohesion, with measures of both derived by spatial disaggregation models. Results. We find regression effects of adverse behaviour measure comparable to those of commonly used neighbourhood risk factors. Adverse environments exert a predominant influence on psychosis levels in London, and account for much of the urbanicity effect. Spatially constrained cluster analysis shows the clear interplay between adverse environments, and the offsetting role of cohesion, across varying highly urban and less urban settings. Conclusion. High psychosis risk in urban areas is well established. We provide a template, based on syndemic ideas, for measuring behaviourally adverse neighbourhood environments, which are found play a significant role in explaining varying psychosis risk across English neighbourhoods, and elevated urban levels. Psychosis. Syndemic. Urbanicity Inner City Neighbourhood Cohesion Adverse Environments Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9461497","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":626674743,"identity":"2009133c-7b7e-492e-8247-3aca14e36db7","order_by":0,"name":"Peter Congdon","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYPACZgYG9gYgXQDjEaWF5wCQNiBJi0QCkVrMGZgfPi74ZS1nLvl462YeAwZ5/gYeYwN8Wiwb2IyNZ/alG1vOTiu7DdRiOOMAj3ECPi0GB3jYpHl7DiduuJ1jBtLCuIGBx/gAcVpungFrsSdOC88PoJYbPGAtiSAteB1m2Qz0C29DurHBmbSym3MMJJJnHGYrxut9c/bmh495/ljLGRw/vO3Gmwob2/725s0SeB0GigPGNggbiCUIRyTECX+Q2KNgFIyCUTAK0AEAo7JAYbC10P4AAAAASUVORK5CYII=","orcid":"","institution":"Queen Mary University of London","correspondingAuthor":true,"prefix":"","firstName":"Peter","middleName":"","lastName":"Congdon","suffix":""},{"id":626674745,"identity":"3744156b-73e3-408e-8bd7-2bba85f2cf3c","order_by":1,"name":"Jeremy Coid","email":"","orcid":"","institution":"Queen Mary University of London","correspondingAuthor":false,"prefix":"","firstName":"Jeremy","middleName":"","lastName":"Coid","suffix":""}],"badges":[],"createdAt":"2026-04-19 11:08:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9461497/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9461497/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107721900,"identity":"5cc669a9-8fe4-4efe-aaa1-72a06de253a5","added_by":"auto","created_at":"2026-04-24 11:11:42","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":541143,"visible":true,"origin":"","legend":"","description":"","filename":"SPPEApril2026.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9461497/v1_covered_63aeb518-e3c0-4677-8835-358f5566031e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Psychosis Prevalence and Syndemic Localisation in English Neighbourhoods: Impacts of Adverse Neighbourhood Behavioural Environments","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Psychosis. Syndemic. Urbanicity, Inner City, Neighbourhood Cohesion, Adverse Environments","lastPublishedDoi":"10.21203/rs.3.rs-9461497/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9461497/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePurpose. There is a need for environmentally explicit measures of neighbourhood psychosis risk, going beyond the black box of urbanicity. We investigate adverse environments defined by high crime and risky behaviours such as substance use, how they may be mutually associated via a syndemic perspective, and how their influence on psychosis compares to existing widely used area characteristics (e.g. area socioeconomic status).\u003c/p\u003e \u003cp\u003eMethods. We develop a composite measure of adverse neighbourhood behaviours (criminality; substance dependence; and risky sexual behaviour) and consider its impact on psychosis using regression and clustering techniques. We aim to establish its explanatory role as compared to existing commonly used neighbourhood risk measures. We consider adverse environment impacts in tandem with those of neighbourhood cohesion, with measures of both derived by spatial disaggregation models.\u003c/p\u003e \u003cp\u003eResults. We find regression effects of adverse behaviour measure comparable to those of commonly used neighbourhood risk factors. Adverse environments exert a predominant influence on psychosis levels in London, and account for much of the urbanicity effect. Spatially constrained cluster analysis shows the clear interplay between adverse environments, and the offsetting role of cohesion, across varying highly urban and less urban settings.\u003c/p\u003e \u003cp\u003eConclusion. High psychosis risk in urban areas is well established. We provide a template, based on syndemic ideas, for measuring behaviourally adverse neighbourhood environments, which are found play a significant role in explaining varying psychosis risk across English neighbourhoods, and elevated urban levels.\u003c/p\u003e","manuscriptTitle":"Psychosis Prevalence and Syndemic Localisation in English Neighbourhoods: Impacts of Adverse Neighbourhood Behavioural Environments","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-24 11:09:42","doi":"10.21203/rs.3.rs-9461497/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4bec8510-5fbe-4c09-bd8d-65d930e28541","owner":[],"postedDate":"April 24th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-24T11:09:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-24 11:09:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9461497","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9461497","identity":"rs-9461497","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}