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Urban residence, victimhood and the appraisal of personal safety in people with schizophrenia: results from the European Schizophrenia Cohort (EuroSC)

Published online by Cambridge University Press:  15 October 2007

G. Schomerus ,
D. Heider ,
M. C. Angermeyer ,
P. E. Bebbington ,
J.-M. Azorin ,
T. Brugha  and
M. Toumi
G. Schomerus*
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
D. Heider
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
M. C. Angermeyer
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
P. E. Bebbington
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, London, UK
J.-M. Azorin
Affiliation:
SHU Psychiatrie Adultes, Sainte Marguerite Hospital, Marseille, France
T. Brugha
Affiliation:
Section of Social and Epidemiological Psychiatry, University of Leicester, Leicester, UK
M. Toumi
Affiliation:
Health Economics Department, Lundbeck S.A., Paris, France
*
*Address for correspondence: Dr med. G. Schomerus, Department of Psychiatry, Leipzig University, Johannisallee 20, D-04317 Leipzig, Germany. (Email: georg.schomerus@medizin.uni-leipzig.de)
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Abstract

Background

Patients with schizophrenia are at increased risk of being victims of violent and non-violent crimes. We have determined how the experience of crime and subjective feelings of safety differ between urban and rural residential areas.

Method

We analysed data from the European Schizophrenia Cohort (EuroSC), a 2-year follow-up study of 1208 patients in the UK, France and Germany. Subjective safety and a history of victimhood were elicited with Lehman's Quality of Life Inventory. Regression models adjusted the effects of living environment for country, education, employment, financial situation, drug and alcohol abuse, criminal arrests and the level of schizophrenic symptoms.

Results

Ten per cent of patients were victims of violent and 19% of non-violent crimes. There was no significant relationship between victim status and residential area. However, subjective safety was clearly worse in cities than in rural areas. Aspects of objective and subjective safety were related to different factors: being the victim of violence was most strongly associated with alcohol and drug abuse and with criminal arrests of the patients themselves, whereas impaired subjective safety was most strongly associated with poverty and victimhood experience.

Conclusions

Although urban living was not associated with increased objective threats to their security, patients did feel more threatened. Such stress and anxiety can be related to concepts of social capital, and may contribute unfavourably to the course of the illness, reflecting the putative role of appraisal in cognitive models of psychosis. Securing patients’ material needs may provide a way to improve subjective safety.

Keywords

Schizophreniasocial capitalurban–rural differencesvictimization
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 4 , April 2008 , pp. 591 - 597
Copyright
Copyright © Cambridge University Press 2007

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