AUTHOR=Mahabadi Zahra , Mahabadi Maryam , Velupillai Sumithra , Roberts Angus , McGuire Philip , Ibrahim Zina , Patel Rashmi 

TITLE=Evaluating physical urban features in several mental illnesses using electronic health record data

JOURNAL=Frontiers in Digital Health

VOLUME=Volume 4 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2022.874237

DOI=10.3389/fdgth.2022.874237

ISSN=2673-253X

ABSTRACT=Objectives: Understanding the potential impact of physical characteristics of the urban environment on clinical outcomes on psychotic disorders.
Materials and Methods: Physical features of the urban environment were examined as predictors for affective and non-affective psychotic disorders, the number and length of psychiatric hospital admissions, and the number of short and long-acting injectable antipsychotic prescriptions. In addition, the urban features with the greatest weight in the predicted model were determined. The data included 28 urban features and 6 clinical variables obtained from 30,210 people with psychotic disorders receiving care from the South London and Maudsley NHS Foundation Trust (SLaM) using the Clinical Record Interactive Search (CRIS) tool. Five machine learning regression models were evaluated for the highest prediction accuracy followed by the Self-Organizing Map (SOM) to represent the results visually.
Results: The prevalence of psychotic disorders, number and duration of psychiatric hospital admission and antipsychotic prescribing were greater in urban areas. However, machine learning analysis was unable to accurately predict clinical outcomes using urban environmental data.
Discussion: The urban environment is associated with increased prevalence of psychotic disorders. However, urban features alone cannot explain the variation observed in psychotic disorder prevalence or clinical outcomes measured through psychiatric hospitalization or exposure to antipsychotic treatments.
Conclusion: Urban areas are associated with greater prevalence of psychotic disorders but clinical outcomes are likely to depend on a combination of urban and individual patient-level factors. Future mental healthcare service planning should focus on providing appropriate resources to people with psychotic disorders in urban environments.