Principal Investigator: Ian Gold
Co-Investigators: Lisa Bornstein, Suparna Choudrey, Ana Goméz-Carillo, Jai Shah and Daniel Weinstock
In 1939 two American sociologists Robert Faris and Warren Dunham published a study reporting higher rates of schizophrenia in population-dense, inner-city neighbourhoods of Chicago than in sparser neighbourhoods, but they found no parallel effect for bipolar disorder. 75 years of study has confirmed the mental health threat of urban living: living in a city adds to the risk of schizophrenia and other psychotic illnesses as much as abusing cannabis. Immigrants appear to be particularly sensitive to cities and show much higher rates of psychosis in urban areas. Whatever their virtues, cities make a real contribution to the untold human suffering of psychosis and the enormous economic burden it creates. No one knows what makes cities so toxic. But psychiatrists are now convinced that the pathogen is other people. How is this possible? How do the millions of people you never meet in the city put you at greater risk of psychosis? Research on psychosis and the city has stalled for lack of a bridge from the city in all its complexity to individual psychology and brain function. The key to this bridge is the concept of trust. Trust turns a neighbourhood into a community and transforms a relationship into a friendship; trust is inscribed in our genes and our brains, and malignant mistrust looks a lot like paranoia. The new paradigm locates the effect of cities in the mistrust of strangers. As the number of unknown others grows, so does mistrust and the risk of psychosis. Our research will explore the links between cities and psychosis in healthy individuals, both natives and immigrants, as well as in those showing the first signs of psychotic illness. Our investigation will bring together political theory and psychiatry and initiate a new research program that takes seriously the subtle texture of social living in the aetiology of the most devastating and costly of mental illnesses.