According to a study, air pollution related to psychosis in adolescents

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"One of the most consistent results of recent decades is a link between cities and psychosis," said Tuesday Joanne Newbury, lead author of the study and postdoctoral researcher at King's College from London. "Children born and raised in urban or rural areas are almost twice as likely to develop psychosis in adulthood."

For the study, published Wednesday in the journal JAMA Psychiatry, Newbury and his co-authors investigated whether psychotic experiences are more common among adolescents exposed to higher levels of air pollution. They used data from a study of more than 2,000 participants, all born in England and Wales in 1994 and 1995.

The researchers followed each child several times at the ages of 5, 7, 10, 12 and more recently at 18, explained Newbury. They were asked during a private interview: "Have you ever heard voices that other people can not hear? Did you think you were being tracked or spied on?"

Dr. Helen Fisher, co-author of the study and psychopathology developmental researcher at King's College London, said Tuesday that "when we talk about psychotic experiences, we are talking about people who experience such things as hearing or seeing things that others do not have. " t or feel very paranoid. "

Such symptoms – which "are in fact quite common in the general population", she said, are considered "as a kind of less severe or less extreme form of the type of psychotic symptom, such as hallucinations or illusions. that we see people with psychotic disorders such as schizophrenia. "

In total, 623 (30%) of adolescents reported having at least one psychotic experience between 12 and 18 years of age.

Next, the researchers collected hourly data on emissions from monitoring sites to assess pollution levels in the places where each teenager spent the most time: a home address and two other places, such as school. .

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Psychotic experiences were significantly more common among adolescents in the upper quartile of pollution exposure, even after researchers had explained factors that may also be related to psychosis, such as smoking, cannabis dependence, and smoking. crime levels in the neighborhood.

Adolescents exposed to levels of nitrogen dioxide, nitrogen oxides and particulate matter (PM2.5, inhalable fine particles derived from chemical smoke) in the upper quartile had 71%, 72% and 45% more chances of experiencing psychotic experiences as exposed to lower quartile levels.

"Chances increase gradually as you move from rural areas to urban areas," Newbury said. Teenagers in "most urban areas" are "94% more likely to experience psychotic experiences than people living in rural areas".

Newbury warned that it was not a cause-and-effect relationship but an association between air pollution and psychosis.

While road traffic accounts for most of the air pollution studied, Fisher said, "it may be really noise pollution that explains what is happening here." Noise disturbs sleep and generates stress. Both are associated with psychotic experiences, she explained.

However, if air pollution is at the root of psychosis, Fisher assumes that gases and particles could cause brain inflammation, which previous research suggests could be related to psychosis. Pollutants can also be a "brain development delay" during sensitive periods, which may be related to psychosis, Fisher said: "Seventy-five percent of mental health problems will begin during this adolescent period," he says. So it's a very good time to go out and prevent and prevent some of these problems in the long run. "

What to do with results

Dr. Jim van Os, professor and head of the brain division of the University Medical Center Utrecht, wrote in an e-mail that the document was "nice" but lacked rigor.

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The result is "highly sensitive to the press" and "taken from a study involving literally thousands of variables," noted van Os, who studied and explored psychosis but did not participate in the new research. At best, it is "an assumption to be considered in future work." In the absence of replication, it does not mean much and is very likely a false positive conclusion. "

Sophie Dix, a cognitive scientist and research director at MQ, a non-profit organization that funds mental health research, told the Science Media Center: "There is still work to do with this study."

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"There is no evidence that pollution necessarily causes psychosis or that it is acting from one of many factors or that it is acting in ways that isolated, "said Dix, who did not participate in the research. "The situation is larger here, but it does not diminish the importance of these discoveries and the potential that results from them."

Stefan Reis, who heads the atmospheric chemistry and effects research unit at the NERC Center for Ecology and Hydrology, told Science Media Center that "the study brings a valuable contribution to the set of increasingly important evidence that air pollution can affect cardiovascular and respiratory health ".

Reis, who did not participate in the study, said that other variables to be explored might include "early schooling attainment and cognitive decline among older people in Canada." because of early exposure to air pollution ". It is important, he concluded, to gain a better understanding of the relationship between air pollution and the consequences for mental health, which could, in the future, have an impact on quality policies. l & # 39; air.

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Marianthi-Anna Kioumourtzoglou, assistant professor in the Department of Environmental Health Sciences at the Columbia University Mailman School, wrote in an editorial published next to the study that "exposure to air pollution is ubiquitous in urban environment ", but it is" modifiable ". and can be reduced by rigorous regulatory measures. "

"It is particularly important to identify other factors that can improve the consequences of air pollution to protect human health," said Kioumourtzoglou, who said played no role in the new research. "These may be lifestyle, nutrition or neighborhood-level factors."

"As the world's population is increasingly urban, it is of utmost importance to integrate public environmental health into urban planning decisions."

According to the study's authors: "Given that 70% of the world's population will be urban by 2050, the discovery of the mechanisms linking the urban environment to psychosis and the development of people living in urban areas," said the researcher. Preventive interventions are an urgent health priority. "

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