TY - JOUR
T1 - Advancing urban mental health research
T2 - from complexity science to actionable targets for intervention
AU - van der Wal, Junus M.
AU - van Borkulo, Claudia D.
AU - Deserno, Marie K.
AU - Breedvelt, Josefien J. F.
AU - Lees, Mike
AU - Lokman, John C.
AU - Borsboom, Denny
AU - Denys, Damiaan
AU - van Holst, Ruth J.
AU - Smidt, Marten P.
AU - Stronks, Karien
AU - Lucassen, Paul J.
AU - van Weert, Julia C. M.
AU - Sloot, Peter M. A.
AU - Bockting, Claudi L.
AU - Wiers, Reinout W.
N1 - Publisher Copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.
AB - Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.
UR - http://www.scopus.com/inward/record.url?scp=85120720287&partnerID=8YFLogxK
UR - https://pure.uva.nl/ws/files/67316438/1_s2.0_S221503662100047X_mmc1.pdf
U2 - https://doi.org/10.1016/S2215-0366(21)00047-X
DO - https://doi.org/10.1016/S2215-0366(21)00047-X
M3 - Review article
C2 - 34627532
SN - 2215-0366
VL - 8
SP - 991
EP - 1000
JO - Lancet. Psychiatry
JF - Lancet. Psychiatry
IS - 11
ER -