• Click to visit the study webpage (external)

Why did we set up the study?

Psychotic disorders, such as schizophrenia, occur more commonly in certain groups of people (like young men, or some ethnic minority groups) & by environmental factors like deprivation, social isolation or inequality (see our paper for a scientific introduction to this ). Most of the research which shows this comes from studies of people living in cities. We want to discover whether these same risk factors applied to people living in more rural areas.

How does it work?

We work with our clinical partners in the NHS to collect basic demographic data, anonymously, on young people experiencing their first episode of psychosis [FEP] in East Anglia over 3.5 years. We use a statistical method to estimate incidence rates in different sociodemographic groups, and by region, in order to discover how FEP risk varied in the population. The study has received full ethical approval.

What have we found?

The main of the study have now been published . The study has established that the incidence of first episode psychoses varies substantially in rural areas. Just like in ore urban populations, rates in rural populations are higher in young adults  – for both men and women before 20 years old – and higher in several ethnic minority groups . Here we found that rates were highest for people of black Caribbean and African backgrounds, but other groups were at increased risk too, including people from Pakistani and Middle Eastern backgrounds. These differences were not explained by differences in age, sex or socioeconomic status. Importantly, migrants from Eastern Europe were not at elevated risk of FEP compared with the white British population . This is an important finding given the significant migration from Eastern Europe over the past 15 years; before the SEPEA study was conducted, we did not know whether this group would have increased psychosis risk. We have also discovered that migrants who move to the UK in middle childhood were at more risk than people migrating at other times , which suggests this period of childhood may be important in social development of the brain. Finally, we discovered that rates of FEP vary between different neighbourhoods, with the most deprived, socially isolated and urban neighbourhoods having the highest rates .

We have also reported that EIP services in the East of England were accepting at least 50% of people with FEP into care within 2 weeks of referral , consistent with targets set by the NHS. We have also found that incidence rate of FEP is higher than expected in East Anglia . Using SEPEA data, we have also created a population-level prediction tool for the NHS to plan mental health services for young people . It predicts which parts of England & Wales are likely to see the largest number of people with FEP, based on what we have learnt about risk in different groups. You can find out much more about the SEPEA study on its website.


Want the science behind the blurb? Follow the links below to the peer-reviewed research papers.