High air pollution tied to psychotic experiences in teens

  • JAMA Psychiatry

  • International Clinical Digest
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Takeaway

  • Adolescents exposed to the highest levels of outdoor air pollution, especially nitrogen dioxide (NO2), nitrogen oxide (NOx), and particulate matter 2.5), had an increased risk for psychotic experiences compared with those exposed to the lowest pollution levels.

Why this matters

  • A 2012 study found that children raised in urban centers are more than twice as likely to be diagnosed with a psychotic disorder by adulthood; these new findings suggest air pollution explains 60% of that association.

Study design

  • 2063 twin children born between January 1994 and December 1995 were followed up from birth to 18 years of age.
  • Participants were privately interviewed about psychotic experiences occurring since 12 years of age.
  • Funding: National Institute of Child Health and Human Development.

Key results

  • Higher rates of psychotic experiences were reported by adolescents in the highest vs lowest quartile of annual levels of:
    • NOx (aOR, 1.72; P<.001>
    • NO2 (aOR, 1.71; P<.001>
    • PM2.5 (aOR, 1.45; P<.01>
  • Psychotic experiences were more common among adolescents residing in urban vs rural neighborhoods at 18 years of age (OR, 1.93; 95% CI, 1.35-2.75).
  • NO2 and NOx together statistically explained 60% of association between urbanicity and adolescent psychotic experiences.

Limitations

  • Adolescent psychotic experiences not verified clinically.
  • Limited generalizability.

Coauthored with Antara Ghosh, PhD