People in low social classes delay seeking treatment for schizophrenia

People born into low social classes are not at increased risk of developing schizophrenia, but they appear to seek treatment at a later age than those in higher social classes, concludes a study in this week's BMJ.

Fiona Mulvany and colleagues used the records of 352 patients referred to psychiatric services in Dublin to determine whether social class of origin influenced the risk of schizophrenia and the age at which patients first made contact with psychiatric services.

They found no link between social class at birth and risk of schizophrenia, but found more than an eight year difference in age at presentation to psychiatric services between the lowest and highest social classes.

People from lower social classes may find it more difficult to access services, suggest the authors. Alternatively, people from the higher social classes may be better informed about schizophrenia or find it easier to identify deviations from normal daily functioning.

This delay in treatment may, at least partly, explain why people in low social classes have a poor outcome, add the authors. Efforts to reduce the duration of untreated psychosis through earlier detection should be particularly focused on people in lower social classes, they conclude.