b'Social Determinants of Health Can Predict Schizophrenia in Veterans Among the most complex patients treated in the VA healthcare system are those with serious mental illnesses, including the more than 120,000diagnosed with schizophrenia. Those veterans not only tend to have worse physician function as they age but also are more likely to engage in suicidal behavior.To better understand what increases the risk of schizophrenia and other serious mental illnesses, VA researchers are taking a close look at social determinants of health.By Brenda L. MooneySANDIEGOSchizophreniaandotherseriousrefugees and asylees, the authors wrote. mental illnesses put veterans at higher risk of sui- Thestudyalsofoundthatschizophreniawas cidalbehaviorandsignificantlycompromisetheincreasinglyprevalentwithsocialfragmentation physical health of older VHA patients. Thats whyand that homeless populations had a 30-fold higher VA researchers are seeking to better understandingprevalence of schizophrenia than the general popula-the causes of schizophrenia-spectrum psychotic dis- tion. Among the prison population, the prevalence of orders (SSPD). nonaffective psychosis was 2.0%-6.5%, compared to More than 120,000 veterans receiving VHA care0.3% in the general population. have been diagnosed with schizophrenia, accordingThe consequences could be dire, the authors wrote, to 2014 study. 1 withseriouslymentallyillpeople2.7timesmore Onepromisingareaofstudyissocialdetermi- likely to report food insecurity than controls. nants of health (SDoHs). A new study involving VASDoHsareassociatedwithhigherratesofand researchers from San Diego and Miami performedworse outcomes in SSPD, the authors wrote. Well-a scoping review of meta-analyses and systematicdesigned longitudinal studies are needed to under-reviews of nine major SDoHs in SSPD. An impetusstand SDoHs contribution to health in persons with was SSPD patients heightened risk of comorbidi- SSPD, to develop interventions, and to implement ties, cognitive and functional decline, according tochanges in clinical care and public health policies the authors. that would reduce adverse health impacts of SDoHs. The study in the Schizophrenia Bulletin found thePositive SDoHs deserve greater attention.followingtobemajorriskfactorsforthegreater incidence of SSPD, as well as worse health: 2 Self-Injurious Behavior childhood abuse,A recent VA study appearing as a preprint prior toparental psychopathology,publication pointed out that patients diagnosed withparental communication problems,schizophrenia (SCZ) or bipolar I disorder (BPI) arebullying, andat high risk for self-injurious behavior, suicidal ide- urban settings with lower socioeconomic status. ation and suicidal behaviors (SB). Characterizing Ontheotherhand,socialnetworksizewasassociations between diagnosed mental and physical inversely associated with overall psychopathologyhealth problems, prior pharmacological treatments, and negative symptoms.and aggregate genetic factors has potential to inform Experiencesofracial/ethnicdiscriminationcor- riskstratificationandmitigationstrategies,the related with the prevalence of psychotic symptomsstudy team wrote. 3and experiences. Compared to native populations,Researchersfocusedon3,942SCZand5,414 theriskofpsychosiswashigherinimmigrants,BPIpatientsreceivingVAcare.Theyassessed 28'