Childhood residential mobility, schizophrenia, and bipolar disorder: a population-based study in Denmark

Abstract

Introduction: Childhood adversity is gaining increasing attention as a plausible etiological factor in the development of psychotic disorders. Childhood residential mobility is a potential risk factor that has received little attention in this context.

Methods: We used registry data to estimate associations of residential mobility with narrow and broad schizophrenia and bipolar disorder across the course of childhood among 1.1 million individuals born in Denmark 1971-1991 and followed from age 15 through 2010. We assessed effect modification by sex, family history of mental disorder, the presence of siblings close in age, and distance moved.

Results: In individual-year models adjusted for family history, urbanicity at birth, and parental age, mobility at all ages except the year of birth was associated with heightened risk of narrow and broad schizophrenia, and risk increased with age at moving and with the number of moves. Further adjustment for mobility at all ages 0-15 revealed associations mainly during the latter half of childhood, which were strongest during adolescence. Associations between mobility and bipolar disorder were fewer and weaker compared to schizophrenia. There was modest evidence of interaction with family history of psychiatric diagnosis, but little evidence for interaction by sex, the presence of closely-aged siblings, or distance moved. Schizophrenia associations did not appear attributable to increased mobility among adolescents with earlier onset.

Conclusions: Mobility may increase risk for psychotic disorders, particularly schizophrenia. Children may be especially vulnerable during adolescence. Future research should investigate the importance of school changes and the potential for interaction with genetic risk.

Keywords: childhood adversity; epidemiology; residential mobility.

Fig. 1.

Proportion of cohort members who moved once (blue line), twice (green line), and 3 or more times (red line) by age during childhood. For a color version, see this figure online.

Fig. 2.

Relative risks and 95% confidence intervals (vertical lines) of narrowly defined schizophrenia (A), broadly defined schizophrenia (B), and bipolar disorder (C) associated with moving each year from birth through age 14. Blue lines represent RRs for 1 move. Green lines represent RRs for 2 moves for narrow and broad schizophrenia and 2 or more moves for bipolar disorder. Red lines represent 3 or more moves. Estimates are adjusted for age, sex, calendar year, birth period, parental age, urbanicity level at birth, and history of mental disorder in a parent or sibling. For a color version, see this figure online.

Fig. 3.

Relative risks and 95% confidence intervals (vertical lines) of narrowly defined schizophrenia (A), broadly defined schizophrenia (B), and bipolar disorder (C) associated with moving each year from birth through age 14. Blue lines represent RRs for 1 move. Green lines represent RRs for 2 moves for narrow and broad schizophrenia and 2 or more moves for bipolar disorder. Red lines represent 3 or more moves. Estimates are adjusted for age, sex, calendar year, birth period, parental age, urbanicity level at birth, history of mental disorder in a parent or sibling, and mobility at all other ages. For a color version, see this figure online.