Do you live in a city? That means your mental wellbeing is at risk

You're more likely to hear voices inside your head due to the stress of urban-living

Living in a city significantly increases the risk of psychotic experiences, such as hearing voices and paranoia, research has shown. Young people growing up in urban areas were 40% more likely to have had such episodes than their rural counterparts – compare Karachi that’s chockfull crime to Khalti in Gilgit Blatistan where people are reportedly happier because they feel safer. For those living in areas with more crime, a whopping 62% reported psychotic experiences, stated Daily Mail.

Dr Helen Fisher, one of the researchers from King's College, explained, “These findings highlight the importance of early, preventative strategies for reducing psychosis risk and suggests that adolescents living in threatening neighbourhoods within cities should be made a priority”

A team from King’s College London and Duke University analysed 2,000 18-year-olds in major. They ranked participants on levels of ‘urbanicity’ and measured neighbourhood social factors through surveys of over 5,000 immediate neighbours of the participants. Personal experience by violent crime was assessed through interviews with participants.



The researchers discovered that among adolescents living in the largest and most densely populated cities, more than a third (34%) reported psychotic symptoms between the age of 12 and 18.

Participants were classed as having suffered from psychosis if they had reported at least one of 13 experiences, which included hearing voices, believing spies were watching them or their food was being poisoned. Just over 21% of adolescents living in more favourable neighbourhoods reported psychotic symptoms.

This meant the rate of psychotic experiences was almost three times greater for young residents in higher crime areas. The researchers suggest a number of reasons why living in a city, such as Karachi, could pose a risk for psychotic experiences, including a heightened biological response to stress, which can in turn disrupt the activity of dopamine in the brain.

Excess dopamine is the best biological explanation researchers currently have for psychotic illnesses such as schizophrenia. Almost half of the association between city life and psychotic experiences was explained by factors such as lack of trust and support between neighbours, and high levels of threat in the neighbourhood.



Adolescents growing up in threatening neighbourhoods – think the less privileged areas of Pakistan -could also develop what the team calls 'maladaptive cognitive responses', such as hypervigilance - that is becoming excessively aware of potential threats. They may also attribute negative intentions to people, which might lead them to become paranoid about those around them.

Up to one in three young people are thought to encounter psychotic experiences at some point, the researchers noted.  These individuals are at an increased risk of developing schizophrenia and other forms of mental illness as adults, they warn. They are also a group at risk of suicide.

Previous research by the same team found higher rates of psychotic symptoms among children living in cities. Co-author Jo Newbury, also from King's College, shared, “Our study suggests that the effects of city life on psychotic experiences are not limited to childhood but continue into late adolescence, which is one of the peak ages at which clinical psychotic disorders are typically diagnosed.”

Have something to add to the story? Share it in the comments below.