학술논문
Migration history and risk of psychosis: results from the multinational EU-GEI study.
Document Type
Article
Author
Tarricone, Ilaria; D'Andrea, Giuseppe; Jongsma, Hannah E.; Tosato, Sarah; Gayer-Anderson, Charlotte; Stilo, Simona A.; Suprani, Federico; Iyegbe, Conrad; van der Ven, Els; Quattrone, Diego; di Forti, Marta; Velthorst, Eva; Rossi Menezes, Paulo; Arango, Celso; Parellada, Mara; Lasalvia, Antonio; La Cascia, Caterina; Ferraro, Laura; Bobes, Julio; Bernardo, Miguel
Source
Subject
*IMMIGRANTS
*ADVERSE childhood experiences
*CONFIDENCE intervals
*SOCIAL support
*CANNABIS (Genus)
*SUBSTANCE abuse
*PSYCHOSES
*SCHIZOPHRENIA
*MULTIPLE regression analysis
*PSYCHOLOGICAL vulnerability
*EMIGRATION & immigration
*CASE-control method
*ECOLOGY
*MANN Whitney U Test
*FISHER exact test
*SOCIOECONOMIC factors
*RISK assessment
*GENES
*DESCRIPTIVE statistics
*AGE factors in disease
*QUESTIONNAIRES
*CHI-squared test
*EMPLOYMENT
*STATISTICAL models
*ODDS ratio
*STATISTICAL sampling
*DATA analysis software
*DOSE-response relationship in biochemistry
*FAMILY history (Medicine)
*EDUCATIONAL attainment
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Language
ISSN
0033-2917
Abstract
Background: Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. Methods: We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case–control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. Results: In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06–2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02–3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03–1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672–2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose–response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06–96.47, p = 0.007). Conclusions: The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants. [ABSTRACT FROM AUTHOR]