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Migration and psychosis: a meta-analysis of incidence studies

Psychological medicine, 2020-01, Vol.50 (2), p.303-313 [Peer Reviewed Journal]

Copyright Cambridge University Press Jan 2020 ;Cambridge University Press 2019 2019 Cambridge University Press ;ISSN: 0033-2917 ;EISSN: 1469-8978 ;DOI: 10.1017/s0033291719000035 ;PMID: 30722795

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  • Title:
    Migration and psychosis: a meta-analysis of incidence studies
  • Author: Selten, Jean-Paul ; van der Ven, Els ; Termorshuizen, Fabian
  • Subjects: Age ; Attribution ; Causality ; Developing countries ; Estimates ; LDCs ; Meta-analysis ; Migrants ; Migration ; Original ; Population ; Population studies ; Positive selection ; Psychosis ; Quality ; Risk factors ; Second generation ; Skin color ; Social exclusion ; Socioeconomic status ; Systematic review
  • Is Part Of: Psychological medicine, 2020-01, Vol.50 (2), p.303-313
  • Description: The aims of this meta-analysis are (i) to estimate the pooled relative risk (RR) of developing non-affective psychotic disorder (NAPD) and affective psychotic disorder (APD) among migrants and their children; (ii) to adjust these results for socioeconomic status (SES); (iii) to examine the sources of heterogeneity that underlie the risk of NAPD. We included population-based incidence studies that reported an age-adjusted RR with 95% confidence interval (CI) published 1 January 1977-12 October 2017 and used a random-effects model. We retrieved studies performed in Europe (n = 43), Israel (n = 3), Canada (n = 2) and Australia (n = 1). The meta-analysis yielded a RR, adjusted for age and sex, of 2.13 (95% CI 1.99-2.27) for NAPD and 2.94 (95% CI 2.28-3.79) for APD. The RRs diminished, but persisted after adjustment for SES. With reference to NAPD: a personal or parental history of migration to Europe from countries outside Europe was associated with a higher RR (RR = 2.94, 95% CI 2.63-3.29) than migration within Europe (RR = 1.88, 95% 1.62-2.18). The corresponding RR was lower in Israel (RR = 1.22; 0.99-1.50) and Canada (RR = 1.21; 0.85-1.74). The RR was highest among individuals with a black skin colour (RR = 4.19, 95% CI 3.42-5.14). The evidence of a difference in risk between first and second generation was insufficient. Positive selection may explain the low risk in Canada, while the change from exclusion to inclusion may do the same in Israel. Given the high risks among migrants from developing countries in Europe, social exclusion may have a pathogenic role.
  • Publisher: England: Cambridge University Press
  • Language: English
  • Identifier: ISSN: 0033-2917
    EISSN: 1469-8978
    DOI: 10.1017/s0033291719000035
    PMID: 30722795
  • Source: ProQuest One Psychology
    ProQuest Central
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