Migration history and risk of psychosis: results from the multinational EU-GEI study

Author:

Tarricone IlariaORCID,D'Andrea GiuseppeORCID,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,Sanjuán Iulio,Santos Jose Luis,Arrojo Manuel,Del-Ben Cristina Marta,Tripoli Giada,Llorca Pierre-Michel,de Haan Lieuwe,Selten Jean-Paul,Tortelli Andrea,Szöke Andrei,Muratori Roberto,Rutten Bart P.,van Os Jim,Jones Peter B.,Kirkbride James B.,Berardi Domenico,Murray Robin M.,Morgan Craig

Abstract

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.

Publisher

Cambridge University Press (CUP)

Subject

Psychiatry and Mental health,Applied Psychology

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