Brian O'Donoghue1,2, Hellen Geros3,4, Holly Sizer3,4, Jean Addington5, G Paul Amminger3,4,6, Carrie E Beaden7, Kristin S Cadenhead8, Tyrone D Cannon9, Barbara A Cornblatt10, Gregor Emanuel Berger11, Eric Y H Chen12, Lieuwe de Haan13, Jessica A Hartmann3,4, Ian B Hickie14, Helga K Ising15, Suzie Lavoie3,4, Ashleigh Lin16, Connie Markulev3,4, Daniel H Mathalon17,18, Thomas H McGlashan19, Nathan G Mifsud3,4, Nilufar Mossaheb6, Dorien H Nieman13, Merete Nordentoft20, Diana O Perkins21, Anita Riecher-Rössler22, Miriam R Schäfer3,4, Monika Schlögelhofer6, Larry J Seidman23,24, Stephan Smesny25, Andrew Thompson3,4, Ming T Tsuang8, Mark van der Gaag15,26, Swapna Verma27, Elaine F Walker28, Stephen J Wood3,4, Scott W Woods19, Hok Pan Yuen3,4, Alison Ruth Yung3,4,29, Patrick D McGorry3,4, Barnaby Nelson3,4. 1. Orygen, Melbourne, Australia. brian.odonoghue@orygen.org.au. 2. Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia. brian.odonoghue@orygen.org.au. 3. Orygen, Melbourne, Australia. 4. Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia. 5. Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. 6. Department of Psychiatry, Medical University of Vienna, Vienna, Austria. 7. Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA. 8. Department of Psychiatry, UCSD, San Diego, CA, USA. 9. Department of Psychology, Yale University, New Haven, CT, USA. 10. Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, USA. 11. Child and Adolescent Psychiatric Service of the Canton of Zurich, Zürich, Switzerland. 12. Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong. 13. Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands. 14. Brain and Mind Research Institute, University of Sydney, Sydney, Australia. 15. Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands. 16. Telethon Kids Institute, Perth, Australia. 17. Department of Psychiatry, UCSF, San Francisco, CA, USA. 18. SFVA Medical Center, San Francisco, CA, USA. 19. Department of Psychiatry, Yale University, New Haven, CT, USA. 20. Psychiatric Centre Bispebjerg, Copenhagen, Denmark. 21. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. 22. Psychiatric University Clinics Basel, Basel, Switzerland. 23. Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, USA. 24. Massachusetts General Hospital, Boston, MA, USA. 25. Department of Psychiatry, University Hospital Jena, Jena, Germany. 26. Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit , Amsterdam, The Netherlands. 27. Institute of Mental Health, Singapore, Singapore. 28. Department of Psychology, Emory University, Atlanta, GA, USA. 29. Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, England.
Abstract
PURPOSE: Migrant status is one of the most replicated and robust risk factors for developing a psychotic disorder. This study aimed to determine whether migrant status in people identified as Ultra-High Risk for Psychosis (UHR) was associated with risk of transitioning to a full-threshold psychotic disorder. METHODS: Hazard ratios for the risk of transition were calculated from five large UHR cohorts (n = 2166) and were used to conduct a meta-analysis using the generic inverse-variance method using a random-effects model. RESULTS: 2166 UHR young people, with a mean age of 19.1 years (SD ± 4.5) were included, of whom 221 (10.7%) were first-generation migrants. A total of 357 young people transitioned to psychosis over a median follow-up time of 417 days (I.Q.R.147-756 days), representing 17.0% of the cohort. The risk of transition to a full-threshold disorder was not increased for first-generation migrants, (HR = 1.08, 95% CI 0.62-1.89); however, there was a high level of heterogeneity between studies The hazard ratio for second-generation migrants to transition to a full-threshold psychotic disorder compared to the remainder of the native-born population was 1.03 (95% CI 0.70-1.51). CONCLUSIONS: This meta-analysis did not find a statistically significant association between migrant status and an increased risk for transition to a full-threshold psychotic disorder; however, several methodological issues could explain this finding. Further research should focus on examining the risk of specific migrant groups and also ensuring that migrant populations are adequately represented within UHR clinics.
PURPOSE: Migrant status is one of the most replicated and robust risk factors for developing a psychotic disorder. This study aimed to determine whether migrant status in people identified as Ultra-High Risk for Psychosis (UHR) was associated with risk of transitioning to a full-threshold psychotic disorder. METHODS: Hazard ratios for the risk of transition were calculated from five large UHR cohorts (n = 2166) and were used to conduct a meta-analysis using the generic inverse-variance method using a random-effects model. RESULTS: 2166 UHR young people, with a mean age of 19.1 years (SD ± 4.5) were included, of whom 221 (10.7%) were first-generation migrants. A total of 357 young people transitioned to psychosis over a median follow-up time of 417 days (I.Q.R.147-756 days), representing 17.0% of the cohort. The risk of transition to a full-threshold disorder was not increased for first-generation migrants, (HR = 1.08, 95% CI 0.62-1.89); however, there was a high level of heterogeneity between studies The hazard ratio for second-generation migrants to transition to a full-threshold psychotic disorder compared to the remainder of the native-born population was 1.03 (95% CI 0.70-1.51). CONCLUSIONS: This meta-analysis did not find a statistically significant association between migrant status and an increased risk for transition to a full-threshold psychotic disorder; however, several methodological issues could explain this finding. Further research should focus on examining the risk of specific migrant groups and also ensuring that migrant populations are adequately represented within UHR clinics.
Entities:
Keywords:
Migrants; Psychotic disorders; Ultra-high risk for psychosis
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