Ilaria Tarricone1,2, Giuseppe D'Andrea1,3, Hannah E Jongsma4,5, Sarah Tosato6, Charlotte Gayer-Anderson7, Simona A Stilo8,9, Federico Suprani1, Conrad Iyegbe9, Els van der Ven10,11, Diego Quattrone12, Marta di Forti12, Eva Velthorst13,14, Paulo Rossi Menezes15, Celso Arango16, Mara Parellada16, Antonio Lasalvia6, Caterina La Cascia17, Laura Ferraro17, Julio Bobes18, Miguel Bernardo19, Iulio Sanjuán20, Jose Luis Santos21, Manuel Arrojo22, Cristina Marta Del-Ben23, Giada Tripoli9,24, Pierre-Michel Llorca25, Lieuwe de Haan13, Jean-Paul Selten11, Andrea Tortelli26, Andrei Szöke27, Roberto Muratori2, Bart P Rutten11, Jim van Os9,11,28, Peter B Jones5,29, James B Kirkbride4, Domenico Berardi3, Robin M Murray9, Craig Morgan7. 1. Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy. 2. Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy. 3. Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy. 4. PsyLife Group, Division of Psychiatry, UCL, London, England. 5. Department of Psychiatry, University of Cambridge, Cambridge, England. 6. Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. 7. Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK. 8. Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy. 9. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England. 10. Mailman School of Public Health, Columbia University, New York, NY, USA. 11. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands. 12. Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK. 13. Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. 14. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA. 15. University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil. 16. Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain. 17. Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129, Palermo, Italy. 18. Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain. 19. Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain. 20. Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain. 21. Department of Psychiatry, Servicio de Psiquiatría Hospital 'Virgen de la Luz', Cuenca, Spain. 22. Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain. 23. Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, Brazil. 24. Department of Biomedicine, neurosciences, and advanced diagnostics, University of Palermo, Italy. 25. Université Clermont Auvergne, EA 7280 Npsydo, Clermont-Ferrand, France. 26. Etablissement Public de Santé Maison Blanche, Paris, France. 27. Univ Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Fondation FondaMental, F-94010Creteil, France. 28. Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands. 29. CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England.
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.
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.
Authors: Giulia Menculini; Francesco Bernardini; Luigi Attademo; Pierfrancesco Maria Balducci; Tiziana Sciarma; Patrizia Moretti; Alfonso Tortorella Journal: Int J Environ Res Public Health Date: 2021-04-08 Impact factor: 3.390
Authors: Grace E Woolway; Sophie E Smart; Amy J Lynham; Jennifer L Lloyd; Michael J Owen; Ian R Jones; James T R Walters; Sophie E Legge Journal: Schizophr Bull Date: 2022-09-01 Impact factor: 7.348