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Perceived ethnic discrimination as a risk factor for psychotic symptoms: a systematic review and meta-analysis

Published online by Cambridge University Press:  22 April 2020

Olivier Bardol ,
Stéphanie Grot ,
Hans Oh ,
Emmanuel Poulet ,
Halima Zeroug-Vial ,
Jérôme Brunelin  and
Edouard Leaune Open the ORCID record for Edouard Leaune [Opens in a new window]
Olivier Bardol
Affiliation:
Grenoble Alpes University, School of Medicine, Grenoble, France
Stéphanie Grot
Affiliation:
Centre de recherche, Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
Hans Oh
Affiliation:
University of Southern California, Los Angeles, USA
Emmanuel Poulet
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response – PSYR2 Team, Lyon, F-69000, France University Lyon 1, Villeurbanne, F-69000, France Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France
Halima Zeroug-Vial
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France
Jérôme Brunelin
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response – PSYR2 Team, Lyon, F-69000, France University Lyon 1, Villeurbanne, F-69000, France
Edouard Leaune*
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response – PSYR2 Team, Lyon, F-69000, France University Lyon 1, Villeurbanne, F-69000, France Institute for Philosophical Research, Lyon 3 University, Lyon, France
*
Author for correspondence: Edouard Leaune, E-mail: [email protected]
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Abstract

Background

Previous studies have shown an elevated risk of psychotic symptoms (PS) and experiences (PEs) among ethnic minority groups, with significant variation between groups. This pattern may be partially attributable to the unfavorable socio-environmental conditions that surround ethnic minority groups. Perceived ethnic discrimination (PED) in particular has been a salient putative risk factor to explain the increased risk.

Methods

We conducted a systematic literature review and meta-analysis to assess the impact of PED on reporting PS/PEs in ethnic minorities. This review abides by the guidelines set forth by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The included studies were obtained from the databases: Medline, PsycINFO, and Web Of Science. Sub-group analyses were performed assessing the effect of PED in different subtypes of PS, the influence of ethnicity and moderating/mediating factors.

Results

Seventeen studies met the inclusion criteria, and nine were used to conduct the meta-analysis. We found a positive association between PED and the occurrence of PS/PEs among ethnic minorities. The combined odds ratio were 1.77 (95% CI 1.26–2.49) for PS and 1.94 (95% CI 1.42–2.67) for PEs. We found that the association was similar across ethnic groups and did not depend on the ethnic origin of individuals. Weak evidence supported the buffering effects of ethnic identity, collective self-esteem and social support; and no evidence supported the moderating effect of ethnic density. Sensitivity to race-based rejection significantly but only slightly mediated the association.

Conclusion

These findings suggest that PED is involved in the increased risk of PS/PEs in ethnic minority populations.

Keywords

Psychotic symptomsracismsocial determinants of healthsocial environment
Type
Review Article
Information
Psychological Medicine , Volume 50 , Issue 7 , May 2020 , pp. 1077 - 1089
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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