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Risk of psychotic disorders in migrants to Australia

Published online by Cambridge University Press:  30 January 2020

Brian O'Donoghue Open the ORCID record for Brian O'Donoghue [Opens in a new window] ,
Linglee Downey ,
Scott Eaton ,
Nathan Mifsud ,
James B. Kirkbride  and
Patrick McGorry
Brian O'Donoghue*
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia Orygen Youth Health, Melbourne, Australia
Linglee Downey
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
Scott Eaton
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
Nathan Mifsud
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
James B. Kirkbride
Affiliation:
Psylife Group, Division of Psychiatry, University College London, London, England
Patrick McGorry
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
*
Author for correspondence: Brian O'Donoghue, E-mail: [email protected]
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Abstract

Background

Certain migrant groups are at an increased risk of psychotic disorders compared to the native-born population; however, research to date has mainly been conducted in Europe. Less is known about whether migrants to other countries, with different histories and patterns of migration, such as Australia, are at an increased risk for developing a psychotic disorder. We tested this for first-generation migrants in Melbourne, Victoria.

Methods

This study included all young people aged 15–24 years, residing in a geographically-defined catchment area of north western Melbourne who presented with a first episode of psychosis (FEP) to the Early Psychosis Prevention and Intervention Centre (EPPIC) between 1 January 2011 and 31 December 2016. Data pertaining to the at-risk population were obtained from the Australian 2011 Census and incidence rate ratios were calculated and adjusted for age, sex and social deprivation.

Results

In total, 1220 young people presented with an FEP during the 6-year study period, of whom 24.5% were first-generation migrants. We found an increased risk for developing psychotic disorder in migrants from the following regions: Central and West Africa (adjusted incidence rate ratio [aIRR] = 3.53, 95% CI 1.58–7.92), Southern and Eastern Africa (aIRR = 3.06, 95% CI 1.99–4.70) and North Africa (aIRR = 5.03, 95% CI 3.26–7.76). Migrants from maritime South East Asia (aIRR = 0.39, 95% CI 0.23–0.65), China (aIRR = 0.25, 95% CI 0.13–0.48) and Southern Asia (aIRR = 0.44, 95% CI 0.26–0.76) had a decreased risk for developing a psychotic disorder.

Conclusion

This clear health inequality needs to be addressed by sufficient funding and accessible mental health services for more vulnerable groups. Further research is needed to determine why migrants have an increased risk for developing psychotic disorders.

Keywords

First-episode psychosisincidencemigrantsmigrationpsychotic disordersrisk
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 7 , May 2021 , pp. 1192 - 1200
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Copyright
Copyright © Cambridge University Press 2020

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References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: American Psychiatric Press Inc.Google Scholar
Anderson, K. K., Cheng, J., Susser, E., McKenzie, K. J., & Kurdyak, P. (2015). Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario. Canadian Medical Association Journal, 187(9), E279–e286. doi: 10.1503/cmaj.141420CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics. (2011). Migration, Australia 2010–2011. Retrieved from www.abs.gov.auGoogle Scholar
Australian Bureau of Statistics. (2012). Year Book Australia, 2012. Humanitarian Arrivals. Retrieved from www.abs.gov.auGoogle Scholar
Australian Bureau of Statistics. (2016a). Characteristics of Recent Migrants, Australia. Retrieved from www.abs.gov.auGoogle Scholar
Australian Bureau of Statistics. (2016b). Census of Population and Housing: Understanding the Census and Census Data, Australia. Retrieved from www.abs.gov.au/ausstats/Google Scholar
Australian Bureau of Statistics. (2017a). Census reveals a fast changing, culturally diverse nation. 2016 Census: Multicultural. Retrieved from http://www.abs.gov.au/ausstats/[email protected]/MediaRealesesByCatalogue/05DEE7DFCA9C2E00CA25814800090FB2?OpenDocumentGoogle Scholar
Australian Bureau of Statistics. (2017b). Standard Australian Classification of Countries. Second. Retrieved from http://www.abs.gov.au/ausstats/[email protected]/0/C8B8914F6C683351CA25744D00818CED?opendocumentGoogle Scholar
Black, E. B., Ranmuthugala, G., Kondalsamy-Chennakesavan, S., Toombs, M. R., Nicholson, G. C., & Kisely, S. (2015). A systematic review: Identifying the prevalence rates of psychiatric disorder in Australia's indigenous populations. Australian and New Zealand Journal of Psychiatry, 49(5), 412–429. doi: 10.1177/0004867415569802CrossRefGoogle ScholarPubMed
Brandt, L., Henssler, J., Muller, M., Wall, S., Gabel, D., & Heinz, A. (2019). Risk of psychosis among refugees: A systematic review and meta-analysis. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2019.1937. Published online ahead of print.CrossRefGoogle ScholarPubMed
Cannon, M., Jones, P. B., & Murray, R. M. (2002). Obstetric complications and schizophrenia: Historical and meta-analytic review. American Journal of Psychiatry, 159(7), 1080–1092.CrossRefGoogle ScholarPubMed
Cantor-Graae, E., & Selten, J. P. (2005). Schizophrenia and migration: A meta-analysis and review. American Journal of Psychiatry, 162(1), 12–24. doi: 10.1176/appi.ajp.162.1.12CrossRefGoogle ScholarPubMed
Dykxhoorn, J., Hollander, A. C., Lewis, G., Dalman, C., & Kirkbride, J. B. (2019). Family networks during migration and risk of non-affective psychosis: A population-based cohort study. Schizophrenia Research, 208, 268–275. doi: 10.1016/j.schres.2019.01.044CrossRefGoogle ScholarPubMed
Eaton, S., Harrap, B., Downey, L., Thien, K., Bowtell, M., Bardell-Williams, M., … O'Donoghue, B. (2019). Incidence of treated first episode psychosis from an Australian early intervention service and its association with neighbourhood characteristics. Schizophrenia Research, 209, 206–211. doi:10.1016/j.schres.2019.04.017CrossRefGoogle ScholarPubMed
Fearon, P., Kirkbride, J. B., Morgan, C., Dazzan, P., Morgan, K., Lloyd, T., … Murray, R. M. (2006). Incidence of schizophrenia and other psychoses in ethnic minority groups: Results from the MRC AESOP study. Psychological Medicine, 36(11), 1541–1550. doi:10.1017/s0033291706008774CrossRefGoogle ScholarPubMed
Fearon, P., & Morgan, C. (2006). Environmental factors in schizophrenia: The role of migrant studies. Schizophrenia Bulletin, 32(3), 405–408. doi: 10.1093/schbul/sbj076CrossRefGoogle ScholarPubMed
Harrison, G., Glazebrook, C., Brewin, J., Cantwell, R., Dalkin, T., Fox, R., … Medley, I. (1997). Increased incidence of psychotic disorders in migrants from the Caribbean to the United Kingdom. Psychological Medicine, 27(4), 799–806.10.1017/S0033291796004643CrossRefGoogle ScholarPubMed
Harrison, G., Holton, A., Neilson, D., Owens, D., Boot, D., & Cooper, J. (1989). Severe mental disorder in Afro-Caribbean patients: Some social, demographic and service factors. Psychological Medicine, 19(3), 683–696.CrossRefGoogle ScholarPubMed
Hollander, A. C., Dal, H., Lewis, G., Magnusson, C., Kirkbride, J. B., & Dalman, C. (2016). Refugee migration and risk of schizophrenia and other non-affective psychoses: Cohort study of 1.3 million people in Sweden. British Medical Journal, 352, i1030. doi: 10.1136/bmj.i1030CrossRefGoogle ScholarPubMed
Kirkbride, J. B. (2015). Epidemiology on demand: Population-based approaches to mental health service commissioning. British Journal of Psychiatry Bulletin, 39(5), 242–247. doi: 10.1192/pb.bp.114.047746Google ScholarPubMed
Kirkbride, J. B., Errazuriz, A., Croudace, T. J., Morgan, C., Jackson, D., Boydell, J., … Jones, P. B. (2012). Incidence of schizophrenia and other psychoses in England, 1950–2009: A systematic review and meta-analyses. PLoS ONE, 7(3), e31660.10.1371/journal.pone.0031660CrossRefGoogle ScholarPubMed
Kirkbride, J. B., Hameed, Y., Ioannidis, K., Ankireddypalli, G., Crane, C. M., Nasir, M., … Jones, P. B. (2017). Ethnic minority status, age-at-immigration and psychosis risk in rural environments: Evidence from the SEPEA study. Schizophrenia Bulletin, 43(6), 1251–1261. doi:10.1093/schbul/sbx010CrossRefGoogle ScholarPubMed
Kirkbride, J. B., Stubbins, C., & Jones, P. B. (2012). Psychosis incidence through the prism of early intervention services. British Journal of Psychiatry, 200(2), 156–157. doi: 10.1192/bjp.bp.111.094896CrossRefGoogle ScholarPubMed
McGrath, J., El-Saadi, O., Cardy, S., Chapple, B., Chant, D., & Mowry, B. (2001). Urban birth and migrant status as risk factors for psychosis: An Australian case-control study. Social Psychiatry and Psychiatric Epidemiology, 36(11), 533–536.10.1007/s001270170003CrossRefGoogle ScholarPubMed
Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B., Burke, M., & Lewis, G. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: A systematic review. Lancet, 370(9584), 319–328.CrossRefGoogle ScholarPubMed
Morgan, C., Charalambides, M., Hutchinson, G., & Murray, R. M. (2010). Migration, ethnicity, and psychosis: Toward a sociodevelopmental model. Schizophrenia Bulletin, 36(4), 655–664. doi: 10.1093/schbul/sbq051CrossRefGoogle Scholar
Morgan, C., Knowles, G., & Hutchinson, G. (2019). Migration, ethnicity and psychoses: Evidence, models and future directions. World Psychiatry, 18(3), 247–258. doi: 10.1002/wps.20655CrossRefGoogle ScholarPubMed
Mortensen, P. B., Pedersen, M. G., & Pedersen, C. B. (2010). Psychiatric family history and schizophrenia risk in Denmark: Which mental disorders are relevant? Psychological Medicine, 40(2), 201–210. doi: 10.1017/s0033291709990419CrossRefGoogle ScholarPubMed
Nielssen, O., Sara, G., Lim, Y., & Large, M. (2013). Country of birth and hospital treatment for psychosis in New South Wales. Social Psychiatry and Psychiatric Epidemiology, 48(4), 613–620.10.1007/s00127-012-0577-7CrossRefGoogle ScholarPubMed
O'Donoghue, B., Roche, E., & Lane, A. (2016). Neighbourhood level social deprivation and the risk of psychotic disorders: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 51(7), 941–950. doi: 10.1007/s00127-016-1233-4CrossRefGoogle ScholarPubMed
Parliament-of-Australia. (2017). Refugee resettlement to Australia: what are the facts? https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1617/RefugeeResettlement#_Toc461022111Google Scholar
Popovic, D., Schmitt, A., Kaurani, L., Senner, F., Papiol, S., Malchow, B., … Falkai, P. (2019). Childhood trauma in schizophrenia: Current findings and research perspectives. Frontiers in Neuroscience, 13, 274. doi:10.3389/fnins.2019.00274CrossRefGoogle ScholarPubMed
Schofield, P., Thygesen, M., Das-Munshi, J., Becares, L., Cantor-Graae, E., Pedersen, C., & Agerbo, E. (2017). Ethnic density, urbanicity and psychosis risk for migrant groups: A population cohort study. Schizophrenia Research, 190, 82–87. doi: 10.1016/j.schres.2017.03.032CrossRefGoogle ScholarPubMed
Selten, J. P., van der Ven, E., & Termorshuizen, F. (2019). Migration and psychosis: A meta-analysis of incidence studies. Psychological Medicine, 50, 303–313. doi: 10.1017/s0033291719000035CrossRefGoogle ScholarPubMed
StataCorp. (2015). Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.Google Scholar
Veling, W. (2013). Ethnic minority position and risk for psychotic disorders. Current Opinion in Psychiatry, 26(2), 166–171. doi: 10.1097/YCO.0b013e32835d9e43CrossRefGoogle ScholarPubMed
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