Ethnic minority position and migrant status as risk factors for psychotic symptoms in the general population: a meta-analysis

Abstract

Psychotic symptoms (PS) are experienced by a substantial proportion of the general population. When not reaching a threshold of clinical relevance, these symptoms are defined as psychotic experiences (PEs) and may exist on a continuum with psychotic disorders. Unfavorable socio-environmental conditions, such as ethnic minority position (EMP) and migrant status (MS), may increase the risk of developing PS and PEs. We conducted an electronic systematic review and a meta-analysis assessing the role of EMP and MS for the development and persistence of PS in the general population. Sub-group analyses were performed investigating the influence of ethnic groups, host countries, age, types of PS, and scales. Twenty-four studies met our inclusion criteria. EMP was a relevant risk factor for reporting PS [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.22-1.70) and PEs (OR 1.36, 95% CI 1.16-1.60). The greatest risk was observed in people from the Maghreb and the Middle East ethnic groups in Europe (OR 3.30, 95% CI 2.09-5.21), in Hispanic in the USA (OR 1.98, 95% CI 1.43-2.73), and in the Black populations (OR 1.85, 95% CI 1.39-2.47). We found a significant association between MS and delusional symptoms (OR 1.47, 95% CI 1.33-1.62). We found no association between EMP and persistence of PEs.EMP was associated with increased risk of reporting PS and PEs, and the risk was higher in ethnic groups facing deprivation and discrimination. We found an association between MS and delusional symptoms. These results raise questions about the precise role of socio-environmental factors along the psychosis continuum.

Lifetime prevalence and potential determinants of psychotic experiences in the general population of Qatar

“…Our lifetime prevalence estimate was significantly higher for Arabs than non-Arabs and did not significantly differ between Arab migrants and non-migrants, but was substantially lower for non-Arab migrants. Migration was not a factor in determining PEs in our sample, which is consistent with findings from a recent meta-analysis (Leaune et al, 2018), but counter to some studies that indicate migration, social adversity, and negative social experience may be cumulative, particularly in migrant groups, in predisposing to PEs (Bourque, Ven, andMalla, 2011) andpsychosis (McKenzie et al, 2008). The context of where the migrant moves to is important, as the high rates of PEs and psychosis reported in second-generation immigrants has been attributed to psychosocial adversity (e.g.…”

The negative self-perceived health of migrants with precarious status in Montreal, Canada: A cross-sectional study

“…However, these health trends seem to deteriorate with years spent in the host country and over time migrant health statuses become closer to the native-born population, as has been observed in Canada and elsewhere [2,3,31]. Racism [10,34], poor living and working conditions [35,36], stresses of integration [17,37], unemployment, lack of social networks and lack of access to services [11] or health care [38], and more globally, deprivation [38], are all factors of vulnerability associated with immigration and reasons for health to decline among recent immigrants. In general, new immigrants experience poor socioeconomic conditions, which may lead to a deteriorating health status, and even after improvement of social conditions, their health status declines to become similar to the Canadian-born population [3] (p.108).…”

Rising inpatient numbers in forensic security hospitals of German federal state of Baden‐Württemberg: Background and explanatory approaches

“…Traub (2017) reported that 79% of forensic psychiatric patients in Baden‐Württemberg forensic psychiatric care were foreign nationals. The literature provides strong evidence that ethnic minority groups from certain world regions are diagnosed with schizophrenia at a much higher rate than others, and there are also substantial correlations among migration, social disadvantage, and the prevalence of schizophrenia (Dykxhoorn et al, 2019; Leaune et al, 2019).…”