Migration and schizophrenia: meta-analysis and explanatory framework

Abstract

Systematic reviews and meta-analyses suggest that there are increased rates of schizophrenia and related psychoses in firstand second-generation migrants and refugees. Here, we present a meta-analysis on the incidence of non-affective psychotic disorders among first-and second-generation migrants. We found substantial evidence for an increased relative risk of incidence among first-and second-generation migrants compared to the native population. As heterogeneity of included studies was high, effect estimates should be interpreted with caution and as guiding values rather than exact risk estimates. We interpret our findings in the context of social exclusion and isolation stress, and provide an explanatory framework that links cultural differences in verbal communication and experienced discrimination with the emergence of psychotic experiences and their neurobiological correlates. In this context, we discuss studies observing stress-dependent alterations of dopamine neurotransmission in studies among migrants versus non-migrants as well as in subjects with psychotic disorders. We suggest that social stress effects can impair contextualization of the meaning of verbal messages, which can be accounted for in Bayesian terms by a reduced precision of prior beliefs relative to sensory data, causing increased prediction errors and resulting in a shift towards the literal or "concrete" meaning of words. Compensatory alterations in higher-level beliefs, e.g., in the form of generalized interpretations of ambiguous interactions as hostile behavior, may contribute to psychotic experiences in migrants. We thus suggest that experienced discrimination and social exclusion is at the core of increased rates of psychotic experiences in subjects with a migration background.

A review of mental health and wellbeing under climate change in small island developing states (SIDS)

“…Consequences can include reduced self-esteem, poor adjustment to the new location, and increased rates of depression, phobias, and schizophrenia (e.g. Bennouna et al 2019 , Henssler et al 2020 , Selten et al 2020 ). Unpublished local anecdotes from people previously affected in the Pacific by forced migration from nuclear testing indicate that psychosocial impacts of forced migration can span generations, so corroboration through research methods would be an important task.…”

Mental health of migrants

“…It can also include homelessness, lack of food and water, xenophobic attacks, poor education, perceived and experienced discrimination, and a high risk of death and injury. [ 4 5 ] Furthermore, social factors, including cultural bereavement, culture shock, social defeat, as well as a discrepancy between expectations and achievement, and acceptance by the new nation can all affect adjustment. [ 3 6 ] Further risk factors in new communities can include social exclusion, stigma, and discrimination.…”

“…In a systematic review and meta-analysis, Henssler et al . [ 5 ] suggested that there are increased rates of schizophrenia and related psychoses in first- and second-generation migrants and refugees. The meta-analysis was on the incidence of nonaffective psychotic disorders among first- and second-generation migrants.…”

Rassismus und psychische Gesundheit

“…Darauf verweisen auch Forschungsergebnisse zu Vorurteilen, Stereotypen und psychischen Belastungen. Vorurteile gegenüber Minoritäten stellen Unterstützung und Solidarität infrage und können dementsprechend zu Diskriminierung und sozialer Isolation beitragen und damit psychische Gesundheit negativ beeinträchtigen [ 6 , 43 ]. Zudem können in sozialen Interaktionen auftretende „ethnische“ und rassistische Stereotype und Vorurteile, die sich gegen Minoritäten richten, zu hohen psychischen Belastungen bei den davon betroffenen Personen führen [ 27 , 42 ].…”