Veling Wim, Susser Ezra, van Os Jim, Mackenbach Johan P, Selten Jean-Paul, Hoek Hans W
Parnassia Psychiatric Institute, Mangostraat 15, 2552 KS, The Hague, the Netherlands.
Am J Psychiatry. 2008 Jan;165(1):66-73. doi: 10.1176/appi.ajp.2007.07030423. Epub 2007 Dec 17.
A high incidence of psychotic disorders has been reported in immigrant ethnic groups in Western Europe. Some studies suggest that ethnic density may influence the incidence of schizophrenia. The authors investigated whether this increased incidence among immigrants depends on the ethnic density of the neighborhoods in which they live.
This was a prospective first-contact incidence study of psychotic disorders in The Hague, by ethnicity and neighborhood of residence. Over a 7-year period, individuals who made contact with a physician for a suspected psychotic disorder underwent diagnostic interviews and received DSM-IV diagnoses. A comprehensive municipal registration system provided the denominator for incidence rates. Data were sufficient to examine incidence rates in native Dutch and in first- and second-generation immigrants from Morocco, Suriname, and Turkey. The ethnic density of a neighborhood was computed for each immigrant group as the proportion of residents belonging to that group. Multilevel regression analyses predicted the incidence of psychotic disorders as a function of individual ethnicity and neighborhood ethnic density. Models were fitted for all immigrants together and for each immigrant group separately.
A total of 226 native Dutch and 240 immigrants were diagnosed as having a psychotic disorder. Compared with native Dutch, the adjusted incidence rate ratio for immigrants was significantly increased in low-ethnic-density neighborhoods (2.36) but not in high-ethnic-density neighborhoods (1.25). There was a strong interaction between individual ethnicity and neighborhood ethnic density as predictors of incidence of illness. These findings were consistent across all immigrant groups.
The incidence of psychotic disorders was elevated most significantly among immigrants living in neighborhoods where their own ethnic group comprised a small proportion of the population.
据报道，西欧移民族群中精神障碍的发病率很高。一些研究表明，族群密度可能会影响精神分裂症的发病率。作者调查了移民中这种发病率的增加是否取决于他们居住社区的族群密度。
这是一项在海牙进行的关于精神障碍的前瞻性首次接触发病率研究，按种族和居住社区划分。在7年的时间里，因疑似精神障碍与医生接触的个体接受了诊断访谈并获得了DSM-IV诊断。一个全面的市政登记系统提供了发病率的分母。数据足以检查荷兰本土居民以及来自摩洛哥、苏里南和土耳其的第一代和第二代移民的发病率。为每个移民群体计算社区的族群密度，即属于该群体的居民比例。多水平回归分析预测精神障碍的发病率是个体种族和社区族群密度的函数。模型分别针对所有移民以及每个移民群体进行拟合。
共有226名荷兰本土居民和240名移民被诊断患有精神障碍。与荷兰本土居民相比，在低族群密度社区，移民的调整发病率比显著增加（2.36），但在高族群密度社区则没有（1.25）。作为疾病发病率预测因素的个体种族和社区族群密度之间存在强烈的相互作用。所有移民群体的这些发现都是一致的。
在其族群在当地人口中占比小的社区中生活的移民，精神障碍的发病率升高最为显著。
