Parnassia Psychiatric Institute, The Hague, Maastricht, the Netherlands.
Am J Psychiatry. 2011 Dec;168(12):1278-85. doi: 10.1176/appi.ajp.2011.11010110.
The purpose of this study was to examine whether the increased risk for developing a psychotic disorder among immigrants is related to their age at the time of migration.
In a 7-year first-contact incidence study, immigrants to the Netherlands and Dutch citizens, ages 15-54 years, who made a first contact with a physician for a suspected psychotic disorder were identified. Diagnostic interviews were administered, and DSM-IV diagnoses were determined by consensus between two psychiatrists. A comprehensive municipal registration system provided the denominator, including information on ethnicity and age at the time of migration.
Lower age at the time of migration was associated with a higher incidence of psychotic disorders among immigrants. People who migrated between the ages of 0 and 4 years had the most elevated risk for psychotic disorders compared with the risk among Dutch citizens (age- and sex-adjusted incidence rate ratio=2.96, 95% confidence interval [CI]=2.10-4.17), and the risk gradually decreased with older age at migration (adjusted incidence rate ratio for migration at 5-9 years, 10-14 years, and >29 years, respectively: 2.31 [CI=1.61-3.29], 1.51 [CI=1.02-2.25], and 1.00 [CI=0.58-1.72]).
The adverse influence of migration on the risk for psychotic disorders is most prominent in early life, suggesting that this is an important period in the etiology of the illness.
本研究旨在探讨移民发生精神病障碍的风险增加是否与他们移民时的年龄有关。
在一项为期 7 年的首次接触发病研究中，确定了移民到荷兰的年龄在 15-54 岁之间、因疑似精神病障碍首次接触医生的移民和荷兰公民。进行了诊断性访谈，并由两名精神科医生进行共识诊断确定 DSM-IV 诊断。一个全面的市级登记系统提供了分母，包括种族和移民时的年龄信息。
移民时的年龄越低，移民发生精神病障碍的发病率越高。与荷兰公民相比，0-4 岁之间移民的精神病障碍发病风险最高（年龄和性别调整发病率比=2.96，95%置信区间[CI]=2.10-4.17），并且随着移民年龄的增加，发病风险逐渐降低（移民年龄为 5-9 岁、10-14 岁和>29 岁的调整发病率比分别为：2.31[CI=1.61-3.29]、1.51[CI=1.02-2.25]和 1.00[CI=0.58-1.72]）。
移民对精神病障碍发病风险的不利影响在生命早期最为明显，这表明这是疾病病因学中的一个重要时期。
