Parnassia Group, The Hague, The Netherlands.
Curr Opin Psychiatry. 2013 Mar;26(2):166-71. doi: 10.1097/YCO.0b013e32835d9e43.
This article reviews the recent literature about migration, ethnic minority position and the risk of psychotic disorders.
A meta-analysis found that both first and second-generation migrants have on average a two-fold increase in risk for psychotic disorders. In the Netherlands, the risk was most elevated for individuals who migrated in early childhood. Several studies investigated diagnostic ethnic bias and reported greater likelihood of schizophrenia diagnosis in ethnic minority patients at the cost of diagnosis of affective psychotic disorders. Neighbourhood ethnic density was related to prevalence of psychotic experiences in ethnic minority populations in the UK. Perceived discrimination was associated with severity of psychotic and depressive symptoms in ethnic minority patients. Both weak and strong ethnic identification, as well as experiences of social adversity, were related to risk for psychosis. Low neonatal vitamin D was associated with adult risk for psychosis and vitamin D levels in childhood were associated with nonclinical psychotic experiences.
The risk for psychotic disorders is increased among ethnic minority populations. Experiences of social adversity and having a disadvantaged outsider status may explain the excess risk. More research is needed into potential biological mechanisms, including vitamin D.
本文综述了有关移民、少数民族地位和精神障碍风险的最新文献。
一项荟萃分析发现,第一代和第二代移民患精神障碍的平均风险增加了两倍。在荷兰,移民在幼儿期的风险最高。有几项研究调查了诊断中的种族偏见,并报告说,少数民族患者患精神分裂症的可能性更大,而患情感性精神病的可能性更小。在英国,少数民族人群中,邻里少数民族密度与精神病性体验的患病率有关。少数民族患者感知到的歧视与精神病和抑郁症状的严重程度有关。弱的和强的民族认同,以及社会逆境的经历,都与患精神病的风险有关。新生儿维生素 D 水平低与成年后患精神病的风险有关,儿童期的维生素 D 水平与非临床精神病性体验有关。
少数民族人群患精神障碍的风险增加。社会逆境的经历和处于不利的局外人地位可能解释了这种风险的增加。需要更多的研究来探讨潜在的生物学机制,包括维生素 D。