Termorshuizen Fabian, Smeets Hugo M, Braam Arjan W, Veling Wim
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands,
Soc Psychiatry Psychiatr Epidemiol. 2014 Jul;49(7):1093-102. doi: 10.1007/s00127-014-0842-z. Epub 2014 Feb 20.
Recent studies have shown increased incidence of non-affective psychotic disorders (NAPD) among ethnic minorities compared to the native population, but not, or less so, in areas with a high own-group proportion. The aim is to investigate this ethnic density effect in Utrecht and whether this effect is due to higher rates of NAPD among Dutch persons in areas with high minority proportions. We also explore the geographical scale at which this effect occurs and the influence of social drift prior to NAPD.
NAPD cases in the Psychiatric Case Registry Middle Netherlands (N = 2,064) and living in Utrecht during 2000-2009 were analyzed in a Poisson model in relation to both individual-level and district- vs. neighborhood-level characteristics.
With increasing minority density, especially of the neighborhood, the rate ratios of NAPD significantly decreased among both non-Western (from 2.36 to 1.24) and Western immigrants (from 1.63 to 1.01), in comparison with Dutch persons. This was partly explained by higher rates of NAPD among Dutch persons in areas with high minority density. But there was also a trend to lower NAPD rates among non-Western minorities in these areas (P = 0.074).This trend was significant among Surinamese/Antilleans (P = 0.001) and Moroccans aged 18-30 years (P = 0.046). Among the Dutch, a social drift to minority-dense neighborhoods prior to NAPD registration was found.
Our findings support the beneficial association with own-group presence at the smaller scale neighborhood level. Findings show also that this association is more pronounced in immigrant vs. native comparisons and is not found within all ethnic groups.
近期研究表明，与本地人口相比，少数族裔中非情感性精神病性障碍（NAPD）的发病率有所上升，但在本族群比例较高的地区，情况并非如此，或发病率上升幅度较小。本研究旨在调查乌得勒支的这种族群密度效应，以及这种效应是否归因于少数族裔比例较高地区的荷兰人NAPD发病率较高。我们还探讨了这种效应发生的地理尺度以及NAPD发病前社会流动的影响。
在泊松模型中，分析了2000年至2009年期间居住在乌得勒支的荷兰中部精神病病例登记处的NAPD病例（N = 2064），这些病例与个体层面以及地区和社区层面的特征相关。
与荷兰人相比，随着少数族裔密度的增加，尤其是社区层面的密度增加，非西方移民（从2.36降至1.24）和西方移民（从1.63降至1.01）中NAPD的发病率显著降低。部分原因是少数族裔密度较高地区的荷兰人NAPD发病率较高。但在这些地区，非西方少数族裔的NAPD发病率也有下降趋势（P = 0.074）。在苏里南人/安的列斯群岛人（P = 0.001）和18至30岁的摩洛哥人（P = 0.046）中，这种趋势显著。在荷兰人中，发现了在NAPD登记前向少数族裔密集社区的社会流动。
我们的研究结果支持在较小尺度的社区层面上，与本族群存在的有益关联。研究结果还表明，这种关联在移民与本地人的比较中更为明显，且并非在所有族群中都存在。
