Pignon Baptiste, Geoffroy Pierre Alexis, Thomas Pierre, Roelandt Jean-Luc, Rolland Benjamin, Morgan Craig, Vaiva Guillaume, Amad Ali
Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France.
Inserm, U1144, Paris F-75006, France; Paris Descartes University, UMR-S 1144, Paris F-75006, France; Paris Diderot University, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Psychiatry and Addiction Medicine Department, 75475 Paris Cedex 10, France.
J Affect Disord. 2017 Mar 1;210:174-180. doi: 10.1016/j.jad.2016.12.039. Epub 2016 Dec 27.
The role of migration as a risk factor remains unknown for mood disorders because of poor data. We sought to examine the prevalence and severity of mood disorders (bipolar disorder (BD), unipolar depressive disorder (UDD) and dysthymia) in first, second, and third generation migrants in France.
The Mental Health in the General Population survey interviewed 38,694 individuals. The prevalence of lifetime mood disorders, comorbidities, and clinical features was compared between migrants and non-migrants and by generation. All analyses were adjusted for age, sex and level of education.
The prevalence of any lifetime mood disorder was higher in migrants compared with non-migrants (OR = 1.36, 95% CI [1.27 - 1.45]). This increased prevalence was significant for UDD (OR = 1.44, 95% CI [1.34 - 1.54]), but not for BD (OR = 1.15, 95% CI [0.96 - 1.36]) or dysthymia (OR = 1.09, 95% CI [0.94 - 1.27]), although the prevalence of BD was increased in the third generation (OR = 1.27, 95% CI [1.01 - 1.60]). Migrants with BD or UDD were more likely to display a comorbid psychotic disorder compared to non-migrants with BD or UDD. Cannabis-use disorders were more common in migrant groups for the 3 mood disorders, whereas alcohol-use disorders were higher in migrants with UDD. Posttraumatic stress disorder was more frequent among migrants with UDD.
The study used cross-sectional prevalence data and could be biased by differences in the course of disease according to migrant status. Moreover, this design does not allow causality conclusion or generalization of the main findings.
Mood disorders are more common among migrants, especially UDD. Moreover, migrants with mood disorders presented with a more severe profile, with increased rates of psychotic and substance-use disorders.
由于数据匮乏，移民作为情绪障碍风险因素的作用尚不明确。我们试图调查法国第一代、第二代和第三代移民中情绪障碍（双相情感障碍（BD）、单相抑郁症（UDD）和心境恶劣）的患病率及严重程度。
“普通人群心理健康调查”对38694人进行了访谈。比较了移民和非移民以及不同代际人群中终生情绪障碍、共病情况和临床特征的患病率。所有分析均针对年龄、性别和教育水平进行了调整。
与非移民相比，移民中任何终生情绪障碍的患病率更高（比值比（OR）=1.36，95%置信区间[1.27 - 1.45]）。UDD的患病率增加具有统计学意义（OR = 1.44，95%置信区间[1.34 - 1.54]），但BD（OR = 1.15，95%置信区间[0.96 - 1.36]）和心境恶劣（OR = 1.09，95%置信区间[0.94 - 1.27]）并非如此，不过BD在第三代移民中的患病率有所增加（OR = 1.27，95%置信区间[1.01 - 1.60]）。与患有BD或UDD的非移民相比，患有BD或UDD的移民更有可能同时患有精神病性障碍。在这三种情绪障碍中，大麻使用障碍在移民群体中更为常见，而酒精使用障碍在患有UDD的移民中更高。创伤后应激障碍在患有UDD的移民中更为常见。
本研究使用的是横断面患病率数据，可能因移民身份导致的疾病病程差异而产生偏差。此外，这种设计无法得出因果关系结论，也不能将主要研究结果进行推广。
情绪障碍在移民中更为常见，尤其是UDD。此外，患有情绪障碍的移民病情更为严重，精神病性障碍和物质使用障碍的发生率更高。
