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移民和芬兰本土居民中精神障碍的发病率和患病率:一项基于登记处的研究。

Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study.

作者信息

Markkula Niina, Lehti Venla, Gissler Mika, Suvisaari Jaana

机构信息

Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Av. Las Condes 12 438, Las Condes, Santiago, Chile.

Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2017 Dec;52(12):1523-1540. doi: 10.1007/s00127-017-1432-7. Epub 2017 Aug 30.

Abstract

PURPOSE

Migrants appear to have a higher risk of mental disorders, but findings vary across country settings and migrant groups. We aimed to assess incidence and prevalence of mental disorders among immigrants and Finnish-born controls in a register-based cohort study.

METHODS

A register-based cohort study of 184.806 immigrants and 185.184 Finnish-born controls (1.412.117 person-years) was conducted. Information on mental disorders according to ICD-10 was retrieved from the Hospital Discharge Register, which covers all public health care use.

RESULTS

The incidence of any mental disorder was lower among male (adjusted HR 0.82, 95% CI 0.77-0.87) and female (aHR 0.76, 95% CI 0.72-0.81) immigrants, being lowest among Asian and highest among North African and Middle Eastern immigrants. The incidence of bipolar, depressive and alcohol use disorders was lower among immigrants. Incidence of psychotic disorders was lower among female and not higher among male immigrants, compared with native Finns. Incidence of PTSD was higher among male immigrants (aHR 4.88, 95% CI 3.38-7.05).

CONCLUSIONS

The risk of mental disorders varies significantly across migrant groups and disorders and is generally lower among immigrants than native Finns.

摘要

目的

移民似乎患精神障碍的风险更高,但不同国家背景和移民群体的研究结果有所不同。我们旨在通过一项基于登记册的队列研究评估移民和芬兰本土对照人群中精神障碍的发病率和患病率。

方法

开展了一项基于登记册的队列研究,纳入184,806名移民和185,184名芬兰本土对照人群(共1,412,117人年)。根据国际疾病分类第10版(ICD - 10)获取的精神障碍信息来自涵盖所有公共医疗保健使用情况的医院出院登记册。

结果

男性(调整后风险比0.82,95%置信区间0.77 - 0.87)和女性(调整后风险比0.76,95%置信区间0.72 - 0.81)移民中任何精神障碍的发病率较低,在亚洲移民中最低,在北非和中东移民中最高。双相情感障碍、抑郁症和酒精使用障碍在移民中的发病率较低。与芬兰本地人相比,女性移民中精神分裂症的发病率较低,男性移民中则不高。男性移民中创伤后应激障碍的发病率较高(调整后风险比4.88,95%置信区间3.38 - 7.05)。

结论

精神障碍的风险在不同移民群体和不同障碍类型之间存在显著差异,总体而言移民中的发病率低于芬兰本地人。

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