Maastricht University, School for Mental Health and Neuroscience, Maastricht.
Rivierduinen Mental Health Institute, Leiden, The Netherlands.
Curr Opin Psychiatry. 2018 May;31(3):231-236. doi: 10.1097/YCO.0000000000000405.
Arguably, the strongest evidence of an environmental contribution to the cause of psychosis is the increased risk for certain groups of migrants and ethnic minorities. This article summarizes findings published since 2016.
Two studies suggested that migration or minority status are proxies for exposure to an inferior social status. A study from Bologna, Italy, showed that the psychosis risk for internal migrants from Southern Italy was as much increased as that for international migrants. A report from New Zealand reported a higher risk for Maoris than for the remainder of the population.Furthermore, a Danish investigation showed that own-group ethnic density of the neighbourhood at age 15 strongly modified the psychosis risk at adult age. This rules out differential mobility during the prodromal phase as an explanation for the ethnic density effect. Preliminary evidence suggests that the psychotogenic effect of migration may be mediated by elevated dopamine in the striatum.
An increasing body of evidence suggests that the higher psychosis risk for certain migrant or ethnic minority groups is due to an inferior social status. Neuroimaging of the dopamine system appears to be a promising avenue for research into pathogenesis.
目的综述：移民和少数族裔群体罹患精神疾病的风险增加，这强有力地证明了环境因素对精神疾病的发生有一定影响。本文总结了 2016 年以来发表的研究结果。
最新发现：有两项研究表明，移民或少数族裔身份可能是社会地位较低的一个替代指标。意大利博洛尼亚的一项研究表明，来自意大利南部的国内移民和国际移民的精神疾病风险同样增加。新西兰的一份报告显示，毛利族的精神疾病风险高于其他人群。此外，丹麦的一项调查显示，15 岁时所处社区的本族裔人口密度在成年时对精神疾病风险有很大影响。这排除了前驱期的差异迁移作为族裔密度效应的解释。初步证据表明，移民的致精神疾病效应可能是纹状体多巴胺升高介导的。
总结：越来越多的证据表明，某些移民或少数族裔群体的精神疾病风险较高是由于社会地位较低。多巴胺系统的神经影像学研究似乎是研究发病机制的一个很有前途的途径。
