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美国的移民与精神障碍:对健康移民假说的新证据。

Immigrants and mental disorders in the united states: New evidence on the healthy migrant hypothesis.

机构信息

School of Social Work, Boston University, Boston, MA, United States.

School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States.

出版信息

Psychiatry Res. 2018 Sep;267:438-445. doi: 10.1016/j.psychres.2018.06.039. Epub 2018 Jun 19.

Abstract

OBJECTIVES

Despite experiencing migration-related stress and social adversity, immigrants are less likely to experience an array of adverse behavioral and health outcomes. Guided by the healthy migrant hypothesis, which proposes that this paradox can be explained in part by selection effects, we examine the prevalence and comorbidity of mental disorders among immigrants to the United States (US).

METHODS

Findings are based on the National Epidemiologic Survey on Alcohol and Related Conditions (2012-2013), a nationally representative survey of 36,309 adults in the US.

RESULTS

Immigrants were significantly less likely than US-born individuals to meet criteria for a lifetime disorder (AOR = 0.63, 95% CI = 0.57-0.71) or to report parental history of psychiatric problems. Compared to US-born individuals, the prevalence of mental disorders was not significantly different among individuals who immigrated as children; however, differences were observed for immigrants who arrived as adolescents (ages 12-17) or as adults (age 18+).

DISCUSSION

Consistent with the healthy migrant hypothesis, immigrants are less likely to come from families with psychiatric problems, and those who migrate after childhood-when selection effects are most likely to be observed-have the lowest levels of psychiatric morbidity.

摘要

目的

尽管移民经历了与迁移相关的压力和社会逆境,但他们出现一系列不良行为和健康结果的可能性较低。受“健康移民假说”的指导,该假说认为这种悖论部分可以用选择效应来解释,我们考察了移民到美国的移民的精神障碍的患病率和共病情况。

方法

研究结果基于全国酒精和相关情况流行病学调查(2012-2013 年),这是一项针对美国 36309 名成年人的全国代表性调查。

结果

与土生土长的美国人相比,移民明显不太可能符合终身障碍标准(AOR=0.63,95%CI=0.57-0.71)或报告其父母有精神问题史。与土生土长的美国人相比,在儿童时期移民的人群中,精神障碍的患病率没有显著差异;但是,在青少年(12-17 岁)或成年(18 岁及以上)移民中观察到了差异。

讨论

与健康移民假说一致,移民不太可能来自有精神问题的家庭,那些在童年后移民的人(最有可能观察到选择效应的时期)精神疾病发病率最低。

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