Eger G, Reuven Y, Dreiher J, Shvartzman P, Weiser M, Aizenberg D, Weizman A, Lev-Ran S
Geha Mental Health Center, Israel.
Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
Schizophr Res. 2022 May;243:247-253. doi: 10.1016/j.schres.2020.03.039. Epub 2020 Mar 28.
To compare the rates of schizophrenia among 1st and 2nd generation immigrants from two distinct backgrounds and across sequential periods of immigration.
A 30-years retrospective cohort study (187,184 individuals) of 1st and 2nd generation East-African immigrants (EAIs) and former Soviet-Union immigrants (FSUIs) who migrated to Israel between 1980 and 2012. EAIs were further divided according to waves of immigration. Period prevalence was calculated between the years 2002-2012. Multivariate logistic regression models were used to examine the association between immigration-related factors and prevalence of schizophrenia (Native-Born Israelis serving as reference group).
The prevalence of schizophrenia in 1st generation EAIs and FSUIs was 1.8% and 1.2%, respectively, compared to 1.0% among NBIs (p<0.001). The prevalence of schizophrenia among 2nd generation EAIs and FSUIs was 1.3% and 0.8%, respectively, compared to 0.6% among NBIs (p<0.001). Adjusted odds ratios for developing schizophrenia compared to NBIs were 1.6 (95%CI:1.4-1.8) and 2.1 (95%CI:1.6-2.7), among 1st and 2nd generation EAIs and 1.1 (95%CI:0.9-1.2) and 1.3 (95%CI:1.0-1.8) among 1st and 2nd generation FSUIs respectively. Among EAIs, we observed the highest rate of schizophrenia in the pioneer wave of immigrants with gradual decline across subsequent waves: 2.4%, 1.9% and 1.0% for the 1st, 2nd and 3rd waves of immigration, respectively (p<0.001).
The increased risk for developing schizophrenia among 2nd generation immigrants and among pioneer groups of immigrants emphasizes the importance of persistent investment in acculturation. Further studies elucidating the impact of country of origin and ethnic density on the risk for developing schizophrenia are warranted.
比较来自两个不同背景的第一代和第二代移民在不同移民时期精神分裂症的发病率。
对1980年至2012年间移民到以色列的第一代和第二代东非移民（EAIs）以及前苏联移民（FSUIs）进行了一项30年的回顾性队列研究（187,184人）。EAIs根据移民浪潮进一步划分。计算了2002年至2012年期间的时期患病率。使用多变量逻辑回归模型来检验与移民相关的因素与精神分裂症患病率之间的关联（以以色列本土出生的人为参照组）。
第一代EAIs和FSUIs中精神分裂症的患病率分别为1.8%和1.2%，而以色列本土出生的人中这一患病率为1.0%（p<0.001）。第二代EAIs和FSUIs中精神分裂症的患病率分别为1.3%和0.8%，而以色列本土出生的人中这一患病率为0.6%（p<0.001）。与以色列本土出生的人相比，第一代和第二代EAIs患精神分裂症的调整后比值比分别为1.6（95%CI：1.4 - 1.8）和2.1（95%CI：1.6 - 2.7），第一代和第二代FSUIs分别为1.1（95%CI：0.9 - 1.2）和1.3（95%CI：1.0 - 1.8）。在EAIs中，我们观察到移民先锋浪潮中精神分裂症的发病率最高，随后各浪潮中逐渐下降：第一代、第二代和第三代移民浪潮中的发病率分别为2.4%、1.9%和1.0%（p<0.001）。
第二代移民和移民先锋群体中患精神分裂症风险的增加强调了持续投入文化适应过程中的重要性。有必要进一步开展研究，以阐明原籍国和种族密度对患精神分裂症风险的影响。
