Orygen, 35 Poplar rd, Parkville, VIC, 3052, Australia.
Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2021 Aug;56(8):1389-1397. doi: 10.1007/s00127-020-02011-7. Epub 2021 Jan 5.
Certain migrant groups have been identified as being at increased risk of developing a psychotic disorder, but there is limited research on the outcomes for migrants who develop a first episode of psychosis (FEP). We investigated symptomatic outcomes (remission and relapse rates), functional outcomes (occupational status and relationships) and service utilization (hospital admission and engagement).
Young people, aged between 15 and 24, who presented with FEP to the Early Psychosis Prevention and Intervention Centre (EPPIC) at Orygen between 01.01.11 and 31.12.16 were included. Place of birth was recorded at the time of presentation. To determine remission, symptoms were scored at three-month intervals using the short-form Scale for the Assessment of Positive Symptoms.
A total of 1220 young people presented with FEP over the six-year period (mean age = 19.6 ± 2.8). Of these, 58.1% were male and 24.0% were first-generation migrants. While there was no difference in overall rates of admission after presentation, migrants were more likely to have an involuntary admission after presentation (31.4% vs. 24.6%, aHR = 1.54, 95% CI [1.19, 2.01]) and this risk was greatest for African migrants (HR = 1.98, 95% C.I. [1.37, 2.86]. The rates of remission and relapse were similar in migrants and those born in Australia and there was no difference in functional outcomes, such as employment rates at follow-up.
The outcomes for migrants who experience FEP appear to be largely similar to those for the Australian-born population. Our finding that a greater rate of involuntary admission for migrants at presentation supports existing literature and needs further exploration to improve clinical care.
某些移民群体被认为罹患精神病的风险增加，但针对出现首发精神病性障碍（FEP）的移民的结局研究有限。我们调查了症状结局（缓解率和复发率）、功能结局（职业状况和人际关系）和服务利用（住院和参与度）。
2011 年 1 月 1 日至 2016 年 12 月 31 日期间，15 至 24 岁的 FEP 患者在 Orygen 的早期精神病预防和干预中心（EPPIC）就诊。在就诊时记录出生地。为确定缓解，使用简短阳性症状评定量表在三个月间隔时对症状进行评分。
在六年期间，共有 1220 名年轻人出现 FEP（平均年龄 19.6 ± 2.8 岁）。其中，58.1%为男性，24.0%为第一代移民。虽然就诊后总体入院率没有差异，但移民在就诊后更有可能被非自愿入院（31.4% vs. 24.6%，aHR = 1.54，95%CI [1.19, 2.01]），非洲移民的风险最大（HR = 1.98，95%CI [1.37, 2.86]）。移民和在澳出生者的缓解率和复发率相似，随访时的就业率等功能结局无差异。
出现 FEP 的移民的结局似乎在很大程度上与澳大利亚出生人群相似。我们的研究结果表明，就诊时移民非自愿入院率更高，这与现有文献一致，需要进一步研究以改善临床护理。
