Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Psychol Med. 2023 Jul;53(10):4395-4404. doi: 10.1017/S0033291722001192. Epub 2022 May 5.
The high risk of psychosis among migrants is often attributed to social stressors in the host country. We examined whether the relative risk of psychosis among migrants is low on arrival and increases thereafter.
In this cohort study, first-generation immigrants to the Netherlands, aged 10 years and older ( = 1 281 678), were matched by birth year and sex to 2 542 313 native-born Dutch controls. The first occurrence of psychosis after arrival was established using data on dispensing of antipsychotic medication (APM) (during 2006-2017) and on insurance claims for treatment of psychosis (2011-2016). The Incidence Rate Ratios (IRRs) for migrants compared to controls were estimated by year since arrival.
The IRR of APM was 0.22 (95% CI 0.21-0.24) in the year of arrival ('year 1') and increased gradually to 1.39 (1.19-1.62) after 10 or more years. The IRR of an insurance claim increased from 0.57 (0.51-0.62) to 1.87 (1.38-2.55) in year 5. Among migrants from sub-Saharan Africa, the IRR of an insurance claim was already high in year 1 [2.46 (1.95-3.11)], especially when aged 10-20 years at arrival [6.09 (2.93-12.64)]. Among migrants from other non-Western countries, the IRR was already significantly increased in year 2 [1.28 (1.03-1.59)].
The relative risk of psychosis among migrants was generally low at arrival and increased thereafter. The increased IRRs in the early years after arrival among those from non-Western countries indicate that for these groups certain risk factors are already relevant shortly after arrival.
移民患精神病的风险较高，通常归因于宿主国的社会压力。我们研究了移民的精神病发病风险是否在抵达后较低，此后会增加。
在这项队列研究中，将年龄在 10 岁及以上的第一代移民荷兰的人（n=1 281 678）与出生年份和性别相匹配的 2 542 313 名荷兰本地出生的对照者进行匹配。使用抗精神病药物（APM）配药数据（2006-2017 年）和精神病治疗保险索赔数据（2011-2016 年）确定抵达后首次发生精神病的情况。通过抵达后的年份计算移民与对照者的发病率比值（IRR）。
在抵达的第一年（“第 1 年”），APM 的 IRR 为 0.22（95%CI 0.21-0.24），并逐渐增加到 10 年或以上的 1.39（1.19-1.62）。保险索赔的 IRR 从 0.57（0.51-0.62）增加到第 5 年的 1.87（1.38-2.55）。在来自撒哈拉以南非洲的移民中，保险索赔的 IRR 在第 1 年就已经很高[2.46（1.95-3.11）]，尤其是在抵达时年龄为 10-20 岁的情况下[6.09（2.93-12.64）]。在来自其他非西方国家的移民中，IRR 在第 2 年就已经显著增加[1.28（1.03-1.59）]。
移民的精神病发病风险在抵达时通常较低，此后会增加。来自非西方国家的移民在抵达后的早期年份中发病率比值增加，表明这些群体的某些风险因素在抵达后不久就已经相关。
