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处于临床精神病高风险的青少年的移民身份、临床症状和功能结局:来自NAPLS-3研究的结果

Migrant status, clinical symptoms and functional outcome in youth at clinical high risk for psychosis: findings from the NAPLS-3 study.

作者信息

Barbato Mariapaola, Liu Lu, Bearden Carrie E, Cadenhead Kristin S, Cornblatt Barbara A, Keshavan Matcheri, Mathalon Daniel H, McGlashan Thomas H, Perkins Diana O, Seidman Larry J, Stone William, Tsuang Ming T, Walker Elaine F, Woods Scott W, Cannon Tyrone D, Addington Jean

机构信息

Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, UAE.

Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2023 Apr;58(4):559-568. doi: 10.1007/s00127-022-02383-y. Epub 2022 Nov 8.

Abstract

PURPOSE

Migrant status is a known risk factor for psychosis, but the underlying causes of this vulnerability are poorly understood. Recently, studies have begun to explore whether migrant status predicts transition to psychosis in individuals at clinical high risk (CHR) for psychosis. Results, however, have been inconclusive. The present study assessed the impact of migrant status on clinical symptoms and functional outcome in individuals at CHR for psychosis who took part in the NAPLS-3 study.

METHODS

Participants' migrant status was classified as native-born, first-generation, or second-generation migrant. Clinical symptoms were assessed using the Structured Interview for Psychosis-Risk Syndromes (SIPS); functional outcome was measured using the Global Functioning Scales:Social and Role (GF:S; GF:R). Assessments were conducted at baseline, 12-months, 18-months, and 24-months follow-up. Generalized linear mixed models for repeated measures were used to examine changes over time and differences between groups.

RESULTS

The overall sample included 710 individuals at CHR for psychosis (54.2% males; Age: M = 18.19; SD = 4.04). A mixed model analysis was conducted, and no significant differences between groups in symptoms or functioning were observed at any time point. Over time, significant improvement in symptoms and functioning was observed within each group. Transition rates did not differ across groups.

CONCLUSION

We discuss potential factors that might explain the lack of group differences. Overall, migrants are a heterogeneous population. Discerning the impact of migration from that of neighborhood ethnic density, social disadvantage or socio-economic status of different ethnic groups could help better understand vulnerability and resilience to psychosis.

摘要

目的

移民身份是已知的精神病风险因素,但这种易感性的潜在原因尚不清楚。最近,研究开始探讨移民身份是否能预测临床高危(CHR)个体向精神病的转变。然而,结果尚无定论。本研究评估了移民身份对参与NAPLS-3研究的CHR个体的临床症状和功能结局的影响。

方法

参与者的移民身份分为本地出生、第一代或第二代移民。使用精神病风险综合征结构化访谈(SIPS)评估临床症状;使用全球功能量表:社会和角色(GF:S;GF:R)测量功能结局。在基线、12个月、18个月和24个月随访时进行评估。使用重复测量的广义线性混合模型来检查随时间的变化和组间差异。

结果

总体样本包括710名CHR个体(54.2%为男性;年龄:M = 18.19;SD = 4.04)。进行了混合模型分析,在任何时间点均未观察到组间在症状或功能方面的显著差异。随着时间的推移,每组的症状和功能均有显著改善。各组的转变率没有差异。

结论

我们讨论了可能解释组间差异缺乏的潜在因素。总体而言,移民是一个异质性群体。区分移民的影响与邻里种族密度、社会劣势或不同种族群体的社会经济地位的影响,有助于更好地理解对精神病的易感性和恢复力。

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