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丹麦创伤后移民与本地出生者的精神病理学风险。

Risk of psychopathology following traumatic events among immigrants and native-born persons in Denmark.

机构信息

Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2023 Sep;58(9):1305-1316. doi: 10.1007/s00127-022-02391-y. Epub 2022 Nov 30.

Abstract

PURPOSE

Immigrants may have increased risk of mental disorders compared with native-born persons. We aimed to expand the limited research on immigrants' posttraumatic psychopathology related to traumatic experiences in their country of resettlement.

METHODS

We obtained data from a cohort of Danish residents with ≥ 1 traumatic event recorded in health and administrative national registries during 1994-2016. We calculated risks of posttraumatic stress disorder (PTSD), depression, and substance use disorders (SUD) within 5 years post-trauma among native-born Danes and immigrants who had been in Denmark for ≥ 10 years at the time of their index trauma (including immigrants overall and immigrants from specific regions). Risks were compared via age- and sex-standardized risk ratios (SRR) with 95% confidence intervals (CI). We restricted to persons with no record of the disorder under investigation in the 10 years pre-trauma, and stratified by non-interpersonal (e.g., transport accidents) versus interpersonal trauma (e.g., assaults).

RESULTS

Following non-interpersonal trauma, immigrants were more likely than native-born Danes to be diagnosed with PTSD (SRR = 5.2, 95% CI 4.6, 5.9), about as likely to be diagnosed with depression (SRR = 0.98, 95% CI 0.92, 1.1), and less likely to be diagnosed with SUD (SRR = 0.89, 95% CI 0.82, 0.95). Results were similar following interpersonal trauma, except the SRR for PTSD was reduced in magnitude (SRR = 3.0, 95% CI 1.7, 5.4). There were differences by region of birth.

CONCLUSION

Immigrants to Denmark have higher risk of PTSD following traumatic experiences than do native-born Danes, possibly due to the combined influence of adverse pre-, peri-, and/or post-migration experiences.

摘要

目的

与本土出生的人相比,移民可能有更高的精神障碍风险。我们旨在扩大有关移民在其定居国家经历创伤后心理病理的有限研究。

方法

我们从丹麦居民队列中获得了数据,该队列中≥1 次创伤事件记录在 1994-2016 年期间的健康和行政国家登记册中。我们计算了在创伤后 5 年内,在丹麦居住≥10 年的本土丹麦人和移民(包括所有移民和来自特定地区的移民)发生创伤后应激障碍(PTSD)、抑郁和物质使用障碍(SUD)的风险。通过年龄和性别标准化风险比(SRR)和 95%置信区间(CI)比较风险。我们将研究中没有记录在创伤前 10 年内的患者进行限制,并按非人际(例如,交通事故)与人际(例如,袭击)创伤进行分层。

结果

在非人际创伤后,移民比本土丹麦人更有可能被诊断为 PTSD(SRR=5.2,95%CI 4.6,5.9),与被诊断为抑郁的可能性大致相同(SRR=0.98,95%CI 0.92,1.1),被诊断为 SUD 的可能性较小(SRR=0.89,95%CI 0.82,0.95)。人际创伤后结果相似,除 PTSD 的 SRR 幅度减小(SRR=3.0,95%CI 1.7,5.4)。出生地存在差异。

结论

与本土丹麦人相比,丹麦移民在经历创伤后发生 PTSD 的风险更高,这可能是由于不利的前、围产期和/或移民后经历的综合影响所致。

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