爱尔兰共和国移民首发精神病后 1 年的结局。
Outcomes 1 year after a first episode of psychosis in migrants to the Republic of Ireland.
机构信息
Department of Psychiatry, University College Dublin, Ireland.
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
出版信息
Int J Soc Psychiatry. 2023 Nov;69(7):1617-1625. doi: 10.1177/00207640231174360. Epub 2023 May 21.
BACKGROUND
Migration is a robust risk factor for developing a psychotic disorder, yet there is a paucity of research on the outcomes of migrants who develop a psychotic disorder. Identifying sub-groups within FEP cohorts who have a poorer outcome, could assist in the development and delivery of more targeted interventions.
AIMS
There is a paucity of research on the outcomes of migrants who develop a psychotic disorder. This study aimed to evaluate a broad range of outcomes for those with a FEP who migrated to the Republic of Ireland, including: (i) symptomatic; (ii) functional; (iii) hospitalisation and (iv) engagement with psychosocial services.
METHODS
All individuals with a FEP aged 18 to 65 who presented between 01.02.2006 and 01.07.2014 were included. Structured and validated instruments were used to measure positive, negative, depressive symptoms and insight.
RESULTS
Of the 573 individuals with a FEP, 22.3% were first-generation migrants and 63.4% ( = 363) were followed up at 1 year. At this time, 72.4% of migrants were in remission of positive psychotic symptoms compared to 78.5% of the Irish born ( = 0.84, 95% CI [0.50-1.41], = .51). In relation to negative symptoms, 60.5% of migrants were in remission compared to 67.2% of the Irish born ( = 0.75, 95% CI [0.44-1.27], = .283). There was no difference in the severity of positive, negative or depressive symptoms between groups and there was a trend for the Irish born to have better insight ( = .056). The functional outcomes were similar across groups. One third of migrants were admitted to hospital compared to 28.7% of the Irish born ( = 1.24, 95% CI [0.73-2.13], = .426). Just over half of both groups attended CBT and 46.2% of caregivers for migrants attended the psychoeducation programme, compared to 39.7% for the Irish born ( = 1.30, 95% CI [0.79-2.16], = .306).
CONCLUSIONS
These findings demonstrate that migrants have broadly similar outcomes to the native-born populations, however there is still considerable scope for the outcomes for all individuals affected by psychotic disorders to be improved.
背景
移民是发展精神病的一个强有力的风险因素，但对于发展精神病的移民的结果，研究却很少。确定 FEP 队列中预后较差的亚组，可以帮助制定和提供更有针对性的干预措施。
目的
对于移民发展精神病的结果，研究很少。本研究旨在评估移居爱尔兰的 FEP 患者的广泛结局，包括：（i）症状；（ii）功能；（iii）住院和（iv）接受心理社会服务。
方法
所有年龄在 18 至 65 岁之间的 FEP 患者，均于 2006 年 2 月 1 日至 2014 年 7 月 1 日就诊。使用结构化和验证的工具来测量阳性、阴性、抑郁症状和洞察力。
结果
在 573 名 FEP 患者中，22.3%为第一代移民，63.4%（ = 363）在 1 年后接受随访。此时，与爱尔兰出生者的 78.5%相比，72.4%的移民患者的阳性精神病症状缓解（ = 0.84，95%CI[0.50-1.41]， = 0.51）。在阴性症状方面，与爱尔兰出生者的 67.2%相比，60.5%的移民患者缓解（ = 0.75，95%CI[0.44-1.27]， = 0.283）。两组之间阳性、阴性或抑郁症状的严重程度没有差异，并且爱尔兰出生者的洞察力有改善趋势（ = 0.056）。功能结局在两组之间相似。三分之一的移民患者住院，而爱尔兰出生者为 28.7%（ = 1.24，95%CI[0.73-2.13]， = 0.426）。两组都有超过一半的人接受认知行为治疗，而 46.2%的移民患者的照顾者参加了心理教育计划，而爱尔兰出生者为 39.7%（ = 1.30，95%CI[0.79-2.16]， = 0.306）。
结论
这些发现表明，移民与本地出生人群的结局大致相似，但所有受精神病影响的个体的结局仍有很大的改善空间。
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