European Archives of Psychiatry and Clinical Neuroscience
2019

Migration and schizophrenia: meta-analysis and explanatory framework (Article)

Henssler J. , Brandt L. , Müller M. , Liu S. , Montag C. , Sterzer P. , Heinz A.*
  • a Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany
  • b Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany
  • c Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
  • d Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany
  • e Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany
  • f Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany, Berlin School of Mind and Brain, Berlin, Germany, Bernstein Center of Computational Neuroscience Berlin, Berlin, Germany
  • g Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany, Berlin School of Mind and Brain, Berlin, Germany, Bernstein Center of Computational Neuroscience Berlin, Berlin, Germany

Abstract

Systematic reviews and meta-analyses suggest that there are increased rates of schizophrenia and related psychoses in first- and second-generation migrants and refugees. Here, we present a meta-analysis on the incidence of non-affective psychotic disorders among first- and second-generation migrants. We found substantial evidence for an increased relative risk of incidence among first- and second-generation migrants compared to the native population. As heterogeneity of included studies was high, effect estimates should be interpreted with caution and as guiding values rather than exact risk estimates. We interpret our findings in the context of social exclusion and isolation stress, and provide an explanatory framework that links cultural differences in verbal communication and experienced discrimination with the emergence of psychotic experiences and their neurobiological correlates. In this context, we discuss studies observing stress-dependent alterations of dopamine neurotransmission in studies among migrants versus non-migrants as well as in subjects with psychotic disorders. We suggest that social stress effects can impair contextualization of the meaning of verbal messages, which can be accounted for in Bayesian terms by a reduced precision of prior beliefs relative to sensory data, causing increased prediction errors and resulting in a shift towards the literal or “concrete” meaning of words. Compensatory alterations in higher-level beliefs, e.g., in the form of generalized interpretations of ambiguous interactions as hostile behavior, may contribute to psychotic experiences in migrants. We thus suggest that experienced discrimination and social exclusion is at the core of increased rates of psychotic experiences in subjects with a migration background. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Author Keywords

Migration Stress Meta-analysis Bayesian inference Dopamine Psychosis

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85067018515&doi=10.1007%2fs00406-019-01028-7&partnerID=40&md5=bb198a5be3020fc1ad9d8bb67ccd57b5
DOI: 10.1007/s00406-019-01028-7
ISSN: 09401334
Cited by: 1
Original Language: English