Schizophrenia Research
Volume 197, 2018, Pages 93-97

Association between migrant worker experience, limitations on insurance coverage, and hospitalization for schizophrenia in Hunan Province, China (Article)

Zhu Y. , Hu X.* , Yang B. , Wu G. , Wang Z. , Xue Z. , Shi J. , Ouyang X. , Liu Z. , Rosenheck R.
  • a The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • b The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • c The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • d The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • e The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • f The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • g Xiangya School of Public Health, Central South University, Changsha, China
  • h The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China
  • i The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, China, The State Key Laboratory of Medical Genetics, Central South University, China
  • j Department of Psychiatry, Yale University, New Haven, United States

Abstract

Background: While transnational migration has been shown to be a risk factor for schizophrenia, studies have not examined whether massive internal rural-to-urban migration in China in recent years has increased the risk of hospitalization for schizophrenia, or schizophrenia symptom severity among migrants. Method: In a sample of patients acutely hospitalized with schizophrenia in Changsha, Hunan Province, China (N = 334), the proportion of past migrant workers among patients was compared to the proportion of past migrant workers in the general adult population of Hunan. Past migrants were also compared to non-migrants on age of onset, and on symptom severity using the Positive and Negative Syndrome Scale (PANSS). The risk ratio for being a migrant among those hospitalized for schizophrenia was stratified by age and gender subgroups. Multiple regression analysis was used to evaluate group differences in age of onset and symptoms. Results: Of 334 patients diagnosed with schizophrenia hospitalized for < 180 days, 150 (44.9%) were identified as having been migrant workers compared to 31.0% in the general adult population of Hunan for a risk ratio of 1.45, a risk that was higher for women (2.19) than for men (1.09). Migrant workers also had higher scores than others on total PANSS symptoms. Conclusion: Migrant workers appear to be at greater risk of hospitalization for schizophrenia than other residents of Hunan and showed more severe psychopathology. These findings may reflect specific lack of health insurance coverage for workers migrating to non-native provinces in China, thereby delaying access to treatment. © 2017 Elsevier B.V.

Author Keywords

schizophrenia Childhood trauma Migrant worker Psychopathological features

Index Keywords

China hospitalization schizophrenia insurance health insurance human Insurance Coverage middle aged priority journal Insurance, Health Young Adult migrant worker Humans Adolescent Severity of Illness Index male female risk factor Article experience major clinical study adult migration age sex factor disease severity Transients and Migrants pathophysiology
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85035243996&doi=10.1016%2fj.schres.2017.11.026&partnerID=40&md5=40eec156b681b323c9734751a6a7df25
DOI: 10.1016/j.schres.2017.11.026
ISSN: 09209964
Cited by: 2
Original Language: English