Schizophrenia Research
Volume 87, Issue 1-3, 2006, Pages 205-211

The incidence of schizophrenia in European immigrants to Canada (Article)

Smith G.N.* , Boydell J. , Murray R.M. , Flynn S. , McKay K. , Sherwood M. , Honer W.G.
  • a Department of Psychiatry, University of British Columbia, 828 West 10th Ave, Vancouver, BC V5Z 1L8, Canada
  • b Division of Psychological Medicine, Institute of Psychiatry, DeCrespigny Park, Denmark Hill, London, United Kingdom
  • c Division of Psychological Medicine, Institute of Psychiatry, DeCrespigny Park, Denmark Hill, London, United Kingdom
  • d Department of Psychiatry, University of British Columbia, 828 West 10th Ave, Vancouver, BC V5Z 1L8, Canada
  • e Kathryn McKay, History Department, Simon Fraser University, Burnaby, BC, Canada
  • f Department of Psychiatry, University of British Columbia, 828 West 10th Ave, Vancouver, BC V5Z 1L8, Canada
  • g Department of Psychiatry, University of British Columbia, 828 West 10th Ave, Vancouver, BC V5Z 1L8, Canada

Abstract

Objective: The risk for schizophrenia in immigrants to Europe is approximately three times that of native-born populations. Discrimination and marginalization may influence the risk for schizophrenia within migrant populations. The primary objective of the present study was to determine whether the risk associated with migration was also evident 100 years ago. A second objective was to determine whether changing social stresses are associated with changes to the incidence of schizophrenia. Method: During the first two decades of the twentieth century, the Provincial Mental Hospital was the sole provider of psychiatric services in British Columbia, Canada. Detailed clinical records have been preserved for 99.5% of 2477 patients who had a psychiatric admission between 1902 and 1913. Diagnoses were made after a detailed file review and 807 patients met DSM-IV criteria for first-episode schizophrenia, schizophreniform disorder, schizoaffective disorder, or psychosis not otherwise specified. Diagnoses had high inter-rater reliability. The incidence of schizophrenia in migrants from Britain or Continental Europe was compared with that in the Canadian-born population using indirect standardization and Poisson models. Results: Migration from Britain or Continental Europe to Canada in the early twentieth century was associated with an increased rate of schizophrenia; IRR = 1.54, (95% CI = 1.33-1.78). Incidence increased over time in immigrants but not in the native-born population and this increase occurred during a period of economic recession. Conclusions: Migration was a risk factor for schizophrenia a century ago as it is today. This risk occurred in white migrants from Europe and increased during a period of increased social stress. © 2006 Elsevier B.V. All rights reserved.

Author Keywords

Incidence schizophrenia Immigration

Index Keywords

immigrant mental health service schizophrenia Europe human middle aged psychosis economic aspect schizophreniform disorder controlled study priority journal standardization diagnostic and statistical manual of mental disorders Confidence interval Humans psychology Adolescent male Canada social problem female interrater reliability high risk population Incidence Article major clinical study adult United Kingdom mental hospital Emigration and Immigration Poisson distribution disease association schizoaffective psychosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-33749133168&doi=10.1016%2fj.schres.2006.06.024&partnerID=40&md5=32df6df505b8b0e9f3f39b1d08f494eb
DOI: 10.1016/j.schres.2006.06.024
ISSN: 09209964
Cited by: 39
Original Language: English