Social Psychiatry and Psychiatric Epidemiology
Volume 51, Issue 12, 2016, Pages 1603-1613

Evidence of an excessive gender gap in the risk of psychotic disorder among North African immigrants in Europe: a systematic review and meta-analysis (Article)

van der Ven E.* , Veling W. , Tortelli A. , Tarricone I. , Berardi D. , Bourque F. , Selten J.P.
  • a School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands, GGZ Leiden, Rivierduinen Psychiatric Institute, Sandifortdreef 19, Leiden, 2333 ZZ, Netherlands
  • b Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
  • c EPS Maison Blanche, INSERM U955, Paris, France
  • d Institute of Psychiatry, Bologna University, Bologna, Italy, West Bologna Mental Health Department, AUSL, Bologna, Italy
  • e Institute of Psychiatry, Bologna University, Bologna, Italy, West Bologna Mental Health Department, AUSL, Bologna, Italy
  • f Institute of Psychiatry, King’s College London, London, United Kingdom
  • g School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands, GGZ Leiden, Rivierduinen Psychiatric Institute, Sandifortdreef 19, Leiden, 2333 ZZ, Netherlands

Abstract

Purpose: Epidemiological studies in the Netherlands have reported an excessive gender gap in the risk for non-affective psychotic disorder (NAPD) among immigrants from Morocco with a higher risk elevation in males compared to females. We examined the consistency of these findings and their generalizability to immigrants from the Maghreb (Mauritania, Morocco, Algeria, Tunisia and Libya) in other European countries. Methods: Systematic review and meta-analysis. Medline, PsychINFO and EMBASE databases were searched for publications in the period from January 1970 to April 2014. We included incidence and prevalence studies of non-affective psychotic disorder (NAPD) among migrants from the Maghreb in Europe and studies of subclinical psychotic symptoms (SPS) in representative samples. A meta-analysis was performed on the subgroup of incidence studies. Results: Five incidence and three prevalence studies of NAPD, and two prevalence studies of SPS, conducted in the Netherlands (n=7), Belgium (n=1), France (n=1) and Italy (n=1) met our inclusion criteria. Across all research designs, the risks of NAPD and SPS were consistently increased among male, not female immigrants from the Maghreb. The meta-analysis of incidence studies of NAPD yielded male-to-female risk ratios of 5.1 [95 % confidence interval (CI) 3.1–8.4] for migrants from the Maghreb, 2.0 (95 % CI 1.6–2.5) for other migrant groups, and 1.8 (95 % CI 1.3–2.5) for non-migrant Europeans. Conclusions: The marked gender gap in psychosis risk among migrants from the Maghreb appears a consistent finding, foremost among the Moroccan-Dutch. The small number of studies limits the strength of conclusions that can be drawn about countries other than the Netherlands. Achievement–expectation mismatch, social marginalization and an increased prevalence of illicit drug use are possible explanations. © 2016, Springer-Verlag Berlin Heidelberg.

Author Keywords

Sex difference Maghreb psychotic disorder Incidence Immigration

Index Keywords

statistics and numerical data male Emigrants and Immigrants Sex Factors female sex difference Psychotic Disorders Africa ethnology Europe Africa, Northern meta analysis human Humans migrant
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84976516426&doi=10.1007%2fs00127-016-1261-0&partnerID=40&md5=ffeec7b49e0ef3e1a5d9155096c4f68c
DOI: 10.1007/s00127-016-1261-0
ISSN: 09337954
Cited by: 11
Original Language: English