Schizophrenia Research
Volume 190, 2017, Pages 82-87

Ethnic density, urbanicity and psychosis risk for migrant groups – A population cohort study (Article) (Open Access)

Schofield P.* , Thygesen M. , Das-Munshi J. , Becares L. , Cantor-Graae E. , Pedersen C. , Agerbo E.
  • a Division of Health & Social Care Research, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
  • b Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark, CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
  • c Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
  • d Centre on Dynamics of Ethnicity, The University of Manchester, Manchester, United Kingdom
  • e Social Medicine and Global Health, Lund University, Lund, Sweden
  • f Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark, CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
  • g Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark, CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark

Abstract

Background Rates of psychotic disorder are raised for many migrant groups. Understanding the role played by the social context in which they live may help explain why. This study investigates the effect of both neighbourhood ethnic density and urbanicity on the incidence of non-affective psychosis for migrant groups. Method Population based cohort of all those born 1965 or later followed from their 15th birthday (2,224,464 people) to 1st July 2013 (37,335,812 person years). Neighbourhood exposures were measured at age 15. Results For all groups incidence of non-affective psychosis was greater in lower ethnic density neighbourhoods. For migrants of African origin there was a 1.94-fold increase (95% CI, 1.17–3.23) comparing lowest and highest density quintiles; with similar effects for migrants from Europe (excluding Scandinavia): incidence rate ratio (IRR) 1.99 (95% CI, 1.56–2.54); Asia: IRR 1.63 (95% CI, 1.02–2.59); and the Middle East: IRR 1.68 (95% CI, 1.19–2.38). This initial analysis found no evidence for an urbanicity effect for migrant groups. Adjusting for ethnic density revealed a positive association between level of urbanicity and psychosis for two groups, with a statistically significant linear trend (average effect of a one quintile increase) for migrants from Europe: IRR 1.09 (95% CI, 1.02–1.16) and the Middle East: IRR 1.12 (95% CI, 1.01–1.23). Conclusions In this first nationwide population-based study of ethnic density, urbanicity and psychosis we show that lower ethnic density is associated with increased incidence of non-affective psychosis for different migrant groups; masking urban/rural differences in psychosis for some groups. © 2017 The Authors

Author Keywords

Psychosis Social determinants Ethnicity etiology

Index Keywords

urban population Cultural Diversity Europe human Cohort Studies Asia Middle East Denmark psychosis Ethnic Groups rural population priority journal ethnic group African behavioral risk factor surveillance system Urbanization neighborhood Humans migrant psychology Adolescent Socioeconomic Factors Psychotic Disorders risk factor Risk Factors socioeconomics population research Incidence Article major clinical study migration cohort analysis ethnicity Transients and Migrants
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85015093303&doi=10.1016%2fj.schres.2017.03.032&partnerID=40&md5=7ed786e576032a94596302330f14a37f
DOI: 10.1016/j.schres.2017.03.032
ISSN: 09209964
Cited by: 15
Original Language: English