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Ethnic density, urbanicity and psychosis risk for migrant groups - A population cohort study

Schofield, Peter R; Thygesen, Malene; Das-Munshi, Jay; Becares, Laia; Cantor-Graae, Elizabeth LU ; Pedersen, Carsten B and Agerbo, Esben (2017) In Schizophrenia Research 190. p.82-87
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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ethnicity, Etiology, Psychosis, Social determinants
in
Schizophrenia Research
volume
190
pages
82 - 87
publisher
Elsevier
external identifiers
  • scopus:85015093303
  • wos:000416984300014
ISSN
0920-9964
DOI
10.1016/j.schres.2017.03.032
language
English
LU publication?
yes
id
7acf7ce8-4983-4618-ac94-e93d12b6b90c
date added to LUP
2017-04-03 10:15:12
date last changed
2018-01-16 13:25:09
@article{7acf7ce8-4983-4618-ac94-e93d12b6b90c,
  abstract     = {<p>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.</p>},
  author       = {Schofield, Peter R and Thygesen, Malene and Das-Munshi, Jay and Becares, Laia and Cantor-Graae, Elizabeth and Pedersen, Carsten B and Agerbo, Esben},
  issn         = {0920-9964},
  keyword      = {Ethnicity,Etiology,Psychosis,Social determinants},
  language     = {eng},
  pages        = {82--87},
  publisher    = {Elsevier},
  series       = {Schizophrenia Research},
  title        = {Ethnic density, urbanicity and psychosis risk for migrant groups - A population cohort study},
  url          = {http://dx.doi.org/10.1016/j.schres.2017.03.032},
  volume       = {190},
  year         = {2017},
}