Abstract
BackgroundIt has been frequently reported a higher incidence of psychotic disorders in immigrants than in native populations. There is, however, a lack of knowledge about risk factors which may explain this phenomenon. A better understanding of the causes of psychosis among first-generation migrants is highly needed, particularly in Italy, a country with a recent massive migration.Methods/DesignThe “Italian study on first-episode psychosis and migration (PEP-Ita)” is a prospective observational study over a two-year period (1 January 2012–31 December 2013) which will be carried out in 11 Italian mental health centres. All participating centres will collect data about all new cases of migrants with first-episode psychosis. The general purpose (“core”) of the PEP-Ita study is to explore the socio-demographic and clinical characteristics, and the pathways to care of a population of first-episode psychosis migrants in Italy. Secondary aims of the study will be: 1) to understand risk and protective factors for the development of psychotic disorders in migrants; 2) to evaluate the correlations between psychopathology of psychotic disorders in migrants and socio-demographic characteristics, migration history, life experiences; 3) to evaluate the clinical and social outcomes of first-episode psychoses in migrants.DiscussionThe results of the PEP-Ita study will allow a better understanding of risk factors for psychosis in first-generation migrants in Italy. Moreover, our results will contribute to the development of prevention programmes for psychosis and to the improvement of early intervention treatments for the migrant population in Italy.
Highlights
It has been frequently reported a higher incidence of psychotic disorders in immigrants than in native populations
It has been shown that the risk of developing psychosis is higher in urban areas [15,16,17], but the meaning of this association remains unclear; it is assumed that one reason could be social isolation which occurs in large urban areas [18,19]
Structured, such an organization would facilitate access to care for migrants presenting first-episode psychosis in Italy; yet, previous studies demonstrated that migrants with mental disorders might follow different and more complex pathways to care [26]
Summary
Expected results and clinical implications The study will gather relevant information on the sociodemographic and clinical features, and pathways to care of migrants with first-episode psychosis in Italy. The comparison with native patients will highlight specific risk factors for psychosis in migrants. The inclusion of mental health centres located in different social and geographic areas will allow interregional comparisons of risk factors for psychosis in migrants. Selected centres will be able to obtain more indepth information on both individual and area-specific social risk factors, as well as an evaluation of the family burden of patients with a psychotic onset. AF is a network co-coordinator and has significantly collaborated to the study design and the manuscript draft. VB, BC, LF, MN, MR, OT, PZ and DB are responsible for the coordination of recruitment and assessment in the local centres, they have advised on the development of the design and have given the final approval of this version to be published.
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