La trajectoire comme facteur associé à l'étiopathogénie des troubles mentaux dans la migration

Abstract

The psychopathology of migrants is usually related to either an original etiopathology, or to traumatic conditions of the migration or to adaptation constraints to the host country. Many researches observed a higher rate of admission in psychiatric hospitals for immigrants, but few were interested in differentiating mental health and illness by comparing a group of healthy individuals with ill ones in a population of migrants. The assumption of this research is that the trajectory, an intercultural variable defined as the spatial and temporal way they integrate migration into family choices, is a linked-factor to etiopathogeny in migration. Within the framework of a study on risk and linked factors related to mental illness (140 variables) this hypothesis was tested on male North Africans migrants ( N = 150) in Southern France, by a questionary elaborated and applied according to a culture contact psychology methodology. The results given by the factor analysis tended to distribute the variables along two main factorial axes: mono-cultural (host country culture vs. country of origin culture) and intercultural (insertion vs. integration), revealing the presence of four groups (over-adapted, marginalized, inserted and integrated). They are characterized by the way they integrate migration into family choices which appeared directly linked to mental morbidity. The results show that it is not the migration by itself which constitutes a trauma but rather its integration into the family plan which either ensures stability or leads to an upset in the family balance jeopardizing mental health by the double pathogenic effect of marital and acculturative stresses. Moreover it appears that the etiopathogenic weight of the contradiction between the cultural norms depends on the culture considered to be the reference by the migrant. The de facto bicultural choice (strong adhesion to host country values in spite of the country of origin in the over-adapted group) is a mental health factor. At the opposite the frustrated bicultural choice (very weak adhesion to host country values, as by necessity the country of origin remains the reference in the marginalized group) appears as a risk factor. The choices of intercultural compromises within the family structure (that I will coin as interculturation) lead to a real betterment for mental health (integrated group). These results change the evaluation of the pathogenic effects of migration which were generally interpreted through either the direct attribution of an etiopathogenic function to migration or by emphasizing an imported psychopathology. Psychopathological illnesses of immigrants turned out to be correlated with the trajectory, a variable defined as the spatial and temporal way they integrate migration into family choices, determining factors in mental health. Thus the trajectory seems to be the non-dyscrasia vs. dyscrasia answer given by immigrants to the break in the symbolic ascendancy imposed by migration.