P-1444 - Psychosis and suicide risk by ethnic origin and history of migration in the Netherlands

Abstract

In the Netherlands, there is an increased incidence of non-affective psychotic disorders (NAPD) among first- and second-generation migrants from Turkey, Morocco, Surinam and the Netherlands Antilles. The purpose of this population-based study was to compare the risk of suicide in Dutch natives and immigrants with or without NAPD. We examined the influence of NAPD, ethnicity and history of migration (first or second generation). Cases of NAPD (n = 12,580) from three Dutch psychiatric registers were linked to the cause of death register of Statistics Netherlands and compared to matched controls (n = 124,547) from the population register, who had no such diagnosis. Hazard ratios (HRs) of suicide were estimated and adjusted for age and gender by Cox regression analysis. The presence of NAPD was strongly associated with suicide risk in each ethnic group. However, for most ethnic minority groups the HRs were somewhat lower than among Dutch natives, for whom the HR was 30.4 (95%; 22.8–40.7). A closer examination revealed that suicide risk was influenced by history of migration. While the risk for immigrants of the first generation, diagnosed with NAPD, was significantly lower than that for native Dutch patients (HR = 0.44; 95% CI: 0.27–0.72), the risk for those of the second generation was similar to that for the Dutch (HR = 0.81; 95% CI: 0.48–1.38). The same pattern was found among first- and second-generation immigrants not diagnosed with NAPD. Immigrants of the first generation appear to be protected against suicide, whereas this protection is waning among those of the second generation.