Refugees and psychosis: A review of the literature

Abstract

Objective: To explore and evaluate the evidence that refugee status is a risk factor for psychosis. Within research relating to mental health problems in refugee populations, studies measuring incidence of psychoses appear to be relatively rare. The existing literature has largely focused on the relationship between migration as a whole and psychosis, finding an increased incidence of psychoses in migrant populations across the generations. Surprisingly, explanatory models have largely ignored trauma as a potential factor. We review studies of refugee populations where psychosis has been systematically evaluated. Results: Although many of the studies evaluated involve small and sometimes highly specific samples, all show increased prevalence of psychoses compared to native populations. Whether such psychoses are best described as “schizophrenia‐like” or “reactive psychosis” is far from clear. Conclusion: Refugees are at an increased risk of psychosis, particularly within the early post‐migratory years for the first generation. The role of psychological trauma is clearly implicated in many studies.