Abstract
In Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (hence: 'minorities'). However, it is unknown how the incidence pattern for these groups varies within this continent. Our objective was to compare, across sites in France, Italy, Spain, the UK and the Netherlands, the incidence rates for minorities and the incidence rate ratios (IRRs, minorities v. the local reference population). The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data on incident cases of non-organic psychosis (International Classification of Diseases, 10th edition, codes F20-F33) from 13 sites. The standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. IRRs for minorities (combined into one category) varied from 0.70 (95% CI 0.32-1.53) in Valencia to 2.47 (95% CI 1.66-3.69) in Paris (test for interaction: p = 0.031). At most sites, IRRs were higher for persons from non-Western countries than for those from Western countries, with the highest IRRs for individuals from sub-Saharan Africa (adjusted IRR = 3.23, 95% CI 2.66-3.93). Incidence rates vary by region of origin, region of destination and their combination. This suggests that they are strongly influenced by the social context.
Highlights
Studies in Western Europe have found an increased incidence of affective and non-affective psychotic disorder among various migrant and minority ethnic groups (Bourque, van der Ven, & Malla, 2011; Selten, van der Ven, & Termorshuizen, 2020)
The remaining cases were diagnosed with affective psychotic disorder (APD) (106 from minorities and 248 from reference populations) or could not be diagnosed with either APD or NAPD
The results show that the rate for minorities in Barcelona, combined into one category, was approximately five times lower than that in Amsterdam (IRR = 0.21, 95% CI 0.13– 0.33), while the rate in Paris was higher than that in Amsterdam (IRR = 1.37, 95% CI 0.99–1.89)
Summary
Studies in Western Europe have found an increased incidence of affective and non-affective psychotic disorder among various migrant and minority ethnic groups (Bourque, van der Ven, & Malla, 2011; Selten, van der Ven, & Termorshuizen, 2020). In most European countries the denominator information is organized around the variable country of birth This permitted a comparison of risk for first-generation migrants to that for the native-born. In Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (: ‘minorities’). It is unknown how the incidence pattern for these groups varies within this continent. The standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. This suggests that they are strongly influenced by the social context
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