Discrimination and risk of first-episode psychosis among immigrants

Poster C1, Wednesday, October 10, 11:30 am - 1:00 pm, Essex Ballroom

Supriya Misra1, Karestan Koenen1,2, David Williams1, Craig Morgan3; 1Harvard T.H. Chan School of Public Health, 2The Broad Institute, 3King's College

Over four decades of research have found higher rates of psychosis among immigrants and ethnic minorities, yet the mechanisms underlying this increased risk remain unknown. Hypotheses related to selective migration, misdiagnosis, genetic factors, or neurodevelopment injuries have not been supported yet. Rather, available evidence suggests social stressors such as experiences of perceived and actual discrimination. In a sample of 1,129 cases of first-episode psychosis (27.5% immigrants) and 1,499 ethnicity-matched controls (19.5% immigrants) from the European Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) study using the Major Experience of Discrimination Scale (12 items on being treated unfairly in employment, education, housing, medical care, public transport, and interactions with police and courts), this preliminary case-control analysis found increased risk of psychosis among migrants (aOR 1.59, 95% CI 1.32-1.92, p <0.001) and separately for cumulative experiences of major discrimination (aOR 1.25, 95% CI 1.16-1.35, p<0.001), after adjusting for age, sex, and catchment site. While more than half of cases (58%) and more than half of migrants (77%) did not experience a single major experience of discrimination, mean levels of cumulative experiences of major discrimination were significantly higher among cases than controls (t(2152)=-6.05, p<0.001), and significantly higher among migrants than natives (t(2152)=-5.18, p<0.001). Taken together, these findings suggest that higher levels of cumulative discrimination might partially explain the increased risk of psychosis among migrants, indicating these are preventable mental health disparities to target for early detection and intervention.

Topic Area: Psychosis NOS

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