The association between migrant status and transition in an ultra-high risk for psychosis population

• Published in: Social Psychiatry and Psychiatric Epidemiology 2021-06, Vol.56 (6), p.943-952
• Main Authors: O’Donoghue, Brian, Geros, Hellen, Sizer, Holly, Addington, Jean, Amminger, G. Paul, Beaden, Carrie E., Cadenhead, Kristin S., Cannon, Tyrone D., Cornblatt, Barbara A., Berger, Gregor Emanuel, Chen, Eric Y. H., de Haan, Lieuwe, Hartmann, Jessica A., Hickie, Ian B., Ising, Helga K., Lavoie, Suzie, Lin, Ashleigh, Markulev, Connie, Mathalon, Daniel H., McGlashan, Thomas H., Mifsud, Nathan G., Mossaheb, Nilufar, Nieman, Dorien H., Nordentoft, Merete, Perkins, Diana O., Riecher-Rössler, Anita, Schäfer, Miriam R., Schlögelhofer, Monika, Seidman, Larry J., Smesny, Stephan, Thompson, Andrew, Tsuang, Ming T., van der Gaag, Mark, Verma, Swapna, Walker, Elaine F., Wood, Stephen J., Woods, Scott W., Yuen, Hok Pan, Yung, Alison Ruth, McGorry, Patrick D., Nelson, Barnaby
• Format: Article
• Language: English
• Subjects: Epidemiology; Heterogeneity; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Original Paper; Psychiatry; Psychosis; Risk analysis; Systematic review; Teenagers; Young adults; Youth
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-020-02012-6

Purpose Migrant status is one of the most replicated and robust risk factors for developing a psychotic disorder. This study aimed to determine whether migrant status in people identified as Ultra-High Risk for Psychosis (UHR) was associated with risk of transitioning to a full-threshold psychotic disorder. Methods Hazard ratios for the risk of transition were calculated from five large UHR cohorts ( n  = 2166) and were used to conduct a meta-analysis using the generic inverse-variance method using a random-effects model. Results 2166 UHR young people, with a mean age of 19.1 years (SD ± 4.5) were included, of whom 221 (10.7%) were first-generation migrants. A total of 357 young people transitioned to psychosis over a median follow-up time of 417 days (I.Q.R.147–756 days), representing 17.0% of the cohort. The risk of transition to a full-threshold disorder was not increased for first-generation migrants, (HR = 1.08, 95% CI 0.62–1.89); however, there was a high level of heterogeneity between studies The hazard ratio for second-generation migrants to transition to a full-threshold psychotic disorder compared to the remainder of the native-born population was 1.03 (95% CI 0.70–1.51). Conclusions This meta-analysis did not find a statistically significant association between migrant status and an increased risk for transition to a full-threshold psychotic disorder; however, several methodological issues could explain this finding. Further research should focus on examining the risk of specific migrant groups and also ensuring that migrant populations are adequately represented within UHR clinics.