38.2 THE INCIDENCE OF PSYCHOTIC DISORDER AMONG MIGRANT AND ETHNIC MINORITY GROUPS IN EUROPE: FINDINGS FROM THE MULTINATIONAL EU-GEI STUDY

Abstract

Background: The incidence of psychotic disorder is increased among various migrant and ethnic minority populations in Europe. Consistent evidence shows that risk estimates are moderated by ethnic background, but there may also be moderation by host country (1,2). We therefore aimed to study the risk of psychotic disorder in first- and second-generation immigrants in areas with varying levels of urbanicity across 5 European countries using uniform methods (3). We were particularly interested in the variation in psychosis risk among immigrants in different host countries. Method(s): The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data of individuals with a standardized, first diagnosis of nonorganic psychosis (International Classification of Disease, 10th edition (ICD-10) codes F20-F33) from 13 sites across the United Kingdom, the Netherlands, France, Spain and Italy. Age- and sexadjusted incidence rate ratios (IRRadj) for immigrants compared to the non-migrant, reference population from the same country were calculated using Poisson regression models. Denominator data were obtained from national statistics offices. Result(s): We identified 775 migrant and 1111 non-migrant cases during the study period. The IRRadj for immigrants varied from 1.15 (95% confidence interval (CI) 0.66-2.00) in Spain to 2.85 (95% CI 2.03-3.99) in the UK. We found a significant difference in risk estimates (p<0.01) by country for migrants from Sub-Saharan Africa with IRRadj's varying from 1.92 (95% CI 0.55-6.65) in Spain to 6.34 (95% CI 4.79-8.39) in the UK. A similar pattern was observed in migrants from the Middle East, the Caribbean and North Africa, while the risk in Western European migrants was not increased compared to the non-migrants. There were no significant risk differences between first- and second-generation migrants. Conclusion(s): We found a higher incidence of psychotic disorders among non-Western migrant groups in Europe and significant variation between host countries. The contextual circumstances in which migrants live appear to be an important determinant for their psychosis risk.