38.1 MIGRANTS FROM AFRICA TO AUSTRALIA HAVE AN INCREASED RISK OF DEVELOPING A PSYCHOTIC DISORDER BUT ARE UNDER-REPRESENTED IN ULTRA-HIGH RISK FOR PSYCHOSIS CLINICS

Abstract

Background: Certain migrant groups have an increased risk of psychosis compared to the native-born population, however the majority of these studies have originated from Europe and the Americas and it is not yet known whether migrants to Australia have an increased risk of developing a psychotic disorder. In addition, there is very limited knowledge on the association between migrant status and the ultra-high risk (UHR) for psychosis state. This presentation will determine whether: (i) Migrants to Australia at an increased risk for developing a first episode of psychosis (FEP). (ii) Migrants are more or less likely to be detected by an UHR clinic. (iii) Migrants who are identified at being UHR have an increased risk of transitioning to a full threshold psychotic disorder. Method(s): Consists of all young people aged 15-24 with a FEP who presented to the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne between 01.01.2011 and 31.12.2013. The second cohort consisted of all young people identified as UHR and attended the PACE clinic between 01.01.2012 and 31.12.2016. the CAARMS assessment was used to determine UHR and transition status. Result(s): A total of 527 individuals with FEP were included and 58.8% were male and the mean age was 19.5 years (SD=2.9). Migrants from Kenya (IRR=9.81), Ethiopia (IRR=5.17), Somalia (IRR=3.78), and Sudan (IRR=3.57), had significantly increased risk of having a psychotic disorder compared to young people born in Australia. Over a 5-year period, 488 young people were identified as UHR and migrants were under-represented in this cohort. A total of 22.2% of migrants transitioned to a full threshold psychotic disorder compared to 19.7% of the Australian born UHR young people. Conclusion(s): First-generation migrants from East Africa and the Horn of Africa have significantly high rates of psychosis however they are underrepresented in the UHR clinics. These findings have significant importance for pathways to care for migrants and ensuring timely access to care.