Migration, ethnicity, and psychosis: Toward a sociodevelopmental model

Abstract

There is consistent and strong evidence that the incidence of all psychoses is higher in many migrant and minority ethnicpopulations in a number of countries. The reasons for thisare, however, unclear and a wide range of explanationshave been proposed, from genetic to neurodevelopmentalto psychosocial. In this article, we describe and evaluatethe available evidence for and against each of these.What this shows is that: (1) there are few studies thathave directly investigated specific risk factors in migrantand minority ethnic populations, with of ten only 1 or 2 studiesof any relevance to specific explanations and (2) whatlimited research there has been tends to implicate a diverserange of social factors (including childhood separationfrom parents, discrimination and, at an area level, ethnicdensity) as being of potential importance. In an attemptto synthesize these disparate findings and provide a basisfor future research, we go on to propose an integratedmodel-of a sociodevelopmental pathway to psychosis-toaccount for the reported high rates in migrant and minorityethnic populations. Aspects of this model will be directlytested in a new Europe-wide incidence and case-controlstudy that we will conduct over the next 3 years, as partof the European Network of National SchizophreniaNetworks studying Gene-Environment Interactionsprogramme. © The Author 2010. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.