Family networks during migration and risk of non-affective psychosis: A population-based cohort study

Abstract

Objective The determinants of increased psychosis risk among immigrants remain unclear. Given ethnic density may be protective, we investigated whether the presence of immediate family, or “family networks”, at time of immigration was associated with risk of non-affective psychosis. Methods We followed a cohort of migrants (n = 838,717) to Sweden, born 1968–1997, from their 14 th birthday, or earliest immigration thereafter, until diagnosis of non-affective psychosis (ICD-9/ICD-10), emigration, death, or 2011. Using record linkage, we measured family network as the presence of adult first-degree relatives immigrating with the cohort participant or already residing in Sweden. We used Cox proportional hazards regression to examine whether risk varied between those migrating with family, migrating to join family, or migrating alone. Results Migrating with immediate family was associated with increased psychosis risk amongst males compared to males who did not migrate with family (adjusted Hazard Ratio [aHR]: 1.16, 95% CI: 1.00–1.34). Migrating with family did not increase risk among females (aHR: 0.91, 95% CI: 0.78–1.07); similar observations were observed for males who immigrated to join family (aHR: 1.35, 95% CI: 1.21–1.51). In contrast, females who migrated alone were at increased risk compared to females who did not migrate alone (aHR: 1.31, 95% CI: 1.11–1.54). Conclusion Family networks at the time of immigration were associated with differential patterns of non-affective psychotic disorders for males and females. These results suggest sex-specific differences in the perceived role of family networks during the migration process.

Risk of psychotic disorders in migrants to Australia

“…First, it could be that certain migrant groups are more or less likely to be exposed to established risk factors for developing a psychotic disorder, such as a positive family history for a psychotic disorder (Mortensen, Pedersen, & Pedersen, 2010), obstetrical complications (Cannon, Jones, & Murray, 2002), trauma (Hollander et al, 2016; Popovic et al, 2019), social deprivation (O'Donoghue, Roche, & Lane, 2016) and drug use (Moore et al, 2007). Second, there may be a factor specific to migration that increases the risk, such as adapting to a new country, the experience of migration or seeking asylum and how the migrants are received in the new country (Dykxhoorn, Hollander, Lewis, Dalman, & Kirkbride, 2019). Third, it is possible that migrants from different regions of origin are more or less likely to be referred to treatment programmes such as EPPIC.…”

Association of neighbourhood migrant density and risk of non-affective psychosis: a national, longitudinal cohort study

“…Migrant density might work through psychosocial pathways 12 to provide increased social support, enhance feelings of inclusion, and buffer individuals from experiences of racism and discrimination. While family members comprise an important source of social support and social capital, 44 relationships with friends and neighbours can contribute to a wider sense of inclusion and belonging. Migrants moving to areas with a high concentration of individuals from the same region could experience a greater sense of belonging, feel connected to others, and have access to emotional and practical support.…”

The Impact of Social Capital, Demographic Factors, and Coping Strategies on Community Adaptation in Supporting People with Severe Mental Illness

“…Furthermore, the migrants and their family members left behind were at higher risk of experiencing severe mental illness (aHR: 1.00, 95% CI 0.93–1.08). 14 , 15 …”

“…Previous studies showed that migration and social changes had negative effects on the mental health issues of parents with an adverse impact on other family members. 14 , 15 …”