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Ethnic minority position and migrant status as risk factors for psychotic symptoms in the general population: a meta-analysis

Published online by Cambridge University Press:  04 September 2018

Edouard Leaune ,
Marie-Jose Dealberto ,
David Luck ,
Stéphanie Grot ,
Halima Zeroug-Vial ,
Emmanuel Poulet  and
Jerome Brunelin
Edouard Leaune*
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France
Marie-Jose Dealberto
Affiliation:
Centre Hospitalier Saint Jean de Dieu, Lyon, France
David Luck
Affiliation:
Centre de recherche, Institut Universitaire en Santé Mentale de Montréal, Canada Department of Psychiatry, Université de Montréal, Québec, Canada Groupe d'Etude en Emotion et Cognition, Institut Universitaire en Santé Mentale de Montréal, Canada
Stéphanie Grot
Affiliation:
Centre de recherche, Institut Universitaire en Santé Mentale de Montréal, Canada Department of Psychiatry, Université de Montréal, Québec, Canada Groupe d'Etude en Emotion et Cognition, Institut Universitaire en Santé Mentale de Montréal, Canada
Halima Zeroug-Vial
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France
Emmanuel Poulet
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France
Jerome Brunelin
Affiliation:
Centre Hospitalier Le Vinatier, Bron, France INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France
*
Author for correspondence: Edouard Leaune, E-mail: [email protected]
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Abstract

Psychotic symptoms (PS) are experienced by a substantial proportion of the general population. When not reaching a threshold of clinical relevance, these symptoms are defined as psychotic experiences (PEs) and may exist on a continuum with psychotic disorders. Unfavorable socio-environmental conditions, such as ethnic minority position (EMP) and migrant status (MS), may increase the risk of developing PS and PEs. We conducted an electronic systematic review and a meta-analysis assessing the role of EMP and MS for the development and persistence of PS in the general population. Sub-group analyses were performed investigating the influence of ethnic groups, host countries, age, types of PS, and scales. Twenty-four studies met our inclusion criteria. EMP was a relevant risk factor for reporting PS [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.22–1.70) and PEs (OR 1.36, 95% CI 1.16–1.60). The greatest risk was observed in people from the Maghreb and the Middle East ethnic groups in Europe (OR 3.30, 95% CI 2.09–5.21), in Hispanic in the USA (OR 1.98, 95% CI 1.43–2.73), and in the Black populations (OR 1.85, 95% CI 1.39–2.47). We found a significant association between MS and delusional symptoms (OR 1.47, 95% CI 1.33–1.62). We found no association between EMP and persistence of PEs.

EMP was associated with increased risk of reporting PS and PEs, and the risk was higher in ethnic groups facing deprivation and discrimination. We found an association between MS and delusional symptoms. These results raise questions about the precise role of socio-environmental factors along the psychosis continuum.

Keywords

Continuumdiscriminationethnicitymigrationpsychosispsychotic experiences
Type
Review Article
Information
Psychological Medicine , Volume 49 , Issue 4 , March 2019 , pp. 545 - 558
Copyright
Copyright © Cambridge University Press 2018 

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