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Risk of first-episode psychosis in migrants to the Republic of Ireland

Published online by Cambridge University Press:  25 May 2021

Brian O'Donoghue Open the ORCID record for Brian O'Donoghue [Opens in a new window] ,
John Lyne ,
Eric Roche ,
Nathan Mifsud Open the ORCID record for Nathan Mifsud [Opens in a new window] ,
Laoise Renwick ,
Caragh Behan  and
Mary Clarke
Brian O'Donoghue*
Affiliation:
Orygen, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
John Lyne
Affiliation:
Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co Wicklow, Ireland Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
Eric Roche
Affiliation:
Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
Nathan Mifsud
Affiliation:
Orygen, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
Laoise Renwick
Affiliation:
Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England
Caragh Behan
Affiliation:
Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
Mary Clarke
Affiliation:
DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland Department of Psychiatry, University College Dublin, Dublin, Ireland
*
Author for correspondence: Brian O'Donoghue, E-mail: brian.odonoghue@orygen.org.au
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Abstract

Background

Migration is an established risk factor for developing a psychotic disorder in countries with a long history of migration. Less is known for countries with only a recent history of migration. This study aimed to determine the risk for developing a psychotic disorder in migrants to the Republic of Ireland.

Methods

We included all presentations of first-episode psychosis over 8.5 years to the DETECT Early Intervention for psychosis service in the Republic of Ireland (573 individuals aged 18–65, of whom 22% were first-generation migrants). Psychotic disorder diagnosis relied on SCID. The at-risk population was calculated using census data, and negative binomial regression was used to estimate incidence rate ratios.

Results

The annual crude incidence rate for a first-episode psychotic disorder in the total cohort was 25.62 per 100000 population at risk. Migrants from Africa had a nearly twofold increased risk for developing a psychotic disorder compared to those born in the Republic of Ireland (IRR = 1.83, 95% CI 1.11–3.02, p = 0.02). In contrast, migrants from certain Asian countries had a reduced risk, specifically those from China, India, Philippines, Pakistan, Malaysia, Bangladesh and Hong Kong (aIRR = 0.36, 95% CI 0.16–0.81, p = 0.01).

Conclusions

Further research into the reasons for this inflated risk in specific migrant groups could produce insights into the aetiology of psychotic disorders. This information should also be used, alongside other data on environmental risk factors that can be determined from census data, to predict the incidence of psychotic disorders and thereby resource services appropriately.

Keywords

Schizophreniamigrationpsychosisincidence
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 2 , January 2023 , pp. 468 - 475
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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