3 results
Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study
- Giuseppe D'Andrea, Jatin Lal, Sarah Tosato, Charlotte Gayer-Anderson, Hannah E. Jongsma, Simona A. Stilo, Els van der Ven, Diego Quattrone, Eva Velthorst, Domenico Berardi, Paulo Rossi Menezes, Celso Arango, Mara Parellada, Antonio Lasalvia, Caterina La Cascia, Laura Ferraro, Daniele La Barbera, Lucia Sideli, Julio Bobes, Miguel Bernardo, Julio Sanjuán, Jose Luis Santos, Manuel Arrojo, Cristina Marta Del-Ben, Giada Tripoli, Pierre-Michel Llorca, Lieuwe de Haan, Jean-Paul Selten, Andrea Tortelli, Andrei Szöke, Roberto Muratori, Bart P. Rutten, Jim van Os, Peter B. Jones, James B. Kirkbride, Robin M. Murray, Marta di Forti, Ilaria Tarricone, Craig Morgan
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- Journal:
- Psychological Medicine / Volume 53 / Issue 13 / October 2023
- Published online by Cambridge University Press:
- 28 October 2022, pp. 6150-6160
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Background
Child maltreatment (CM) and migrant status are independently associated with psychosis. We examined prevalence of CM by migrant status and tested whether migrant status moderated the association between CM and first-episode psychosis (FEP). We further explored whether differences in CM exposure contributed to variations in the incidence rates of FEP by migrant status.
MethodsWe included FEP patients aged 18–64 years in 14 European sites and recruited controls representative of the local populations. Migrant status was operationalized according to generation (first/further) and region of origin (Western/non-Western countries). The reference population was composed by individuals of host country's ethnicity. CM was assessed with Childhood Trauma Questionnaire. Prevalence ratios of CM were estimated using Poisson regression. We examined the moderation effect of migrant status on the odds of FEP by CM fitting adjusted logistic regressions with interaction terms. Finally, we calculated the population attributable fractions (PAFs) for CM by migrant status.
ResultsWe examined 849 FEP cases and 1142 controls. CM prevalence was higher among migrants, their descendants and migrants of non-Western heritage. Migrant status, classified by generation (likelihood test ratio:χ2 = 11.3, p = 0.004) or by region of origin (likelihood test ratio:χ2 = 11.4, p = 0.003), attenuated the association between CM and FEP. PAFs for CM were higher among all migrant groups compared with the reference populations.
ConclusionsThe higher exposure to CM, despite a smaller effect on the odds of FEP, accounted for a greater proportion of incident FEP cases among migrants. Policies aimed at reducing CM should consider the increased vulnerability of specific subpopulations.
Synergistic effects of childhood adversity and polygenic risk in first-episode psychosis: the EU-GEI study
- Monica Aas, Luis Alameda, Marta Di Forti, Diego Quattrone, Paola Dazzan, Antonella Trotta, Laura Ferraro, Victoria Rodriguez, Evangelos Vassos, Pak Sham, Giada Tripoli, Caterina La Cascia, Daniele La Barbera, Ilaria Tarricone, Roberto Muratori, Domenico Berardi, Antonio Lasalvia, Sarah Tosato, Andrei Szöke, Pierre-Michel Llorca, Celso Arango, Andrea Tortelli, Lieuwe de Haan, Eva Velthorst, Julio Bobes, Miguel Bernardo, Julio Sanjuán, Jose Luis Santos, Manuel Arrojo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean-Paul Selten, Peter B. Jones, Hannah E. Jongsma, James B. Kirkbride, Bart P. F. Rutten, Jim van Os, Charlotte Gayer-Anderson, Robin M. Murray, Craig Morgan
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- Journal:
- Psychological Medicine / Volume 53 / Issue 5 / April 2023
- Published online by Cambridge University Press:
- 29 September 2021, pp. 1970-1978
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Background
A history of childhood adversity is associated with psychotic disorder, with an increase in risk according to the number of exposures. However, it is not known why only some exposed individuals go on to develop psychosis. One possibility is pre-existing polygenic vulnerability. Here, we investigated, in the largest sample of first-episode psychosis (FEP) cases to date, whether childhood adversity and high polygenic risk scores for schizophrenia (SZ-PRS) combine synergistically to increase the risk of psychosis, over and above the effect of each alone.
MethodsWe assigned a schizophrenia-polygenic risk score (SZ-PRS), calculated from the Psychiatric Genomics Consortium (PGC2), to all participants in a sample of 384 FEP patients and 690 controls from the case–control component of the EU-GEI study. Only participants of European ancestry were included in the study. A history of childhood adversity was collected using the Childhood Trauma Questionnaire (CTQ). Synergistic effects were estimated using the interaction contrast ratio (ICR) [odds ratio (OR)exposure and PRS − ORexposure − ORPRS + 1] with adjustment for potential confounders.
ResultsThere was some evidence that the combined effect of childhood adversities and polygenic risk was greater than the sum of each alone, as indicated by an ICR greater than zero [i.e. ICR 1.28, 95% confidence interval (CI) −1.29 to 3.85]. Examining subtypes of childhood adversities, the strongest synergetic effect was observed for physical abuse (ICR 6.25, 95% CI −6.25 to 20.88).
ConclusionsOur findings suggest possible synergistic effects of genetic liability and childhood adversity experiences in the onset of FEP, but larger samples are needed to increase precision of estimates.
Migration history and risk of psychosis: results from the multinational EU-GEI study
- Ilaria Tarricone, Giuseppe D'Andrea, Hannah E. Jongsma, Sarah Tosato, Charlotte Gayer-Anderson, Simona A. Stilo, Federico Suprani, Conrad Iyegbe, Els van der Ven, Diego Quattrone, Marta di Forti, Eva Velthorst, Paulo Rossi Menezes, Celso Arango, Mara Parellada, Antonio Lasalvia, Caterina La Cascia, Laura Ferraro, Julio Bobes, Miguel Bernardo, Iulio Sanjuán, Jose Luis Santos, Manuel Arrojo, Cristina Marta Del-Ben, Giada Tripoli, Pierre-Michel Llorca, Lieuwe de Haan, Jean-Paul Selten, Andrea Tortelli, Andrei Szöke, Roberto Muratori, Bart P. Rutten, Jim van Os, Peter B. Jones, James B. Kirkbride, Domenico Berardi, Robin M. Murray, Craig Morgan
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- Journal:
- Psychological Medicine / Volume 52 / Issue 14 / October 2022
- Published online by Cambridge University Press:
- 10 February 2021, pp. 2972-2984
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Background
Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration.
MethodsWe used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case–control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models.
ResultsIn total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06–2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02–3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03–1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672–2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose–response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06–96.47, p = 0.007).
ConclusionsThe cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants.