The associations between migrant status and ethnicity and the identification of individuals at ultra-high risk for psychosis and transition to psychosis: a systematic review

Danielle Moore, Emily Castagnini, Nathan Mifsud, Hellen Geros, Holly Sizer, Jean Addington, Mark van der Gaag, Barnaby Nelson, Patrick McGorry, Brian O’Donoghue*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Purpose: Migrant and ethnic minority populations exhibit a higher incidence of psychotic disorders. The Ultra-High Risk for psychosis (UHR) paradigm provides an opportunity to explore the stage at which such factors influence the development of psychosis. In this systematic review, we collate and appraise the literature on the association between ethnicity and migrant status and the rate of identification of individuals at UHR, as well as their rate of transition to psychosis. Methods: We conducted a systematic review in the Ovid Medline, PsychINFO, Pubmed, CINAHL and EMBASE databases according to PRISMA guidelines. We included studies written in English that included an UHR cohort, provided a measure of ethnicity or migrant status, and examined the incidence, rate, or risk of UHR identification or transition to psychosis. Results: Of 2182 unique articles identified, seven fulfilled the criteria. One study found overrepresentation of UHR individuals from black ethnic groups, while another found underrepresentation. Two studies found increased rates of transition among certain ethnic groups and a further two found no association. Regarding migrant status, one study found that first-generation migrants were underrepresented in an UHR sample. Lastly, a lower transition rate in migrant populations was identified in one study, while two found no association. Conclusion: Rates of UHR identification and transition according to ethnic and migrant status were inconsistent and insufficient to conclusively explain higher incidences of psychotic disorders among these groups. We discuss the clinical implications and avenues for future research, which is required to clarify the nature of the associations.

Original languageEnglish
Pages (from-to)1923-1941
Number of pages19
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume56
Issue number11
Early online date28 Feb 2021
DOIs
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
Dr Brian O'Donoghue is funded by NHMRC Early Career Fellowship—APP1142045.

Publisher Copyright:
© 2021, Springer-Verlag GmbH, DE part of Springer Nature.

Keywords

  • Ethnicity
  • Migrants
  • Systematic review
  • Transition to psychosis
  • Ultra-high risk for psychosis

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