TY - JOUR
T1 - The associations between migrant status and ethnicity and the identification of individuals at ultra-high risk for psychosis and transition to psychosis
T2 - a systematic review
AU - Moore, Danielle
AU - Castagnini, Emily
AU - Mifsud, Nathan
AU - Geros, Hellen
AU - Sizer, Holly
AU - Addington, Jean
AU - van der Gaag, Mark
AU - Nelson, Barnaby
AU - McGorry, Patrick
AU - O’Donoghue, Brian
N1 - 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.
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
KW - Ethnicity
KW - Migrants
KW - Systematic review
KW - Transition to psychosis
KW - Ultra-high risk for psychosis
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U2 - 10.1007/s00127-021-02047-3
DO - 10.1007/s00127-021-02047-3
M3 - Article
AN - SCOPUS:85101846475
SN - 0933-7954
VL - 56
SP - 1923
EP - 1941
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
IS - 11
ER -