People who migrate in adolescence are at increased risk of psychosis, researchers have found, noting that the link is especially strong among black and North African people.
Although research has previously suggested that migration could play a role in the increased risk of psychosis among people from ethnic minorities, the research suggests that age could be an important factor.
James Kirkbride, professor of psychiatric and social epidemiology at University College London (UCL) and co-author of the study, said adolescence was a time when individuals formed a sense of identity and went through social, cognitive and neurological development.
He said: “So migrating during adolescence, which interrupts the formation of social networks, and may require teenage migrants to learn a new language, adopt new social and cultural norms and customs, and manage new social environments – including potential exposure to racism and discrimination known to be associated with the risk of psychosis – could all play a role in making adolescent migration a particularly vulnerable period for increasing future risk of psychosis.”
Writing in the journal PLOS Mental Health, Kirkbride and colleagues explain how they analyzed data from 2,132 people aged 18 to 64 in England, France, Italy, Spain and the Netherlands who were part of a larger study. Of this group, 937 people had experienced a first episode of a psychotic disorder, with this occurring post-migration in those who had migrated.
Most people who migrated, Kirkbride said, had done so for economic reasons, rather than, for example, seeking asylum.
After taking into account factors such as ethnicity, characteristics of social disadvantage and parental history of psychosis, the team found that those who migrated between the ages of 11 and 17 had almost twice the risk of developing psychosis compared to white people who had not migrated. However, there was no increased risk for people who migrated in infancy, early childhood or adulthood.
In a further analysis, the team found that the increased risk of psychosis in adolescents was only significant among black and North African migrants. Although Kirkbride noted that the exact link was difficult to determine due to the small size of the latter group in the study, the risk of psychosis for these groups was at least two to three times higher than for white people who had not migrated.
The analysis also found that North African adults, black people of all ages and non-migrants who were black or of mixed ethnic background were at greater risk of psychosis compared to white non-migrants. There was no such increase for white or Asian migrants.
Humma Andleeb, the study’s first author, also from UCL, said white people were not visible minorities in Europe, meaning they did not face the same disadvantages or might find it easier to adapt. “They are also more likely to migrate within Europe and not experience the same disadvantages before or after migration,” she says.
The study has limitations, including that it cannot prove cause and effect, does not follow people over time, and the sample size for some groups is small. Further research is also needed to unravel why adolescents who migrate have an increased risk of psychosis.
Kirkbride said: “What we need to focus on for that group is ways to help them manage their mental health and help them integrate into society so that they are armed with the social skills they need to navigate new environments navigate and prevent them from developing serious mental health problems. problems.”
Dr. Adam Coutts of the University of Cambridge, who was not involved in the work, said the health impact on asylum seekers would be worse given the insecurity and lack of access to services and jobs they faced. “The key issue is that the plight of economic migrants, refugees and asylum seekers has exposed the fragile nature of government frontline services such as mental health. These need to be improved for everyone, including locals and migrants.”
Dr. Gracia Fellmeth, from the University of Oxford, agreed. She said: “(These) findings highlight the urgent need to ensure that young migrants receive the care and support they need to thrive in their new environment.”