Subclinical psychosis in adult migrants and ethnic minorities: systematic review and meta-analysis
Andrea Tortelli,
Aurélie Nakamura,
Federico Suprani,
Franck Schürhoff,
Judith Van der Waerden,
Andrei Szöke,
Ilaria Tarricone,
Baptiste Pignon
Affiliations
Andrea Tortelli
U955-15, INSERM, Créteil and Pôle GHT Psychiatrie Précarité, Paris, France
Aurélie Nakamura
UMR_S 1136, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, France
Federico Suprani
Department of Medical and Surgical Sciences, Bologna University, Italy
Franck Schürhoff
U955-15, INSERM and Pôle de Psychiatrie et d'Addictologie, DHU PePSY, Hôpitaux universitaires Henri-Mondor, AP-HP and Fondation FondaMental Scientific Cooperation Foundation, F-94010 Creteil and Faculté de médecine, University Paris-Est Créteil, France
Judith Van der Waerden
UMR_S 1136, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, l'université Pierre et Marie Curie, France
Andrei Szöke
U955-15, INSERM and Pôle de Psychiatrie et d'Addictologie, DHU PePSY, Hôpitaux universitaires Henri-Mondor, AP-HP and Fondation FondaMental, France
Ilaria Tarricone
Department of Medical and Surgical Sciences, Bologna University, Italy
Baptiste Pignon
U955-15, INSERM and Pôle de Psychiatrie et d'Addictologie, DHU PePSY, Hôpitaux universitaires Henri-Mondor, AP-HP and Fondation FondaMental and Faculté de médecine, University Paris-Est Créteil, France
BackgroundIt is well established that migration and ethnic minority status are risk factors for psychotic disorders. Recent studies have aimed to determine if they are also associated with subclinical psychosis (psychotic-like experiences and schizotypal traits).AimsWe aimed to determine to what extent migrant and ethnic minority groups are associated with higher risk of subclinical psychosis.MethodWe conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and examined findings by ethnicity, migrant status, outcomes of subclinical psychosis and host country. A meta-analysis was carried out with robust variance estimation where possible, to handle statistically dependent effect size estimates.ResultsWe included 28 studies (19 studies on psychotic-like experiences and 9 studies on schizotypal traits) and found that ethnicity, but not migrant status, was associated with current and lifetime psychotic-like experiences. In the narrative analysis, we observed the effect of psychosocial risk factors on this association: Black ethnicity groups showed consistent increased prevalence of current and lifetime psychotic-like experiences compared with the reference population across countries.ConclusionsMore generalisable and standardised cohort studies of psychotic-like experiences and schizotypal traits in relation to migration/ethnicity are necessary to examine the effects of exposures and outcomes in different contexts, and to understand the underlying mechanisms of the association between subclinical psychosis and migrant and ethnic minority status.Declaration of interestNone.
