Psychiatric disorders and social characteristics among second-generation Moroccan migrants in Belgium: An age–and gender–controlled study conducted in a psychiatric emergency department

Summary Purpose. Clinically, one of the most consistent clinical findings among migrant patients is an increase in the rate of psychosis. The aim of the present study was to confirm this finding in Belgium by comparing second-generation Moroccan migrant patients with Belgian patients, matched for the variables of age and gender. Subjects and method. We conducted a cross-sectional survey on 272 patients admitted in a psychiatric emergency unit during the year 1998. We used univariate and multivariate analyses to compare the two subgroups. Results. Multivariate analyses showed that migrant patients lived more often with their parental family and that they presented a higher rate of admission for psychotic disorders and a lower rate of employment. Discussion. Our findings add to the growing body of results showing increased incidence of psychosis among immigrants to European countries, but several factors have to be taken into account, particularly with regard to selection biases and differences in help-seeking behaviour and in family perception of the mental illness. Conclusion. Our results are compatible with the hypothesis that unemployment is a contributing factor in the risk for psychosis among migrant groups. Further studies would be needed to better explain some of our results, particularly the role played by the families of migrant patients.

[1]  R. Goodman,et al.  Child and Adolescent Psychiatric Presentations of Second-Generation Afro-Caribbeans in Britain , 1995, British Journal of Psychiatry.

[2]  R. Mass,et al.  Potential for misdiagnosis amongTurkish migrants with psychotic disorders:a clinical controlled study in Germany , 2000, Acta psychiatrica Scandinavica.

[3]  M. Abou-Saleh,et al.  Problems in validating endogenous depression in the Arab culture by contemporary diagnostic criteria. , 1997, Journal of affective disorders.

[4]  R. Murray,et al.  Understanding the excess of psychosis among the African-Caribbean population in England. Review of current hypotheses. , 2001, The British journal of psychiatry. Supplement.

[5]  E. Johnson-Sabine,et al.  Incidence of psychotic illness in London: comparison of ethnic groups , 1994, BMJ.

[6]  H. Hoek,et al.  Incidence of psychotic disorders in immigrant groups to The Netherlands. , 2001, The British journal of psychiatry : the journal of mental science.

[7]  G. Glover.  Psychiatric illness among British Afro-Caribbeans. , 1988, BMJ.

[8]  G. Rwegellera.  Differential use of Psychiatric Services by West Indians, West Africans and English in London , 1980, British Journal of Psychiatry.

[9]  R. Murray,et al.  Schizophrenia and Afro-Caribbeans a Case-Control Study , 1991, British Journal of Psychiatry.

[10]  M. Lambert,et al.  Impact of ethnicity on the prevalence of psychiatric disorders among migrants in Germany. , 1998, Ethnicity & health.

[11]  S. Gupta.  Can environmental factors explain the epidemiology of schizophrenia in immigrant groups? , 1993, Social Psychiatry and Psychiatric Epidemiology.

[12]  S. S. Bal,et al.  Migration and schizophrenia: an examination of five hypotheses , 2004, Social psychiatry.

[13]  B. V. D. van de Wetering,et al.  Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities , 2001, European Psychiatry.

[14]  G. Thornicroft,et al.  Ethnic differences in satisfaction with mental health services among representative people with psychosis in South London: PRiSM Study 4 , 1997, British Journal of Psychiatry.

[15]  M. F. El-Islam.  A Better Outlook for Schizophrenics Living in Extended Families , 1979, British Journal of Psychiatry.

[16]  J. Mendlewicz,et al.  Immigration and psychopathology: a clinical study , 1995, European Psychiatry.

[17]  J. Selten,et al.  First admission rates for schizophrenia in immigrants to the Netherlands , 1994, Social Psychiatry and Psychiatric Epidemiology.

[18]  N. Fulop,et al.  Ethnicity and use of acute psychiatric beds: One-day survey in North and South Thames regions , 1997, British Journal of Psychiatry.

[19]  P. McGuffin,et al.  The Functional Psychoses in Afro-Caribbeans , 1990, British Journal of Psychiatry.

[20]  E. Cantor-Graae,et al.  Increased rates of psychosis among immigrants to Sweden: is migration a risk factor for psychosis ? , 2001, Psychological Medicine.

[21]  M. Lambert,et al.  Psychiatric disorders among migrants in Germany: prevalence in a psychiatric clinic and implications for services and research , 1997, European Psychiatry.

[22]  P. Jones,et al.  Increased incidence of psychotic disorders in migrants from the Caribbean to the United Kingdom , 1997, Psychological Medicine.

[23]  J. Eagles.  The Relationship Between Schizophrenia and Immigration are There Alternatives to Psychosocial Hypotheses? , 1991, British Journal of Psychiatry.

[24]  E. Cantor-Graae,et al.  Increased rates of schizophrenia among immigrants: some methodological concerns raised by Danish findings , 1997, Psychological Medicine.

[25]  G. Der,et al.  Incidence and outcome of schizophrenia in Whites, African-Caribbeans and Asians in London , 1997, Psychological Medicine.

[26]  R. Poland,et al.  Ethnicity and Family Involvement in the Treatment of Schizophrenic Patients , 1991, The Journal of nervous and mental disease.

[27]  R. Cochrane.  Mental illness in immigrants to England and Wales: An analysis of mental hospital admissions, 1971 , 1977, Social psychiatry.

[28]  R. Perkins,et al.  Perception of problems in psychiatric inpatients: denial, race and service usage , 1993, Social Psychiatry and Psychiatric Epidemiology.

[29]  P. McGorry,et al.  Who cares? Pathways to psychiatric care for young people experiencing a first episode of psychosis. , 1995, Psychiatric services.

[30]  P. Bebbington,et al.  Life Events and Psychosis , 1993, British Journal of Psychiatry.

[31]  D. Owens,et al.  A prospective study of severe mental disorder in Afro-Caribbean patients , 1988, Psychological Medicine.

[32]  G. Harrison.  Searching for the causes of schizophrenia: the role of migrant studies. , 1990, Schizophrenia bulletin.

[33]  D. McGovern,et al.  First psychiatric admission rates of first and second generation Afro Caribbeans , 2004, Social psychiatry.

[34]  D. Owens,et al.  Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors , 1989, Psychological Medicine.

[35]  R. Murray,et al.  Psychotic illness in ethnic minorities: clarification from the 1991 census , 1996, Psychological Medicine.

[36]  J. Hurry,et al.  Psychiatric disorders in selected immigrant groups in Camberwell , 1981, Social psychiatry.

[37]  R. Murray,et al.  Life events, ethnicity and perceptions of discrimination in patients with severe mental illness , 1999, Social Psychiatry and Psychiatric Epidemiology.

[38]  M. Osborn,et al.  Psychiatric Morbidity and Compulsory Admission Among UK-Born Europeans, Afro-Caribbeans and Asians in Central Manchester , 1993, British Journal of Psychiatry.

[39]  G. Thornicroft,et al.  Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London , 1996, BMJ.