Social adversity contributes to high morbidity in psychoses in immigrants - a national cohort study in two generations of Swedish residents
Social adversity contributes to high morbidity in psychoses in immigrants - a national cohort study in two generations of Swedish residents
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DOI：
10.1017/s003329170300148x
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发表时间：
2004-08-01
影响因子：
6.9
通讯作者：
Dalman, C
中科院分区：
文献类型：
--
作者：
Hjern, A;Wicks, S;Dalman, C
背景资料。最近的报告表明，移民患精神分裂症的风险更高，社会排斥的趋势也越来越大。本研究的目的是比较不同民族的移民及其子女与瑞典多数人口的精神分裂症和其他精神病的发生率与社会逆境的关系。研究人群包括全国队列中的147万成年人(1929-1965年出生)和116万儿童和青年(1968-1979年出生)，这些人来自1985年全国人口普查。对1991-2000年的出院数据与1985-1990年的社会经济家庭指标(单身成人家庭、已领取社会福利的成年人、父母失业、城镇居民、住房和社会经济状况)进行多因素COX回归分析。与瑞典大多数人口相比，第一代和第二代移民患精神分裂症和其他精神病的年龄和性别调整后的风险比更高(分别为1.4-3.1和1.0-2.0)。在对所有群体的社会经济指标进行调整后，这些风险比率大幅下降，尤其是对非欧洲移民而言。然而，芬兰、东欧和南欧研究组的风险仍然较高。不同种族的两代移民患精神分裂症和精神病的风险更高。结果表明，社会逆境导致了较高的风险。
Background. Recent reports have indicated that immigrants have an elevated risk of schizophrenia as well as an increasing tendency for social exclusion. The aim of this study was to compare rates of schizophrenia and other psychoses in immigrants and their children of different ethnic groups with the majority population in Sweden in relation to social adversity.Method. The study population consists of a national cohort of 1.47 million adults (born 1929-1965) and 1.16 million children and youth (born 1968-1979) in family households from the national census of 1985. Multivariate Cox regression analyses was used to study hospital discharge data during 1991-2000 in relation to socio-economic household indicators from 1985 and 1990 (single adult household, adults having received social welfare, parental unemployment, urban residency, housing and socio-economic status).Results. First as well as second generation immigrants had higher age and sex adjusted risk ratios for schizophrenia as well as for other psychoses (RRs 1.4-3.1 and 1.0-2.0 respectively) compared with the Swedish majority population. These risk ratios decreased considerably after adjusting for socio-economic indicators, for all groups, but particularly for the non-European immigrants. However, an elevated risk still remained in the Finnish and Eastern and Southern European study groups.Conclusions. A higher risk of schizophrenia and psychoses was found in two generations of immigrants of diverse ethnicity. The results indicate that social adversity contributes to the higher risk.