Background and Hypothesis Although migration is a well-established risk factor for psychotic disorders, less is known about factors that modify risk within migrant groups. We sought to assess whether socio-demographic, migration-related, and post-migration factors were associated with the risk of non-affective psychotic disorders (NAPD) among first-generation migrants, and to compare with estimates for common mental disorders (CMD) to explore specificity of the effect. Study Design We constructed a retrospective cohort of first-generation migrants to Ontario, Canada using linked population-based health administrative data (1992–2011; n = 1 964 884). We identified NAPD and CMD using standardized algorithms. We used modified Poisson regression models to estimate incidence rate ratios (IRR) for each factor to assess its effect on the risk of each outcome. Study Results Nearly 75% of cases of NAPD met the case definition for a CMD prior to the first diagnosis of psychosis. Our findings suggest that younger age at migration, male sex, being of African-origin, and not having proficiency in national languages had a specificity of effect for a higher risk of NAPD. Among migrants who were over 19 years of age at landing, higher pre-migratory education and being married/common-law at landing showed specificity of effect for a lower risk of NAPD. Migrant class, rurality of residence after landing, and post-migration neighborhood-level income showed similar effects across disorders. Conclusions Our findings help identify high-risk groups to target for intervention. Identifying factors that show specific effects for psychotic disorder, rather than mental disorders more broadly, are important for informing prevention and early intervention efforts.

中文翻译：

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流动人群非情感性精神障碍与常见精神障碍的危险因素比较：200 万流动人口的 25 年回顾性队列研究

背景和假设 虽然移民是精神病的公认危险因素，但人们对改变移民群体内风险的因素知之甚少。我们试图评估社会人口统计学、移民相关因素和移民后因素是否与第一代移民的非情感性精神病 (NAPD) 风险相关，并与常见精神障碍 (CMD) 的估计值进行比较探索效果的特异性。研究设计 我们使用基于人口的相关健康管理数据（1992-2011 年；n = 1 964 884）构建了加拿大安大略省第一代移民的回顾性队列。我们使用标准化算法确定了 NAPD 和 CMD。我们使用修正的泊松回归模型来估计每个因素的发生率比 (IRR)，以评估其对每个结果风险的影响。研究结果 在第一次诊断为精神病之前，近 75% 的 NAPD 病例符合 CMD 的病例定义。我们的研究结果表明，较年轻的移民、男性、非洲血统和不精通本国语言对 NAPD 的较高风险具有特异性影响。在登陆时年满 19 岁的移民中，更高的移民前教育和登陆时已婚/同居对降低 NAPD 风险具有特异性。移民阶级、登陆后的农村居住地以及移民后的邻里收入在各种疾病中表现出相似的影响。结论 我们的研究结果有助于确定高危人群以进行干预。确定对精神障碍（而非更广泛的精神障碍）显示特定影响的因素对于告知预防和早期干预工作很重要。