Andrea Tortelli et al. , « Subclinical psychosis in adult migrants and ethnic minorities : systematic review and meta-analysis », BJPsych Open, nov. 2018

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Résumé

Back­ground

It 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).

Aims

We aimed to deter­mine to what extent migrant and ethnic mino­rity groups are asso­ciated with higher risk of subcli­nical psychosis.

Method

We 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.

Results

We 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.

Conclu­sions

More 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.