Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-17T14:52:14.777Z Has data issue: false hasContentIssue false
  • English
  • Français

Perceived major experiences of discrimination, ethnic group, and risk of psychosis in a six-country case−control study

Published online by Cambridge University Press:  02 March 2021

Supriya Misra Open the ORCID record for Supriya Misra [Opens in a new window] ,
Bizu Gelaye ,
David R. Williams ,
Karestan C. Koenen ,
Christina P.C. Borba ,
Diego Quattrone ,
Marta Di Forti ,
Giada Tripoli ,
Caterina La Cascia  and
Daniele La Barbera
...Show all authors
Supriya Misra*
Affiliation:
Department of Public Health, San Francisco State University, San Francisco, CA 94132, USA
Bizu Gelaye
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
David R. Williams
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Karestan C. Koenen
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Christina P.C. Borba
Affiliation:
Department of Psychiatry, Boston Medical Center; Boston University School of Medicine, Boston, MA 02118, USA
Diego Quattrone
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
Marta Di Forti
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
Giada Tripoli
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129 Palermo, Italy
Caterina La Cascia
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129 Palermo, Italy
Daniele La Barbera
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129 Palermo, Italy
Laura Ferraro
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129 Palermo, Italy
Ilaria Tarricone
Affiliation:
Department of Medical and Surgical Science, Bologna Transcultural Psychosomatic Team, (BoTPT), Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
Domenico Berardi
Affiliation:
Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater, Studiorum Università di Bologna, 40126 Bologna, Italy
Antonio Lasalvia
Affiliation:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Sarah Tosato
Affiliation:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Andrei Szöke
Affiliation:
INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, 94010 Créteil, France
Pierre-Michel Llorca
Affiliation:
University Clermont Auvergne, CMPB CHU Clermont-Ferrand, EA 7280, France
Celso Arango
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad, Complutense, IiSGM, CIBERSAM, 28007 Madrid, Spain
Andrea Tortelli
Affiliation:
Etablissement Public de Santé Maison Blanche, 75020 Paris, France
Lieuwe de Haan
Affiliation:
Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic, Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
Eva Velthorst
Affiliation:
Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic, Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
Julio Bobes
Affiliation:
Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, 33006 Oviedo, Spain
Miguel Bernardo
Affiliation:
Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, 08036 Barcelona, Spain
Julio Sanjuán
Affiliation:
Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de, Investigación Biomédica en Red de Salud Mental (CIBERSAM), 46010 Valencia, Spain
Jose Luis Santos
Affiliation:
Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,”, 16002 Cuenca, Spain
Manuel Arrojo
Affiliation:
Department of Psychiatry, Psychiatry Genetic Group, Instituto de Investigación Sanitaria de, Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain
Cristina Marta Del-Ben
Affiliation:
Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo 14049-900, Brazil
Paulo Rossi Menezes
Affiliation:
Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo 01246-903, Brazil
Jean-Paul Selten
Affiliation:
Rivierduinen Institute for Mental Health Care, 2333 ZZ Leiden, The Netherlands
Peter B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
Hannah E. Jongsma
Affiliation:
Psylife Group, Division of Psychiatry, University College London, London W1T 7NF, UK
James B. Kirkbride
Affiliation:
Psylife Group, Division of Psychiatry, University College London, London W1T 7NF, UK
Bart P.F. Rutten
Affiliation:
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
Jim van Os
Affiliation:
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF, UK
Robin M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF, UK
Charlotte Gayer-Anderson
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London SE5 8AF, UK
Craig Morgan
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London SE5 8AF, UK
*
Author for correspondence: Supriya Misra, E-mail: supriya@sfsu.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority.

Methods

We used data from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions Work Package 2, a population-based case−control study of incident psychotic disorders in 17 catchment sites across six countries. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between perceived discrimination and psychosis using mixed-effects logistic regression models. We used stratified and mediation analyses to explore differences for minority ethnic groups.

Results

Reporting any perceived experience of major discrimination (e.g. unfair treatment by police, not getting hired) was higher in cases than controls (41.8% v. 34.2%). Pervasive experiences of discrimination (≥3 types) were also higher in cases than controls (11.3% v. 5.5%). In fully adjusted models, the odds of psychosis were 1.20 (95% CI 0.91–1.59) for any discrimination and 1.79 (95% CI 1.19–1.59) for pervasive discrimination compared with no discrimination. In stratified analyses, the magnitude of association for pervasive experiences of discrimination appeared stronger for minority ethnic groups (OR = 1.73, 95% CI 1.12–2.68) than the ethnic majority (OR = 1.42, 95% CI 0.65–3.10). In exploratory mediation analysis, pervasive discrimination minimally explained excess risk among minority ethnic groups (5.1%).

Conclusions

Pervasive experiences of discrimination are associated with slightly increased odds of psychotic disorders and may minimally help explain excess risk for minority ethnic groups.

Keywords

Case−controldiscriminationfirst-episodeminority ethnic groupmulti-countrypsychosispsychotic disorder
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 15 , November 2022 , pp. 3668 - 3676
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bentall, R. P., De Sousa, P., Varese, F., Wickham, S., Sitko, K., Haarmans, M., … Read, J. (2014). From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology, 49(7), 1011–1022.10.1007/s00127-014-0914-0CrossRefGoogle ScholarPubMed
Berger, M., & Sarnyai, Z. (2015). “More than skin deep”: Stress neurobiology and mental health consequences of racial discrimination. Stress (Amsterdam, Netherlands), 18(1), 1–10.10.3109/10253890.2014.989204CrossRefGoogle ScholarPubMed
Bhopal, R. (1997). Is research into ethnicity and health racist, unsound, or important science? BMJ, 314, 1751–1756.10.1136/bmj.314.7096.1751CrossRefGoogle ScholarPubMed
Collip, D, Myin-Germeys, I, & Van Os, J. (2008). Does the concept of “sensitization” provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophrenia Bulletin, 34(2), 220–225.CrossRefGoogle ScholarPubMed
de Freitas, D. F., Fernandes-Jesus, M., Ferreira, P. D., Coimbra, S., Teixeira, P. M., de Moura, A., & Fontaine, A. M. (2018). Psychological correlates of perceived ethnic discrimination in Europe: A meta-analysis. Psychology of Violence, 8(6), 712–725.10.1037/vio0000215CrossRefGoogle Scholar
Dohrenwend, B. P. (2006). Inventorying stressful life events as risk factors for psychopathology: Toward resolution of the problem of intracategory variability. Psychological Bulletin, 132(3), 477–495.10.1037/0033-2909.132.3.477CrossRefGoogle ScholarPubMed
Dykxhoorn, J., & Kirkbride, J. B. (2018). Psychoses sans frontieres: Towards an interdisciplinary understanding of psychosis risk amongst migrants and their descendants. Epidemiology and Psychiatric Sciences, 28, 146–152.10.1017/S2045796018000501CrossRefGoogle ScholarPubMed
Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rössler, A., Schultze-Lutter, F., … & Yung, A. (2013). The psychosis high-risk state: A comprehensive state-of-the-art review. JAMA Psychiatry, 70(1), 107–120.10.1001/jamapsychiatry.2013.269CrossRefGoogle Scholar
Gayer-Anderson, C., Jongsma, H. E., Di Forti, M., Quattrone, D., Velthorst, E., de Haan, L., … & Morgan, C. (2020). The EUropean network of national schizophrenia networks studying gene–environment interactions (EU-GEI): Incidence and first-episode case–control programme. Social Psychiatry and Psychiatric Epidemiology, 55(5), 645–657.10.1007/s00127-020-01831-xCrossRefGoogle ScholarPubMed
Gilvarry, C. M., Walsh, E., Samele, C., Hutchinson, G., Mallett, R., Rabe-Hesketh, S., … & Murray, R. M. (1999). Life events, ethnicity and perceptions of discrimination in patients with severe mental illness. Social Psychiatry and Psychiatric Epidemiology, 34(11), 600–608.10.1007/s001270050181CrossRefGoogle ScholarPubMed
Halvorsrud, K., Nazroo, J., Otis, M., Hajdukova, E. B., & Bhui, K. (2018). Ethnic inequalities and pathways to care in psychosis in England: A systematic review and meta-analysis. BMC Medicine, 16, 223.10.1186/s12916-018-1201-9CrossRefGoogle Scholar
Howes, O. D., & Murray, R. M. (2014). Schizophrenia: An integrated sociodevelopmental-cognitive model. The Lancet, 383, 1677–1687.10.1016/S0140-6736(13)62036-XCrossRefGoogle ScholarPubMed
Jongsma, H. E., Gayer-Anderson, C., Lasalvia, A., Quattrone, D., Mulè, A., Szöke, A., … Kirkbride, J. B. (2018). Treated incidence of psychotic disorders in the multinational EU-GEI study. JAMA Psychiatry, 75(1), 36–46.10.1001/jamapsychiatry.2017.3554CrossRefGoogle ScholarPubMed
Jongsma, H. E., Gayer-Anderson, C., Tarricone, I., Velthorst, E., van der Ven, E., Quattrone, D., … Lasalvia, A. (2020). Social disadvantage, linguistic distance, ethnic minority status and first-episode psychosis: Results from the EU-GEI case–control study. Psychological Medicine, 1–13.Google ScholarPubMed
Kessler, R., Mickelson, K., & Williams, D. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40(3), 208–230.10.2307/2676349CrossRefGoogle ScholarPubMed
Krieger, N. (2014). Discrimination and health inequities. International Journal of Health Services, 44(4), 643–710.10.2190/HS.44.4.bCrossRefGoogle ScholarPubMed
Leaune, E., Dealberto, M. J., Luck, D., Grot, S., Zeroug-Vial, H., Poulet, E., & Brunelin, J. (2019). Ethnic minority position and migrant status as risk factors for psychotic symptoms in the general population: A meta-analysis. Psychological Medicine, 49(4), 545–558.10.1017/S0033291718002271CrossRefGoogle ScholarPubMed
Lewis, T., Cogburn, C., & Williams, D. R. (2015). Self-reported experiences of discrimination and health: Scientific advances, ongoing controversies, and emerging issues. Annual Review of Clinical Psychology, 11, 407–440.10.1146/annurev-clinpsy-032814-112728CrossRefGoogle ScholarPubMed
McGrath, J., Saha, S., Welham, J., El Saadi, O., MacCauley, C., & Chant, D. (2004). A systematic review of the incidence of schizophrenia: The distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Medicine, 2(13), 1–22.10.1186/1741-7015-2-13CrossRefGoogle ScholarPubMed
Misiak, B., Krefft, M., Bielawski, T., Moustafa, A. A., Sąsiadek, M. M., & Frydecka, D. (2017). Toward a unified theory of childhood trauma and psychosis: A comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neuroscience and Biobehavioral Reviews, 75, 393–406.10.1016/j.neubiorev.2017.02.015CrossRefGoogle Scholar
Morgan, C., Charalambides, M., Hutchinson, G., & Murray, R. M. (2010). Migration, ethnicity, and psychosis: Toward a sociodevelopmental model. Schizophrenia Bulletin, 36(4), 655–664.10.1093/schbul/sbq051CrossRefGoogle Scholar
Morgan, C., Reininghaus, U., Fearon, P., Hutchinson, G., Morgan, K., Dazzan, P., … & Craig, T. (2014). Modelling the interplay between childhood and adult adversity in pathways to psychosis: Initial evidence from the AESOP study. Psychological Medicine, 44(2), 407–419.10.1017/S0033291713000767CrossRefGoogle ScholarPubMed
Morgan, C., & Gayer-Anderson, C. (2016). Childhood adversities and psychosis: Evidence, challenges, implications. World Psychiatry, 15(2), 93–102.10.1002/wps.20330CrossRefGoogle ScholarPubMed
Morgan, C., Knowles, G., & Hutchinson, G. (2019). Migration, ethnicity and psychoses: Evidence, models and future directions. World Psychiatry, 18(3), 247–258.10.1002/wps.20655CrossRefGoogle ScholarPubMed
Murray, R. M., Bhavsar, V., Tripoli, G., & Howes, O. (2017). 30 Years on: How the neurodevelopmental hypothesis of schizophrenia morphed into the developmental risk factor model of psychosis. Schizophrenia Bulletin, 43(6), 1190–1196.10.1093/schbul/sbx121CrossRefGoogle ScholarPubMed
Nazroo, J. Y. (2003). The structuring of ethnic inequalities in health: Economic position, racial discrimination, and racism. American Journal of Public Health, 93(2), 277–284.10.2105/AJPH.93.2.277CrossRefGoogle ScholarPubMed
Oh, H., Cogburn, C. D., Anglin, D., Lukens, E., & DeVylder, J. (2016). Major discriminatory events and risk for psychotic experiences among Black Americans. American Journal of Orthopsychiatry, 86(3), 277–285.10.1037/ort0000158CrossRefGoogle ScholarPubMed
Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., … & Gee, G. (2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS One, 10(9), 1–48.10.1371/journal.pone.0138511CrossRefGoogle Scholar
Pearce, J., Rafiq, S., Simpson, J., & Varese, F. (2019). Perceived discrimination and psychosis: A systematic review of the literature. Social Psychiatry and Psychiatric Epidemiology, 54(9), 1023–1044.10.1007/s00127-019-01729-3CrossRefGoogle ScholarPubMed
Schmitt, M. T., Branscombe, N. R., Postmes, T., & Garcia, A. (2014). The consequences of perceived discrimination for psychological well-being: A meta-analytic review. Psychological Bulletin, 140(4), 921–948.10.1037/a0035754CrossRefGoogle ScholarPubMed
Selten, J. P., van der Ven, E., & Termorshuizen, F. (2020). Migration and psychosis: A meta-analysis of incidence studies. Psychological Medicine, 50(2), 303–313.10.1017/S0033291719000035CrossRefGoogle ScholarPubMed
StataCorp (2017). Stata statistical software: Release 15. College Station, TX: StataCorp LLC.Google Scholar
Stilo, S. A., Gayer-Anderson, C., Beards, S., Hubbard, K., Onyejiaka, A., Keraite, A., … & Morgan, C. (2017). Further evidence of a cumulative effect of social disadvantage on risk of psychosis. Psychological Medicine, 47(5), 913–924.10.1017/S0033291716002993CrossRefGoogle ScholarPubMed
Taylor, T. R., Kamarck, T. W., & Shiffman, S. (2004). Validation of the Detroit area study discrimination scale in a community sample of older African American adults: The Pittsburgh healthy heart project. International Journal of Behavioral Medicine, 11(2), 88–94.10.1207/s15327558ijbm1102_4CrossRefGoogle Scholar
Termorshuizen, F., van der Ven, E., Tarricone, I., Jongsma, H. E., Gayer-Anderson, C., Lasalvia, A., … & Selten, J. P. (2020). The incidence of psychotic disorders among migrants and minority ethnic groups in Europe: Findings from the multinational EU-GEI study. Psychological Medicine, 1–10.Google ScholarPubMed
Valeri, L., & VanderWeele, T. J. (2014). Mediation analysis allowing for exposure-mediator interactions and causal interpretation: Theoretical assumptions and implementation with SAS and SPSS macros. Psychological Methods, 18(2), 137–150.CrossRefGoogle Scholar
VanderWeele, T. J., & Vansteelandt, S. (2010). Odds ratios for mediation analysis for a dichotomous outcome. American Journal of Epidemiology, 172(12), 1339–1348.10.1093/aje/kwq332CrossRefGoogle ScholarPubMed
Van Winkel, R., (2013). Childhood trauma as a cause of psychosis: Linking genes, psychology, and biology. Canadian Journal of Psychiatry, 58(1), 44–51.CrossRefGoogle ScholarPubMed
Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., … & Bentall, R. P. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin, 38(4), 661–671.10.1093/schbul/sbs050CrossRefGoogle ScholarPubMed
Veling, W., Hoek, H. W., & Mackenbach, J. P. (2008). Perceived discrimination and the risk of schizophrenia in ethnic minorities. Social Psychiatry and Psychiatric Epidemiology, 43(12), 953–959.10.1007/s00127-008-0381-6CrossRefGoogle ScholarPubMed
Williams, J., Bucci, S., Berry, K., & Varese, F. (2018). Psychological mediators of the association between childhood adversities and psychosis: A systematic review. Clinical Psychology Review, 65, 175–196.10.1016/j.cpr.2018.05.009CrossRefGoogle ScholarPubMed
Williams, D. R., Lawrence, J. A., & Davis, B. A. (2019). Racism and health: Evidence and needed research. Annual Review of Public Health, 40(1), 1–21.10.1146/annurev-publhealth-040218-043750CrossRefGoogle ScholarPubMed
Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47.10.1007/s10865-008-9185-0CrossRefGoogle ScholarPubMed
Williams, D. R., Yu, Y, & Jackson, J. S. (1997). Racial differences in physical and mental health: Socio-economic status, stress and discrimination. Journal of Health Psychology, 2(3), 335–351.10.1177/135910539700200305CrossRefGoogle ScholarPubMed
Supplementary material: File

Misra et al. supplementary material

Misra et al. supplementary material

Download Misra et al. supplementary material(File)
File 82.4 KB