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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*
Affiliation:
Department of Public Health, San Francisco State University, San Francisco, CA94132, USA
Bizu Gelaye
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
David R. Williams
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
Karestan C. Koenen
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
Christina P.C. Borba
Affiliation:
Department of Psychiatry, Boston Medical Center; Boston University School of Medicine, Boston, MA02118, USA
Diego Quattrone
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AE, UK
Marta Di Forti
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AE, UK
Giada Tripoli
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
Caterina La Cascia
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
Daniele La Barbera
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
Laura Ferraro
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
Ilaria Tarricone
Affiliation:
Department of Medical and Surgical Science, Bologna Transcultural Psychosomatic Team, (BoTPT), Alma Mater Studiorum Università di Bologna, 40126Bologna, Italy
Domenico Berardi
Affiliation:
Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater, Studiorum Università di Bologna, 40126Bologna, Italy
Antonio Lasalvia
Affiliation:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134Verona, Italy
Sarah Tosato
Affiliation:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134Verona, Italy
Andrei Szöke
Affiliation:
INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, 94010Créteil, France
Pierre-Michel Llorca
Affiliation:
University Clermont Auvergne, CMPB CHU Clermont-Ferrand, EA7280, 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, 28007Madrid, Spain
Andrea Tortelli
Affiliation:
Etablissement Public de Santé Maison Blanche, 75020Paris, France
Lieuwe de Haan
Affiliation:
Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic, Medical Centre, University of Amsterdam, 1105AZAmsterdam, The Netherlands
Eva Velthorst
Affiliation:
Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic, Medical Centre, University of Amsterdam, 1105AZAmsterdam, 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, 33006Oviedo, Spain
Miguel Bernardo
Affiliation:
Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, 08036Barcelona, Spain
Julio Sanjuán
Affiliation:
Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de, Investigación Biomédica en Red de Salud Mental (CIBERSAM), 46010Valencia, Spain
Jose Luis Santos
Affiliation:
Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,”, 16002Cuenca, 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, 15706Santiago 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 Paulo14049-900, Brazil
Paulo Rossi Menezes
Affiliation:
Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo01246-903, Brazil
Jean-Paul Selten
Affiliation:
Rivierduinen Institute for Mental Health Care, 2333 ZZLeiden, The Netherlands
Peter B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, CambridgeCB2 0SZ, UK
Hannah E. Jongsma
Affiliation:
Psylife Group, Division of Psychiatry, University College London, LondonW1T 7NF, UK
James B. Kirkbride
Affiliation:
Psylife Group, Division of Psychiatry, University College London, LondonW1T 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, 6200MDMaastricht, 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, 6200MDMaastricht, The Netherlands Department of Psychosis Studies, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
Robin M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
Charlotte Gayer-Anderson
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
Craig Morgan
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
*
Author for correspondence: Supriya Misra, E-mail: supriya@sfsu.edu

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.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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